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tand Ylanni�ng �J"/,rr/'!,/ � . 687i H,qbway No.65N.E.
11YIM1��utvtying • . • � Minneoprolis�
ss�i. 1.a�„g �//!!////'/'If/l�� •�/II'. M�„r. ssos�
Civi� 6apmlennq . , . . iriephonr 78��6086
Mwvicipol Engrnrene�q F.n�ineE�rs fit SIITVI'}'OI'K 4.ru Code 617
�
Certificate of Survey for �� 1��A��.� ��t �LC-,i� �'���� 5
CAMELpT LANE N.E.
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liil►�H6 ot,r,c�s �,
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;���� (� BR 1HF��npN PURPOSES ONLY AND
PERSO�'7S V��' R SNOUID VERIFY iHE INFO�iION
ppi TNE SRE
Sc.4it Y�-^• �{}Llat
—IMPO_ R_- "
NOTIFY THE FRIDLEY ENGR.
pIVISION REGARDING CUR$
� p ODRIVEWAY OP NINGSN�
l��T >o�BI�OCK 2�
_H�_ l.ax� Esta�s
� ��� ..� � QnaKO iOuAfu
I�h�teby crrlify lhar �heai. u �iue ond �o��tr<1 rrp+w>.•nlo��on ol o turvey pf fhe bpundun�r of 1M obov
d��<�ibed lond, and of 1he lo<u��o.� o� nll bu�ld�nyry rh.��eo�, und ull vis�6lr enu�ouehmenrf� il aay� Ir�m w oa
foid lond. As xurveyed by rar 1h�c,_...._�jur o{ f. ." . 4 D�V_1,. .
o pENGr;.s it�n MJNUMENT
------ D"e1V�TE5 �fl�uh6Qu� �. UTiU;' E�StVI"rUT
SU6URBAN EN6INEERING, INC.
Fny�noert . Su�reyOrl
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PEfiMIT NO. -
�rEdl£'� _ � , � �-_ O �3�i3�i
BU1�E��� P�R1d�IT- . .
s�ECf�ar wo.
n�r o�ve�oPr,�x cw. ���i�� -
Et� lt2$PECflQF} �. .
LL�� PRI[�LE�'�.��'��` , NUMBER .. R[p. -�: � -4kT� .PAGf. OF . APPR�VE09Y . . -
S� , `� 910-F15 � � 7��•�76 � "�� � �� � . . � .
t�4� 7i8IIB r�.$.
���? ' TApGT#tADW710N.� ' � SEEAttACHED �
'� '�e fi31^:1S �2 �'S�S�$$ �, � :.. SHEET � � �
�--. ', IAALL �� 6 �. . `- ..��Ip ..- � PHONE� � �
i37�,i` ��:. 1600 Rice C�eolc �oac� •eF.k:, Fridley
MA4A4'�F$5.' . . . .2W �� � . PHONE �:.- LICENSENO. �
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M±�t1���8b� . � - . . ZW PHONE �.- 4 �N� �
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h�RH.AQb�N�6� � ZIF � PH6NE�.��-��.l�EN5Eii6. �..
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NE�: � � t3 , k�DITtOM ��. ❑ ALTERAT14� ��"{� `�fEPIK7R � :d-: � MOVE "� � ❑ REMAYE �
:t $`+4a" .� �' n�reusng and a ao ` a�:2�; casaye �%1���
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[� �. �,.stlxiSCa d�iveway. P�S3V�,ai���:'ifying..surveY bef�iYe
Provid�, �qd 3.n the front and s�- .
i68�I{tltz �t�sc. 9' De�) i02` �+}�€xD[asahole iinv. 879.OQ)
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< > � YliE FRfOLEY EMGFt.
`" � � "�l�f RE�13tNG ��i9 �
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Y _t� � �y�Z►ON5. , A7'DRIVEWAY QPFiVlNGS,
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. � ��� ¢._ _ ' NQ`�OWIG..IlN138 _s(fT F3iRE@Y PqRK1ARu . �
E REAQ AN#�. [�pPGipATADOF �� . - STAkLS � GARAGES � . .
t$Api3C¢RpE(�eT G�f�P���S?FF�1WS VMl#A .•` SUA7AX .. .
Ti#� .TYA,€ 4F W� E�t'YiN.t.$E i�MPL1ED � .
e+a wrrotst, i+r� �'a��a�ir $33�3 ,_ ,; � $7.6,54�
AU�NF#Ei17Y fQ y� Git�3CE1. TM�� PERMITFEF � .S GCHAfiGE,.:: �:� .
