AF - 44005�
U
Gity of Fridley, Minn.
BUII�DING PERMIT N° 3 fi 9'7
Date: . . . . :'� . . . . � . s . � . (�. . . . . . . . . . . .
Owner ....................................... BuiIder .�.................. ��s��/w!r!�!......
Address...................................... Address .............................................
LC)CATIO�N OF BUILDING
No. .(O V..�� Street ...t�!.���J'�4Sr /S..l�rt/:�,�. Part of Lot ......... ............
Lot . . . . .� . . . . Block . . � . . . . . . . . . . . . . Addition or Sub-Division . . . . . . . . . "���i!�f�C; . . �� ��
.. . Setback .��. . .. r Sideyard . / .. . .
� y
Corner Lot ............ Inside I.ot ......... '� :0 .................
DESCRIPTION OF BUILD[NG
To Used
. . . . . . . . . I'' 1'Orit �� � � �2�1 ��� �� Height / ! . O �� .SQ. �. /oo S�! . �1. '�. / /. ��� /� �—•
�• . . . . Front /.�: � Depth �� .� Height / .� � Sq. F't. a�p, G�. F't. � p� 1 .�
Type of Cons ction . . . . . . . . . . . . . . . . . . . �t. Cost. .�� j � R .,1. � : . To be Completed . . . . . . . . . . . . . . . . . . .
In consideration of t'he issuance to me of a permit to construct the building desribed above, I agree to do
the proposed work in accordance with the descrlption above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
i� .................................................
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In consideration of the payment of a fee oP $.��......, permit is hereby granted to ...................
......................... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is gi�anted and his agents, employees and worlunen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota: regarding location, construction, alteration, maintenance, repair and moving of buildings wfth-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of ssid
ordinances.
���.a ia.�
NOTICE:
This permit does not cover the construction, installation or�Jteration fo� wi�in�, pl , gas heating,
sewer or water. Be aure to aee the Buildlnp Inspector for �eparate permits for th ma
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City of Fridley, Minn.
BUILDING PERMIT
Date: _.._..F �TOBER 28� 1965 __�_�
� / � 7!!
N'° 8571
Owner, J M. CONSTRUCTIOft COMPA1�lY gu�der RICHARD MILLER HOMES
. •
Address ....._$�56.Monroe St. N. E. 8256 Monroe..�t.��.E �._
_.._...___._..__._...__._._ Address _.._.._.���.....____.___._
Minneapol,is 32, Minnesota Minneap�lis 32, Minnesota
LOCATION OF BUILDING
6850 Brookview Drive .- .-• --.---_.... Part of Lot ...__._.__....___..__..._—__._.
No. .._._.._._..._._.__.._. Street ._._....__.__._.._.�_...__..____�__...��.....___. _. _.
Lot _..._....__.� _....._...._ Block -_----_.._?.__.._..._._.._. Addition or Sub-Division ..--.---BrOakview_ Terrace,. Plat 2
Corner Lot _.____.._.._._.._ Inside Lot ___.._?�._.._._----_. Setback .__..__.__._.._...__.__ Sideyard _._._---..__.._..._ ._.._._....r._
Sewer Elevatiam
Founda.tion IIevation
DESCRIPTION OF BUILDING
To be Used as:
� DWLLLING ._ _.._ Fro�t _. 42 .�. DePth ....24._..._. Height .__x 8__.._.. Sq. F� �� 008 �� 18,1�+
GARAE�E I3� 22 ],0 297 2 970
_ Front De th . Height Sq. F't. Cu. FL _._ �
_._._.._.._----- ....—._._.�..__. _._..__..__ p _..._.__... __ ....._..._..._._ _.___._...._..
Z'ype of construction _.._.._. Frame__._..�.._.____ Es� Cost __�16.2000._00..---...... To be Completed ....:__.____.:.._.
REBUILD DIIE TO STORM DAMAGE
In consideration oP the issuance to me of a permit to construct the building described abave, I agne to do
th� proposed work in accordance with the d�scription abov t forth and in compliance with all provisions of
ordinancea o! the dty of F'ridley. � A�
_. __ .