7f�iE 17R1f 604'(EL ; �F�Y4NG GON- . .
a� � 547.36 :,TS�S�:eo9
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APpLl �A1'ION I�OR RL'SIllliNTIAL, ALT'IiRATION,
OR AllDI1'ION ]iUILDING PL=RMIT
CITY OF FRIDLlY, b1INNLSOTA
OWNER`S NAME:�\claarz0 t`1����L BUILDER:��u♦r,ccn ("��L�� i�ovies
ADDRESS:I�+� fL��E Cer-�x 12 ADDRESS: Sq�F
NO:.I6�� STREET: -
LOT: ;�p BLOCK: Z ADDITION: �YyZO[� LAic�' �c�re�.
� id� r+o�.sc
CORNER LOT: 1JC� INSIDE LOT: �IES SETBACK: '_�S SID�YARD: S 6n��aoc
Applicant attach to this form ltao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
T9y$e Used As:
//���...�,�- Front • �a
Depth• �- 6 Hei�ht• ��
S uare Feet: ��� y� 20� $O d
4 Cubic Feet•
Front• 2G Depth•� � Aeight� / a
Square Feet; � d d Cubic Feet: �j g O D
Type of Construction: ��-_��� Estimated Cost: $��
To Be Completed: �(j li�'��? �._.--
The undersigned hereby makes applicatiDn for a permit for the work herein
specified, agreeing to do all work in strict accordance �aith the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereUy
declares that all the facts and representations stated in tfiis application
are�true and correct.
:-��tV 1 ��lb SIGNATUFE:�f� ����
(See Reverse Side For Additional Infomiation.)
� .d� 'XJ, .3 G
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y �' yis.9a
CjTJ/�Ltt/� 7itl�: S �
/ ��OIOd/QL cr7"f� cJ�Ta/ Cd�� �` '
� TitKSS �,pES•e� '
�� /�iQp /iGr' �Ai� Tii.E EXTiFRiO�
q�J J/od ��u� '�`�� . Acco�n�OMt
-S,�t�c�.w �Y."t 'G�++� .�.._. _�
BUILDIfVG PLRMI'I' FE� SCI1EllULE
SECTION 2. The Inspector of Buildings shall, before issuing pesmits for the
erection of any building or structure, ox for any addition to any existing
building or structure, 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 £ees to the amount herein below,set forth and in
the manner herein prwided to-wit:
UNIFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3& 5-$1.85 for
each one thousand cubic feet.
ADDITIONAL ItiFORb1ATI0N
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point six (6) inches below the floor line of the basement
ox the celiar to the average heights of the upper surface or to the average:-
height of the xoof surface of the main gable of a pitched roof.
For ^-egairs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE; Permits for eonstruction will 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 Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceeding with the framing.
CLFTIFICAT� OP OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for which a building permit has been
issued; and said structure shall not be used or occupied until a Certificate
of Occupancy has been issued.
� ���
_EY.TISI?JQ}t I:NVI'I,nl'ti AVI;1rAt;1�: °U" Ct)Mit7TATION
Pagc
oWN:x: ff/cH.PRl� �i�i�it �Es• D�2E �z�96
� STTE ADDRESS: �� ��d+J.&�,l1f���.C�. PHONE: S�/�'%�C�10 �
CONTR7iCTOx: /pi�,el.�a�GT �,� �f/iNt/f
. :�
, ,,
`��„ Detetmine working square fwtage of'each
;
1. Tota3 e�tposed wall area...... f 9/a _ sq. ft. x .17 = �eZ7, %Q
i
2. Toal roof/ceiling area ...... �o ya sq. ft. x .OS = ,�� ��j d
2bta1 exposed wall area above floor = /7,;y,00 /
a: Total wall kin3ow area ........ ................... �1fo"' v /
b. 2bta1 door area ... . . .. .. .. . . .. . . . . . . . . .. . .. . . ... .. . . S�?. 3 i� V
, c. Rbtal sliding gl: :s doar area .........................
; d. Tc�tal fireplace wall area ........... ................. �
� e. Totsil wa21 fr�aainq area (average 10�) . . . . . . . . . . ... .. ... 19Y. 0 �
' f. Zbtal ri.m joist area ........................ J/D / /
.......... .Ob V
, 9• _/�d� Wall area above floox .......................... /,��9.Yo "
h. wall area above Eloor .................... . ,
i. wall area above floor ..........................
° � �� wall area above floor ..........................
f, Total exposed ioundation area = 6,( , D U
k. Rbtal f.uun_dation window area ... .............:... .... �
I. Total net foundation area above grade ........... .... G���_
Detenaine "t1" value of each wall segment
(e.g. wi.ndow, door, each separa wa12 section)
A• _ l�%.%�. X °U° �Sf = f, r{
k, . � . � . . .. .
� . � . . -`--L . � �
b. _ Si�.� X' "tl° •�� _ , � �(
�J
. . _ � . � c. X nU�� �� _ �� . .
� .. � �� d � . u �. � .....�+ . � .
X U =
_ e- /, o U_ x „U,. ./3 =
f. �D.Op X ���� _ .07 =
e • / e� • �o _ x "u" `°�_ �
. . . h.. $ . nIi � . _
1. �r"'
� � --- —
x ��u° '--
g �.���
2N. $3
7a
_9_ �
k. �__ _ � X :,��� �
. � : _ c6. oc ;; „�„ ` , G = N�.�.
� 3. ..... ...... .. .............. 'i'c;al = �s . �
+`
�
�
-�
;
�
�
R
If itom u3 is thc same a�,
or less than item #l, you
have met the int�nL o£
SBC 60�6 (c) 2.
� .
��
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i �.
,�Fterior Envelope Average "U" Computation
Page 2 of 4
� Total•exposed.roof/ceiling area.�+ �Qy�� " �
m. Rbtal skylight area G/�f 7�� �/ rr�( S.'1g
� A. 7bta1 roof/ceiling f�aming area•(average 10#)... 7/,f0 $),90
; o. Total net insulated roof/ceiling area........... ��g a �9�� a
k
Determiqe "U" value for each roof/ceiling segmen
, m. X riUu _— _
�
� n. 7/./7J g„U�� ,,y = a� a`% � �
�,90 x �1� �s
o. L34�4o x ,�U�� ,c3 = /9.ao '9t,/o ,� ,oS � /y.Sl
4, .........
. .. . . .. . . . . . . . . �tal = �/D. SO �;i
; If tota7. of #4 is the same as, or less than #2, you have met the intent of
58C 6U06 (cj 1.
Alternate Suilding Envelope Design
7b utilize the total envelope syst� method, the values established by the sum o8
items #3 and #4 shall not be greater than the sum of items #1 and #2. �
i. 3a S�.7o + 2. s�.c�o =�?�,
3. asb� � 7 + 4. (�o, 80
i
.
� �.
f-lr� Ca
uN;� ��
�" " WALL SECTIONS-
�,,,ti� Use 10� of opaque wall area for
� frame construction
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e-
Fzc. �i��
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r•zc. �2 <
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� �/ ru
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TOPVIEW OF'
FW1l9E 1?nLL
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Constrnction
Page 3 of 4
R-Value
1. Interior air film 0.68
2. a'� /�o�_..+ S��'
3. 3''�sr 5# �r..D �f, f
4• �3 � �'�a� a,6s,�Jl�ae , T �-
5. 7le�iYs..I6dr./� � i%
6. Exterior air film 0 17
Total �
U ` l.J�
�f7�ra 1. Interior air film 0.68
� ' • �r�.Jsf/s� 2. �_ � G�y�pa,.n ��S"
--0 3• 3rwp F,6.y/}�� � ��o
_-{�7 4•%N l:di. s�� . �� �t a�
._: ,p s • �te `"' �iL.,,�//,f�.�,,� , i 7
_„O �' 6. Hcterior air film 0.17
_� Totai �
-'� V a �. O ]
—Q/ ' Rr�l l, Znterior air film 0.68
"'°...� �bi" ' � '
"-Q3 rt . 2. 3� r=6L�! ter ' l/� D J
��
.�-� 3. l�.d.��`W�.Q ! �Y
",l� 4. ,_.
,U 5. �G �' /iv ` i G 7
'—� '
6. ffiterior air film p,l�
4bta1
,"`.Q .
: ,07
\� . ���{
�� f' I. Iaterior air film 0.68
...,v z. --.
., .
. • 3. --
4. �'
5• �e 'I S�,G S/�e/F , 7/
6. Fxterior air film 0.17
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Pag 4 of 9
Constcuction � R-Value
1. Interior air film 0.61
N rry�. . . � � .
55,, G�
2. ��'_-30'•�- a+�a-� �i I C
3 . ` � • Fib..¢/rss . Sfi
4. Exterior air film (still) 0.61
Total aS�i s
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s�4 �' s�:tw��d
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�� 1. interior air film 0.61
f�.l��'��. SIt" (.�_ . Tif
F'/�!' s.� o!�'� 6..qL#r. 30 � o0
4. Exterior air film (still) 0.61
Total 3�� i Ci
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la� R,. �;/aa , 6/
Sh"G�� •3'Y
L�FiI..g%+s ' /l.00
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_.—
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�—
1. Inside air film 0.61
2.