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In comsideration o! the payment of a fee o! � 21. 00 ._..._.._.., permit ie hereby granted to._._..RICHARD MILLER
HOMES to comstruct the building or addition as described above. Thispe rmit ia grarited tipo�
the express condition that thepe rson to whom it is granted and his agents� employees and workmen, in all work
done in, around and upon said building, or anypart thereof, ahall conPorm in all reapects to the ordinances o2
Fridley, Minneeota reg g location, c�struction, alteration, maintenauce, repair and movin8 0! buildings
within the dty limits and�this peraiit may be revoked at any time upau violation o! aay o� the provLrios'�s o� said
ordiaaaoes.
AT.T.FN G. JELQSEN 8�� �
NOTIC�:
iM� p�nnh dea net eewr � eon�rualloe► In�hIl�Nen h� vrlrM�� PhnnbinY� /as h�Nln�, NwK a wabr. N wn to �
1h� lnildino In�p�alo� for ap�rah p�nniM h� fh�n iqna. � ,�„ ,.
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APPLICATION FOR $UILDING PER1�tT
CITY DF FRIDLEY, MINNESOTA
_� T � J/
t I % j' �'i J / �� .ii1�'� 1 1� 1 i'
DWATER S ATTAME �., � � , . . � �(y ; _ _ BUILDER f � �- � _� :� : � : � '�'�`.�.,�
ADDRESS ;� --7 G'j E: '%''�i�c-y�.�''1��.. �� e9DDItES3 �a !�S �- � i - �t��� �.-c� -f1`I
LOCATION OF BUILDING
� �_ `( _� {, , - � �7 ( '
�..�� E' � , „ Street �'�� ;.'- � - � �-- Part of Lot �_' �.
....._._......
L� _ %��I�QCK -�;Z..- ,ADDITION OR SUBDIVISIOIIF.���'�•-.� �"�
,_..... '' �- �.
a �
Corner Lot�_Inside LOT ��Setback 3ide-�Yard
SSWER ELEVAT2oN F11iTNDATION ET,EVATi0I11 �, w„ _„�._
Applicant �ttach to this form Two Certificates of Survey of Lot 8nd propoeed
building location drawn on these Certificates,
DESCRIPTION OF BUILDING
To be used as: �
� ` �/
Front �-�DeP�� °Z ��Height�/.......,"�......_
� Sq. Ft. � G e� Ct�. Ft. / c�. /��
�:
'�-� Frcmt /� �� Depth � oZ-wgeight / �
,
Sq. Ft . ��_• Cu. Ft ._ � y�U
? e of Construction .,1 � >�
YP ,F..t� ..�th Es t ima t ed Cos C %�-. . C`-� ���
To be campleted ��� , � r
�The undersigned hereby makes application for a permft for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridleq Ordinances
an.d rulings of the Department of Suildings, and hereby declares that alI the facts
and representations stated in this application are true and correct.
�.-
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�. /) 9A. /,I�f.Y. f�r�•
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(Schedule of Fee Costs can be found on the Reverse Side).
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BUILDI� FERMIT F�B , SCHEDZA,E ,
SECTION 2. The Inspector of Buildings shall, before issuing any permit for the
erection of any building or structure, or foz any addition to any existing build-
ing or structure, or for aay alterations or repairs to any existiag building or
structure, upon applicativn therefore, require the.p�yment.by the applicant for
such permit of fees to the amount herein below set forth and in the.ma.naer herein_._
provided to-Grl.t;
2.1. For any such permit for tbe erection of any fire-•praof building,
other than a garage, warehouae, factory or grain elevator, or for the erection
of any fire�proof addition, for aimilar occupancy, to any existing building,
shall be aC the rate of $1.40 for each one thousand cubic feet, or fraction
thereof, ia such cubical contents.
2.2. For any auch permit for Che erection of any fire-praof garage,
Warehouse, factory or grain elevator, or for the erection of anq fire-proof
addition, for similar occupancy, to any esisting building shall be �t Che rate
of $1.25 for each oue thousand cubic feet, classified as "fireproof" by
Sectiou 502 of the Minneapalis Buildin� Code.
HOUSES , . � . _ �.
2.3. For any such �ermit for the erection of any naa-fireproof building,
other than a garage, warehouse, faceory or grain elevato�, or any nan-fireproof
addition, for similar occupancy, to any existing building - permit $1.00 for esch
oae thousand cubic feet.
GARAGES
2� 4. For any such permiC for the erection of any non-fireproof garage,
warehouse, factory or grain elevator, or for the erecCion of any nrnn-fireproof
addition, £or similar occupancy, to any existing building or for each such
buiZding or addition - ninety cents ($0.90) far each one thousand cubic feet
or fraction thereof, in the cubical contents thereof with the minimum of $4.00.