3.
4. .
5. Outside air film ��Y��� 0.1"7
� 7bta1
Note: Use additional sheets if more space is
nceded for details and calculations
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�it� o� �rictte� '
ANOKA COCENTY
6437 UNIVERSITY AVENUE NE August 13, 1476 PRIDLEY, MINNESOTA 55432
Ms. Hel Ford
Ri.chard Miller 8amea Inc.
1bEf0 Rice Creek Road x.E.
Frictley. Mn. 55432 ,
Rez 1660 Camelot Lane N.E.
i
Dear Mela
. Dtui.ng our recent footing inspection of 1660 Camelot Lane, ft was mentioned
to the cmient contractor foreman that we suggest an eicterior drain tile
arounai the footings be installed. I'm mvare that you hava been conscientious
in reqard �c moisture prot�ction of footings in the Harris Lake �states plat.
This is merely to remind you of the excessive gmund vater pmbl� in the
"clay lens" south of the house sita at 1660 Camelot Iane.
Z£ should be noted that.Mr. 71�m Hrickner, the builder on the lot to the
easE uf 1670 Camelot Iane, £elt the problem on his 1ot to be acute enough
to warrant separate independent drain tile systems in the back yard.
If you have any teohnical queations regardinq the gmund watEr in this area,
I sugg�st you contact Mr. Pete Mo3inaro or Mr. Bill Meyer of Suburban
Engineeri:tq at 5�1-6066.
Sf I can tie of any iurther assistance please call me at 571-3450.
��+ ;
Inspection Officer
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LOS3 CALM.ATIONS �° 7 : " � rJ }
WeatAentrips A. ...• Con�truction No. In�ulation
Guide
Window� 1 Doon II Rekrence II Out Wall Int. Wall Ceilina Roof Floor Kind How Applied
� Ye— �— '�o � Yn� 19_
� FI �%j �; �,� Room Lenyth j<<,•, Width "" HeiQht "�✓ FI.� 7 � Room L.enqth � Width J. Height �t; °_
Wmdow� and Doo�rCnckase and Are• Window� and Doon—�neka;e �nd Area
H•Idl� NHt�t No. af Llnul tt. wro� �� W�O�h N�Ifnt rie. o! LIM�1 tt Ar��
Ho. of D�ne ot p�n� ❑��U. oI tr�cM �Y. fL � No. of D�n� af p�n� II��l1 . Of cMCY �Y. ![.
� :� : . .✓ ..: 3^' (i� �'f'� .'j ` ' C
r�.�71
Coef. Btu Coef. Btu
Infiltra�ion �",�. � � ]nfiltration '�'`� � -
Glaaf ��. ,. � Glasf t ' '`! .2-U-.
Eap. wall r (o ExP. wall °? `) •
Nel exp. wall �� � Net ezp. wall ' 6 �'/ /
Int. wa�l • Int. �+all
— _ _. . . : —
� Cei�mg . . b .�/ � � .r.. -.,. -Ce��ung�__ ._ ._ . __ .... .. .. . � . . �_' . ff�.-Si O
� Floor Fioor
Towl Btu. ,_ � Total Bta U D
Required sq. fL E.D.R. or sq. ins. W.A. Leader area � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area �
�I.�:7L�1 Room � Length Wid�h /! Height �' f FI.I/ "� t'• Room I L.ength :;,. Width / Height Y:►
Window� and Doora--CrackaQe and Area Windows snd Doon—Crockage end Area
wlClh H�I�h{ Ho. of Llnul tl. Are• µ����ry µ���pt No. o[ Line�l [L Arc�
No. nl-ypan� ot p�n� Il��u ot cr�ck W. ft. No. al v�ne o( p�n� II�M1b ot cr�ck �a tt.
d� � ,� { �" l�. I �...
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Coef. Bm ef. w
Infillrstion a �� �� lnfiltration � �� 's .� �' 'L{,j
Glaa Glase / (,-,
Fsp. wal) � F�cP. wall .t �4'
Net eap. wall Z Net ezp. wall " i. i i /�—
Inl. wall � Int. wall
CuLng� �-?� V , y Ceiling . � ,j �
Floor Floor � ..-�-� ��"� �
Total Btu. � � '� Total Btu. � ,2. �
Required sq. ft. E.D.R. or tq. im. W.A. Leader srea Required aq. ft: ED.R. or sq. ins. W.A: L.tader arc�
FI. ;' Room Length /' Widt C) . Height •";,. ������ �. �m I Length � J_ Width Height -'
Window� and Doon—Crackage �nd Aro Windowe �nd Doon�racicage and Area
WI01� H�I��t No. ot Lln��l f�. Are� Wb�❑ H�t��t Na. of L�n��l tt Are� / �
No. of.p�n� af D�n� ❑f��• of cnck .. �p. f[. . No. of O���e ot pan• Ilfrb o! cr�cY N. tt J f.S .
,i` . / �P
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Qi,.. G Glaae � �— R.
Esp. wali,,;:;^ % Exp. wall � ,,,, .
Net tap. wall Net exP. wall b� �! ff' z-�%
Inl. w��� Int. wall � G / .
:
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� f �OOf F�aol < � J �- .:�J � .
Tobl Btu. , j U c; Total Btu. ' �N� ,
Required �q. Ft E.D.R. or �q. ins. W.A. Leader are• Required �q. ft. E.D.R. or ia. ins. WA. Leadcr arca /
/ �'L �[� Raom �l.erratA Width eight�=— Fl. � ----__ _ _ _ __ —
= -�•t. ,� � °,�,. ',„•.oi RoomlLength Width Height `�
Window� an Doorf—Crxk'ige and Area I Windows and Doon-�ncicage and Area
WIAtn HUi�I .... No. of Llne�l fL Arc� P'10�� ..HNi�� No. of LIV�I�H. wn�
� No, ot O�n� of D�n� Itf��� of cuck �Q. fl. . . � �Na. ot D�v ef o�n� II[M1U of crack �Q, t0. �
-�� � � '�.5-... /. 'r,:-, f}��fl : /. � 3 . " .., ..
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Infiltution
Glap
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fnt. wall
Ceilin�
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Btu I
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560•3450
�iL� o� �Y���ey
v
ANOKA GOUNTY
6431 UNIVERSITY AVENUE NE Dec�ber 14, 1976 FRIDLEY, MINNESOTA 55432
O. S. ThampBOn Electsic
12201 Minnetonka Houlevard
Minnetonka, Mn. 55343
Ite: E].ectrical Work Done at 1660 Camelot Lane N.E.
Dear Sirs:
Duriaq an iaapection at 1660 Camelot Lane it was noted that no ground
fault interpreter had been insCalled. We will expect this to be completed
by Jaauary 2, 1977 when a reinspection will be made to dete�ine compliance.
If you have any questions on this matter, please fee2 free to contact me
at 571-3450 between the hours of 9:00 a.m. and 10:00 a.m. Nbnday thmugh
P'riday.
Sfncexely,
y�(xjjsR(1 $j(`F{{({ i.T.FR
Blectr3ca2 Inspector
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City of Fridley ��ewr 0 18014
� . t�� ATTMETOPOFT1iEiWtNS� ` �� � BUILDI��r � �ERMIT � � �
' � � RECE NO.
� � ��� _ COMMUNITV �EVELOPM�NT D14. �
� � ' .� Y�' . � � PiUDTEGTIVE INSPEC710N.SEC. . � . I ./ 4 �
i � � �
� lo 0
� �"9 � CITV NALL FRIO�E� 55�32' NUMBER . REV: � WiE'� PAGE OF qPRROVED BY
�'"."�"��• •'' 612-571-3460 910-F15
5/29/85 / / I
a�s �uoness 1660 Gamelot Lane,.N. E.
� ��Q�� .- LOT�NO. '��. �BLOCK :. � TRACTORADDITION - � SEEAT7qCHED � �
oescn. 30 2 i�rris Lake,Estates srEer
' � � 2 PRpPERTYOWNER MAkLADDHEB$'�. � . ZIP PHONE �� �
E��dn Kaul same
3'GONTANGTOR ��� MAILAO�RESS�. . � 21P � . PHOIVE UCENSENO
` Gar�! Jansi:ck G480 Squire Drive
4 +� . �T$C70p0E310NER�-- �. ..MAILADDNESS'�. . � � � ZIP PHOME � UCEN5EN0. �
5 EN81NE@R � � MAILAODRESSi- � . .�� ZIP PN@NE 4�CENSENO:
..��&.!:USEQFBUILqNO � . ., ' , .
,
.. 7 �ClABSGFWORK� . . � .. . :
. � . ❑ . NEW �C ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ R£M�VE
� : -.�e�. �cscxieeworiK � � � � .
. � . DBC�C - _ . . . . .
� 0 CR1¢NQE OF UBi FROM �� � � TO � -
S'�Lk7JONS
� s
y�,:
� SEPfU7ATEPERMITSpREpEQU�PEDFOREIEGLR1GAi,PLUMBING,MEATING, TMPEOKCAN87. �
:VENTILATINt{ OR AIN CANDITIONING�. ��.