For the purpose of eomputing fees for building permits, th� cubical contents
of any building or additioa to a uniform height throughout by multiplying the
ground area covered from:a poicrt six (6) inches below the flaor line of the
basement or cellar to the average height of the upper surface or to the average
height of the raof su,rface of the maia gable of a pitched roof.
2.5. For repaire or alteratioria to an existing structura, the fee shall
be aC the rate of $3.00 per each Five Hundred Dollars ($500.00) ar fractfon
thereof in the ceat of all proposed work. •
2�6. In no case sha11 the fee charged for, any permit as set forth in
Section 2 be less than $4.00.
. �. ,�
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sus�ecr PE .
c�ty of Fridley _- 16 5 4 5
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r �
; � RECEIPT NO.
' COMMUNITY DEVELOPMENT DIV.
' � �.- - � /
r � � PROTECTIVE INSPECTION SEC. ��
� i
� � �"�1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE - PAGE OF APPROVED BV
� ----�.� `.�
612-571-3450 910-I�►15 4-27-82 � �
JOB ADDRESS 6850 Brook view Drive
LOT NO. BLOCK TRACT OR ADDITION
1 LEGAL SEE ATTACHED
DESCR. 7 2 Brookvi ew Terrace 2nd Addn— SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Philip & Debra Hanson 6850 Brookview Qrive 574^1048 B. 376-4 89
3 CONTRACTOR MAIL AODRESS ZIP PHONE LICENSE NO.
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDlNG
residential
7 CLASS OF WORK
❑ NEW C)( ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
23' x 26' addition
9 CHANGEQFUSEFROM TO
STIPULATIONS
` 1. Provide Products of combustion alarm
2. Provide outside combustian air to furnace or fireplace.
SEPERATE PERMITS R�EQUIRED FOR Yllt€if�i��
k�t4°�'�1G, PLU�6ING ANQ SIG��,,
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PIUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. Fja�jje ,'
THIS PERMIT BECOMES NULL AND VOID IF WORK OF 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 720 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 COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT ZO OOO. OO � O. OO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 1�(,)j��(j '� (�O. 5O
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. R�� Y�
PLAN CHECK FEE TOTAL FEE
35.1 185.63
S ATURE OF CO 'AACTOR OR AU OA�ZED AGENT IDATEI EN�Y VA I�S IS YOUR PERMIT �
.. z _ L� .z P ��
SiGNA7 RE OF OWNE UF OWNE BUi�DERi �DATE� BLDG irvSP �ATE
sus�ecr PERMI
City of Fridley 2 0 6 2 6
AT THE TOP Of THE TWINS g U I L D 1 N G P E R M I T
i • RECEIPT NO.
� . �
� • COMMUNITY OEVELOPMENT DIV.
� �y---�--
r � � PROTECTIVE INSPECTION SEC.
� � /'�'1 � CITY HALL FRIDLE� 55432 NUMBEF REV. DATE PAGE OF APPROVED BV
�"'°'�'� ��' 612-571-3450 9t0-F15 10/12/90 � �
JOB ADDRESS 6850 Brookview Drive N,E.
1 LEGAI LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. % 2 Brookview Terrace 2nd Addition SHEET
2 PROPERTY OWNER MAIL AODRESS ZIP PHONE
Phil Hanson 685Q B.rookview Drive N,ER 574^1048
3 CONTRACTOF7 MAIL AODRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO.
5 ENGtNEER MAIL AODRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residentia,l
7 CLASS OF WORK
O NEW � ADDITION ❑ ALTERATION � REPAIR � MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 24' x 15` Addition and a 22.4' � 1Q` Garage Addition7 a 15� x 5`
arage orage it�n
9 CHANGE OF USE FROM TO
STIPl1LATIONS
See notations on plan. �rovide a hard surface drivewa,Y.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTFICAL, PLUMBING, HEATING,
VENTI�ATING OR AIR CONDITIONING.
THIS PEFMIT BECOMES NULL AND VOID IF WOFiK OR CONSTRUCTION ZONING SO. 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 AEAD AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WIL� BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $211�SQ y51Q.98
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAI �AW REGUTATING CON- $22rJ.00.