� �TV41S PEAMIT BECOtAES NULL AND V010 IF WORK OFI CONSTpUCT10N ZONING �
. � AUTHpQIZED IS NOT COMMENCED WITHIN 9�::QkYB� Qq IF CONSTHUCTI�bH
OR qlQRK 1& SUSPENDED Op ABANDONED ffYR A'$ERWQI�-0F 120-OAYS AT �
ANV iIME AFTER WOHK IS COMMEN('.E0. �� � NO. DWL6: UMI�?'
1 HEREBY C6flT�Y,iHAT I MAVE REAO AND EXAMINED TMIS APPUCATION � �
ANOXNOyJ THf $AME iO BE TRUE AN� CORWECT. ALL PROWISIONS O: LAWS yALUATfON�. �
AJQO:,ORDIli7@NCES 6�VERNING.TNIS TVPE OF WORK WII!L BE COMPLIEO .
WIiH WH£TMEF�SPECIFIED IIEREIN OH.NOT. THBORANTIMG OF A PERMIT � S ZS
� �� D�7E8 NQT PRESHMe TO�61VE AUTHORITY TO VIOLATE Op CANCEL TME pEqMiTFEE
.� Wi.OV151QNS OF,�NV'OTMER STATE OR LOCAI LAW.REGULATINQ CON- �� '
� STRUCTION�,OR THE PERFORMANCE OF CONSTRUCTION.. ZZ.00 �� �
�- .�+r PLANCN KfEE
l'7'i^GJ �C'�
� 161UTUAFOFC � RCTORO TNOB¢EO�GENT: ,,, IOATEI WHE� ROP
' ��SiGNC.IIREOF WNEAniOWNEA8UiL0ERr� �D�TEI � .-jrysp.
� . . . . . . . � . . $ .. , .
FEE
2s.i�
i5 �Y�n��
i i
�
-
�+ [ ]
�nun. [ 7
�.Tex. I 7
Conatwotlon Addr�ss:
Lesai D�ao�iptlon:
Cl;q of Fridle�
R-1 �ID 8-2
Huiiding Perait �pplioatioa
Sffective 4/1/B4_
Ovnez Ya�e i 1►ddress: l�1. •
Coatraotors lel. #
Wdnss:
LIYIMG AllBA:
GARAGE �BA:
DEC[ i1tSA:
0l8ER:
�Lt�ch to Lhia applicatipa, a Certificate of Survey of t�e
lot. xitA the propoaed epnatructioa drara on it to scale.
DSSCRIr7I0� � a1PlOYBl�NT
Langth Midth Aeight Sq. Ft.
I.�rigth YidtA Bei;ht SQ. Ft.
Lerigtd Yidth Bgt/Ground _ Sq. Ft.
Corner Lot [) Inaide Lot I 7
Type of Conatructioa:
Approx. Completian Date:
Ft. 2d. Setback 31de Yard Setback
8atimated Coat: _
Alt. A Ali B
PropoaeQ Drixexay Width If liew Opening Is Deairod: � __
See Hack Page for Explanation
DATE:
Permit Pee
Plan Cbaak
State Sprcharse
StC Ch�rse
Park fep
Sevtr !!�i¢ CAarge
Eii�
STIPULATIONS•
1PPLICANT:
CIY7 D3E �t.!
s
i _�
i
i
i
s
i��s
iel.
Fee Schedule on Reverae Side
25f of Building Perait Fee
�.50/;7,000 Yalu�tion
f#25 p�r SAC Uait
Yee Deternined by Engineering
lgreemeat Neceaaary [ ) lToj Neceasary [ ]
a '
HD�.DIAG PBRlIIT FSE SC�DIILS
ihe Chief Huilding Official shall� before iasuing per�sita for the erection.of any
building or atructure, or for any addition to anq exiatiag Duilding or etructure, or
for any alteration or repair to any exiating building or atructure, upoo application
therefore, reQuire the paymee! Ey tAr applicant for aueh penit of feea to the �mount
derein belorr set fortd and in the �anaer herein provided to-wit:
Sotal hluation
i1.00 to =500.00
SSOI.00 to ;2,000.00
=2,001.00 !o =25,000.00
=25,001.00 to =50,000.00
Fees
�70.00 (Ninieum Fee ia =15.00)
=t0.Q0 for the tirst =500 plua =1.50 for each
additional =100 or lraction thereof, to and including
i2r000.
j32•50 for the first =2,Q00 plua �6.00 for each
additional =1,000 or tractioa thereof, to and
including =25,000.