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
Fire SC $21.95 $257.93
ATURE ON'iiACTOA AUTMOA�ZEDAGENT IDATEi WHEN PROPERIY VA ATED THIS IS VOUR PEFMIT
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iG AT EOF OWNEAi F N �LDERi �DATE� BIDG �NSP � �tiTE
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Construction Addre.ss:
Legal Descriprtion: �
Ownex Name & Addrz�s :
Contraetor: l J t�J ��
iT:. -
r�vnaG �,:
GAR�ICE AREA:
�y �+;�'.�;� � F
R-1 AND R-2
Buildit�g P+ermi.t Applicati�
Effective 8/16/90
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Attach to this applicatioaz, a Cextificate of SuYVey of the
lot, with the prc�osed oonstYUCtion drawn o� it to scale.
D�ESCRIPTI�T aF
r�tn z w�atn �� xe�gnt -, sq. r�. �Q — �;:3`�''�
L�ax�th . Width _/(� Height � Sq. Ft. ���
Lerigth Width iigt/Graur�d Sq. Ft.
O'1'F�R: � /
3ys�t �.�s � ��,v��� , �� �~ �,� �.� y �`��`� d° � � , � s
Gbrner Ir�t [] Inside IAt [v]� . Yd Setback Side Yard SetbacJcs
Zype of Construction: -�2 Fstimated C7ost: $ e� �� q�a
Approx. �letion Date:
Proposed Driv�way Width If New Is Desired: Ft. $ $
Width + 6' See Bacac ge
DATE: g APPLICAI�'t': Tel. # D
CITY IISE �L,Y �O�r s��8
P�exmit Fee $ �. c�+;�, ��
Fire Surcharge $ �, � �'� ��
state surrhan�e S ! 0 ��-1$
SAC Charge $
Driveway Escraw $
Park Fee $
sewer 1�1ain Charge $
rnom� S o �,
Fee Schedtite on Revezr.�e Side
.00l x Permit valuation (1/loth $)
S.SO/Sl,000 valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Abave
Fee Det.exmiried bY F..r�git�eerir�g
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CITY OF FRIDLEY
APPLICATION FOR PWMBlNG AND GAS FITTING PEFMIT
A a m c w � .; � d water
s N N � 4 c•� N q ✓ 0. 6. c Heater
ii ✓ .Mr N f-� �x.a �0 M YI E�0 f+ O, �p
4 I�A C K ,qa� C� ip MQ U.�+ p C� < • C ►�
O � •M � ul C YI M O .0 " N �n Y u� N M M L
vr u � � � a 7i o �. �n w u n� i s � i� ti o s le
lst
2nd
3td
4�►,
(R) � EUtur� Corn�ction Openinq Coru►ected with Sower
(•) � Nw Fixwr�, Old Op�oinq Mater
RATE SCHEDULE
PLUMBING FIXTURE RATGS: N0.
New Pixtures ]
Old Opening, New Fixture �
eeer Dispenaer
81ow Oft Basin �
Catch Basin
Aain Water Leader
Su�ap/peceivinq Tank
Water Trealing Appliance
Mater Heater - Electric
Mater Heatar - Gas
Gas Range
Gas Dry�r
Hack Flow Preventer Required () Yes
Type
1RATC TO'fAL
s �.00 = s %�%�'
S �.00�S
$ 5.00 • S
S 7.00 � $
S 7.0� � S
S 7.00 = $
s %.Q� a s
S 1� . �� a S
S 7.00 � $
S 10.U� ° S
S 10.00 a $
S 10.0� a �/
( � NO
S 5.00 = $
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
lt oi Valu• of Fixture or Ap.pliance
State Surcharge
�2EINSPECTION FEE 530.00
TOTAL FEG
S
5 . 50
s�S C)
t:ffectivc U�[c January 1, 1991
Job Addre:;s __ ���� I�,j/�-GL-�«l� ��� p�/�
Building Inspection Div. 6431 University Ave NE
Tel. No. 572-3604 Fridley MN 55132
Tt�e undersigned her�by makes application for a permit for Lhe work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the De��artment of Buildinqs, and hereby declares that all
the facts and representations stated in this a�plicatio� e 6 ttve and correct.
�� / r , i9,�L
�►►JEa [� � c. t`'l� �1 S� �l
KIND OF HUILDING
USED AS
TO BE COMPLETED 11BOUT ���/Ll�� J f
ESTItMTED COST � 7, ��v
/ oLgi- NEW BUILDING PERMIT NO. PERM2T NO. 6(J (G'L �
�, _���
Company
Siqned B�
Tel. No. � �
��� ' S� / 3 `d�
itOI�GH It7SP.
Date
� '�-,� � �' "�--�
FItinL I275P.
Gatc � I��
APFkOVAL F'Ok DEk.MIT ,���
MINIMUM FGE FOR AivY PLU�15I'iG/GAS PERMIT IS S15.Q0
PLUS THE $.50 STATE SUP.CHARGE
CITY OF FRlDL�Y INSPECTlON DIV,
6431 University Ave NE
Fridfey, MN 55432
572 —3604
�• t •
APPLICAi'ION FOR POWER PLANTS AND HEATING, COOLING, VENTILATIOlJ,
REFRIGERATlON AND AIR CONDITIONlNG SYSiEMS ANp DEVICES
Residential
Fumace Sheil and Duct Work, Burner —
Aiso Rep{acement Furnace
Gas Piping (Needed with new furnacej
Gas Range
Gas Dryer
*Air Conditioning — Afl Sizes
AllOthers/Repalrs & Afteratlons (LIST ON BACt�
1%a of Value of Appliance or Work
CommercialJlndustflal
1°/, of Vaiue of Appliance or Work
Rate T07AL
$ 2U.00 $ ZO � GG�
$ 10,00 $
� 10.00 $
$ 10.00 $
� � o,00 $ /0 � o O
$
�
State Surcharge
TOTAL FEE
��50
��
MINIMUM FEE FOR ANY HEAT7NG/COOLlN�ENTII.ATION
REFRtGERATiON/A!R CONDITtONING PERMIT iS 15.00
PLUS THE 5.50 STATE SURCHARGE
REINSPECTI�N FEE $30.00
Effective On January 1, 1993
•' •��' � • Z� �Lf►Z�/L��.! � '
The undersigned hereby makes application for a permit tor the work herein
spec�ed agreeing to do aii v�.�ork.in strict accordance with the City Codes and
rulings of the Building Division, and hereby declares that all the facts and
representations sfated in this application are true and correc .
�� a jC � ,199�
ii� � -- »t
OWN
BUILDING USED AS
ESTIMATED COST ���� � • � PERMIT NO. �� �����
pESCRIPTION OF FURNAC� AND OR BURNER
No, of Heating nits i Circle Or�e {Steam) {Hot ater) a m A'
Trade Name �' Y � E� Sfze No. � v�—
BTU , �� HP EDR
Fuel 1"otai Connected Load
Burner Trade Name Size No.
BTU HP EDR
HEATI NG
DE�'ENDABLE lNO�OR l�ER -�tJfiLITY. INC.
Approved � augh—in Date Final Date
*Air Conditioners can not be piaced in a side yard without
written permission from adJoining property owner. FILL OUT BACK SIDE FOR STACK VERfFiCATION ON
REPLACEMENTFURNACE
Y�
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes (� No ()
2. Is free from rust or deterioration Yes �) No ( j
3. Has no foreign objects lodged within Yes � No ()
4. Is securely supported Yes ,�) No ()
5. Meets all current Code requirements for
size and total BTU's connected Yes (�y No ()
6. Has total heating BTU' s of $d� �� �
All other BTU' s � ` � �'�
TOTAL BTLT' s J 7� •�� '
Remarks
List Alterations Beinc7 Done:
e
'�,. . _ . .
� 2619 COqI�! ;:11F'i�;�? ;;?:iU'..��"�f;\E�Ci ,i
HEATING COMPAN:
Signed By
Date
Nov¢mben 8, 1994
Td U1HOM IT MAY CuNCERN:
!,U¢. gJi..ve awc pe�una.b�i..an. xa Ph�i.e, ccncl Debna ficcn�san., 6& 50 f3n.oah.v-i.ew i)n,+..ve,
�n.i,d2.¢.y, Mn.. , �a .P..acu.te #h¢.vc c¢r�t�ca.2 c�,i.n. uni� an. #he �ou.th �.i.,d¢. a.� #hQ.i�c
home..
Y ;�
/
� . . : �-r , _ -, .. , � ,� : -_; _
Pau.2 an.d Jea►t Ukcg¢nvc
6840 f3�c,oah.v-i..¢,w i)n.i.ve `r
��t.i.d.Q.¢.y , Mn..
.. � . � .� Su9�EGi � . � - .
c�cy of Fridley 2 924 3
AT THE TOP Of TME TWINS g �� L D i N G P E R M I T
r
� .