�170.50 for the firat =25.ODD plua 14.50 for each
additional =1,000 or fractioa thereof, to and
Sncluding 550,000.
i50,007.00 to =10D,000.00 =283.00 for the firat =50,000 plua =3•00 for eaeh
additional =1,000 or fraction thereot, to and
ieclutling =100,000.
a700,001.00 and up
=�33.00 for the first =100,000 plu� E2.50 for each
additional E1,D00 or traction thereof.
DRITEYAT DBPRBSSIOM BSCROY
(Concrete CurD Streeta Only)
. Alternate "A": Removal and replacement of curD and gutter only - Driveway rridth plus
6 feet times =13•50
Alternaie "B": Removal rnd replacement of curb and gutter and install a 3 foot wide
approach with 6 inch dept� - Driveway width plua 6 feet times =15•TS
YBRIFICliION OF FOONDA?ION
Permita for construction wi11 De faaued a einimnm of 24 houra from the time of
application to allov ior proper reviev of Lhe propoaed atructure and of the
constructioa site.
A Certificate of Surve� ot the loL, aifoving t6e location of tde foundation once it
�aa paen 000structed will Ee raquired Defore proeeeding ritd tbe framing.
a �
City of Fridley
.� �'TME'°°°F'ME�'�S BUILDIN� PERMIT
,.
� `v���� COMMUNI7Y OEV£�OPMENt D1V. � � .
� � ��� PROiEC7�VE INSPECiION SEC. �
�
i �� '. �"'1 � UFV MI,LL FRIOIEY. .yy�32 . NYU�ER REV � OaTI
� ' `
'°'�" '� 612-571-3450 gto-F75 4/25/00 � / /
ioe �opqess 1660 Camelot Lane NE
1 LEGAL �dT N0. BLOCK ��� � TRACT ON ADOITION
o�scn. 30 2 $arris Lake Estates
7 PRpPERTV OWNER MAtL AODRES$
Lala Ghani 1660 Camelot Lane NE
3 CONTqACTOR MAILADOHE33
ABC 12247 Nicallet Ave S,'Surnsville, MN 55337
5
30856
SEE�TTACHED
SMEET
PMONE
571-2037
PMONE LICENSE NO
707-6959
VMONE UCEHSENO.
V110NE
Residential
iSOF WONK
�❑ NEW ❑ ADDITION � ALTERATION �- REPAIR ❑ MOVE ❑ REMOVE
;nise wor+K
Reroof House 5 Garage (27 Sq) Tear-off
OFUSEPNOM
IInderlayment must comply with the State Building Code.
SEPAR�TE PERMITS PRE PEOUINED FOR ElEC7RiCAL, PlUM81NG. NEAT�N6. �� ��
VENTI�ATING OR AIq (',pNpTIONING. � �
TNIS PERMIT @ECOMES NUIL AND VOIO li WQRK OR GONSTNUQTIpN 20NING
AUTMOFU2E0 IS NOT COMMENCEO N(ITNIN 60 OAYS, OR IF CONSipUCTION
OR WORK IS SSYSPENpED OR ABANppNED FOA A PERIpD QF 120 DAyg AT
�NY TIMf RFTER� WORN IS COMMENCED. NO. DWIG
1 MEFEBY CERTIFV TNAi I MAVE AEAD AND EXAM�NED TMIS �PPI�CATIpN 1
ANO KNOW TME SpME TO BE iNUE ANO CORRECi. �LL PROVI$IONS OF IAWS yALUA ION
•ND OHDIN CES GOVERNING THIS TYPE OF WORK WILL BE COMP�IEO $2 36O
WITM WMET ER SPECIf1E0 HEREIN ON NOT. TME G�7�NTINQ OF � iERM1T •
OOES NOj RESUME TO GIVE AUTMORITY TO VIOL�TE OR CANCEL TMk pERM1TFE1
PAOVISIO OF RNY OTHEN ST'ALTE 0�1 LOCAL UW FEGUUTING LON� @83.,z5
ST�UC�T1 .OP�,TNE iERiOFMAry�,EOf CONSTFUCTION � •P
�u��0ai2ED�GEH� �6�iE�
-c.y��+a.i.
( /
ST��lS
$1.18
�C CMAPGE
ire SC $2.36
�T11y FEE
�$91.79 i .