� �
� •
COMMUNITY DEVELOPMENT DIV.
f � � �� PROTECTIVE INSPECTION SEC. �//�
� �
� � �'��1 � CITY HALL FRIDLE� SS�.jZ NUMBEt1 pEV OATE PAGE OF APPROVEO BY
�'""�"� �'� 612-571-3450 9t0-F15 4/19/99 � �
J08 AODRESS
6850 Brookview Drive NE
t IEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACHEO
oescR. �. 2 Brookview Terrace 2nd Addition SNEET
2 PROPEHTY OWNEii MAI� A,DORESS 2�P PMONE
Phil Hanson 6850 Brookview Drive NE 574-1048
3 CONTRACTOR MAIL ADORESS Z�P PMONE LICENSE NO
Williams Famil Roofin 3720 Balsam Lane, Plymouth, MN 55441 577-9093
4 ARCHITECT OR OESIGNER MAIL AOORESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII ADDRESS Z�P PHONE LICENSE NO
6 USE OF BUIIDING
Residential
7 CIASS OP WOFK
O NEW O ADDITION O ALTERATION �7 REPAIR O MOVE O REMOVE
8 OESCRIBE WORK
Reroof House & Garage (35 Sq) Tear-off
9 CNANGEOFUSEFROM TO
STIPU�ATIONS
Underlayment must comply with the State Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
TVPEOFCONST. OCCUPANCYGROUP OCCUPANCV�OAO
SEPARATE PERMITS ARE fiEOUIRED FOF ELECTRICAL. PIUMBING, HEATING.
VENTILATING OR AtR CONDITIONING
THIS PERMIT BECOMES NULI AND VOIO IF WORK OR CONSTRUCTION 20NING SO. fT CU fT.
AUTHOR12ED IS NOT COMMENCED WITMIN fi0 DAYS, Ofi If CONS7RUCTION
OR WORK IS SUSPENOEO OR ABANDONED FOR A PER100 OF 120 pAVS AT
ANY TIME AFTER WOFK IS COMMENCED NO DWLG. UN17S OfFSTREET PARKING
1 MEREBY CERTIFV THAT I MAVE AEAD AND EXAMIN�O THIS APP�ICA710N 1 STALIS GApAGES
ANO KNOW THE SAME TO BE TAUE AND CORRECT. ALl PROVISIONS Of LAWS VAlUAT10N SURTAX
AND ORDINANCES GOVERNING 7HIS TVPE OF WORK WILL 8E COMPUED I.SO
WITH WMETHER SPEGFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT �2,999 � $
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL THE pEqM1T fEE SAC CH GE
PROVISIONS OF ANY OTHER STATE OR LOGAL �AW REGULATING CON- $74 � 7,r FlY C�3.00
STRUCTION OR THE PERfORMANCE OF CONSTRUCTION
%'� P1,AN CHECK F E TO FEE
` ' �°'"g`i s SC 0 $84.25
S�GN4TU�7E 0� N'PA(;TOQOA �UT�OpIjEO oGENT �O�iE� yyM P V D THIS I R P i
� �
S�GN4TUAE O� OWNEA��� OwNEA Bu��DERi IOATE� �OG �NS� ' f1��E
Effective 1/1/99
NEW [ l
ADDN [ ] CITY OF FRIDLEY
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION ��
aa� �,�
��
ConstructionAddress: • Ce � S d �+�`�",`�� •� D�•v �
Legal Description:
Tel. # 5��� ' �O �y
Owner Name & Address: ��� �-- �`� ^'S`'Y`� ,
Contractor: trv�L� �� S�'►� � L Y�a� "��
MN LICENSE #
Ls+-�L` Tel .# �a-� - G3 0`3 3
Address: 3 a-.L � ��l't-S✓-F�'''� -
' Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: I-enSth Width Height Sq. Ft. _ .
GARAGE AREA: Length W idth Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft. _______
OTHER: �� �%�' ,A�� �� �'°'�' l� �-�' + 4.�.-�- � �
3 ��
Construction Type: ��� ��-
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Estimated Cost: $ � � � � ��
(Fee Schedule on Back)
Ft x $ _ �
�� Tel. # �i � -- G S4 �
DATE:'� / g -- � � _ APPLICAN'�: /�� `
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ /����;
$ Li �
$ lS0
$
$ s. ��
$
$
$
$
$ ���
CITY USE ONLY
Fee Schedule on Reverse Side
.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 [ ]
.���