�W [ l
ADDN, [ ]
.��.,T�t• Il
Construction Address:
I.egal Description: _
�1 Effecrive 5/10/99
CITY OF FitIDLEY " `: �� �
SINGLE FAMII�Y AND DUPLEXES R-1 AND R-2
BTJII�DING PERMIT APPLICATION � � t ;'�Q ��� �`�
� f�i � �' Q./'Y1 �.1 U % tiJ � �i�
Owner Name & Address: 1 f� (� ���N� Tel. J�(0}y� j%� — Z03 �'
Contractor: ��jC . MN LICENSE # ahlj/1��3
Address: I���� a.Sti�alf�T ��� SE��,t�h`h�µ��sv�ll� M�l%Te�. #��� �D�-�a�-��`i
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTFIER:
DESCRIPTION OF IMPROVEMENT
I;ength Width Height _
Length Width Height _
Length Width �_ Hgt/Ground
�' �9 / S- ,�-!I _ n �L�
Sq. Ft.
Sq. Ft. - __ _
� � � •' ; �� ' - � r ... �v7:O jl /f'I � A� •C•
Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x$
_$
DATE: �7—Z{�-OC�. APPLICANT: �(��P I.�� (� Tel. Jat �'Z��z�
Permit Fee
Fire Surcharge
State Surchazge
SAC Charge
License Surchazge
Driveway Fscrow
Erosion Controi
Park Fee
Sewer Main Charge
TOTAL
S'T�ULATIONS:
CITY USE ONLY
$ g'-�� Fee Schedule on Reverse Side
$_� 3� .001 of Permit Valuation (1/lOth%)
$ I �$ $.50/$1,000 Valuation
$ $1050 pet SAC Unit �
$ 5�S $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ j Not Necessary []
$�
�_ ___
„ : ; :
�s;;r �
; 7�� , � _�r> �• ; �+ �
,. �� . ��� `
Building
Inspections
763-572-3604
xDAre g-aa-�s
� SITE ADDRESS i �
THIS APPLICANT IS:
k TENANT
SUBMIT A COPY OF
YOUR STA?E L[CENSE
WI7'H APPWCATION
PROPERTY TYpE
TYPE
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
ELeT �
in N
❑ OWNER OCONTRACTOR
.EceT
ic s� G
Pemut
Received By:
Date Rec'd:
sSr3�
STATE LICENSE # EXP DA7E �
ADDRESS: CI'CY STATE ZIP
f.�
❑ BASEMENT FAIGSH ❑ ROOF
❑ DECK 0 SmING
I❑
DESCRIBE WORK BEING I
SQUnRFs
GAAAGES
PROPQSED SIZE:
PROPOSEDF�]GHT:
SIDWG
❑ Vinyl
❑ Alumimim
❑ Otha
❑ HOUSE @ GARAGE
0 ATfACNED GARAGE
❑ DETACHED GARAGE
�Soffit
❑ Trim
❑ Fascia
WINDOWS
IN EXISTING OPENAIGS OYes ONo LOCATION OF WINDOWS
OR FOR NEW OPENRdGS-DESCRIBE SIZE OF
OPENPIG CHANGES &
Plan Review
Surcharge
F'ue Surc6arge
License Surcharge
SAC Charge
� Curb Cut Escrow
Erosion Conuol
Park Fee
Sewer Main Charge
Total Due
ARE BASED ON VALUATION, WCLUDING THE COST OF
r^^ __ �_ (USING TFIE 1997 U.B.0 FEE SCHEDULE)
❑ DRAIN Tll,E
O OTIiER
BASEMEM REMODELINC SUBMf[�
1. Existing Floor Plan
2. Proposed floor plan
3. List Mstrucuual manbers W be used
FOR NEW CONSTT2UCTION INCWDiNG DECKS, �
ADDITIONS & POACIiEC S BMIT•
l. Site PImJSurvey showing the existing swctura
and proposed project.
2. Two sets of construction plans
3. Energy Calculatio�
$ See Back Page for Fee Schedule
$ 65% of Building Pemiit Fee
$ (.0005) times the total job valuation — Minimum $.50
a .001 x Permit Valuation (1/10%)
$ „ 55.00 (State Licensed Residential Contractors)
$ 51450 per SAC Unit (Plans to MWCC fordetermination)
$ �R+,�ft=_�ftx$20=� !60
$ 5450 Conservation Plan Review `
$ Fee Determined by Engineering
$ Ageement necessary ( ) Non Necessary ( )
e.. - ._ • - • --
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a buitding permit and I aclmowledge that the information a6ove 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 app(ication for a permit and work is not w start without a permit that the work will be in accordance with the approved
plan in the case of al! work w uires revie and approval of plans.
�SIGNATUREOFAPPL[CANT``� � 9 PRWTNAMES�lA7� Lr/�pS?KO.� DATE �{'�J—os
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 applica6on 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
VERIFICATION OF FOUNDATION
Permits for construcrion will be issued a minimum 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 locarion of the existing foundation will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977