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AF - 35661� > � � � O � � C" 1 G► v � � � � � h 00` �' 7 � "�, " � � � � � � � � � 0 a � � � �� r.�.._- � ! 0 � � � � � �� , � �l �� 1 � � w � b0 �a�� a W � � � °� K � v� s � �.+ ,. � o �� 3: . � �E: �e « °1 « ° 8 0� 8 � « « « � V � O � � a $ �� i � O r Oe � <� �� W� � W �� ~ � o � G '7 � � � E �[�� m A � �* � o �e z x � � � � � � `� � � � � � � � � ;�� 1\ � �� ,� � � � � �y � � � �4 � �. � �. � �' � A � � � �. � � � �� $ « � � O � � � � � � � � � 7 0 �a��x ��o N '*' � � y os�� . x�� ° � � $ � 8 � � � � � � x � o �' 8 � � w p� o 0 g " g g ;»�� I � I ! O � � � � � � 0 O � O `.0 � t� y m � �. � � � �� , ! g �� i 1 � � � � I I °' T I �� x � � � �� ;�� d � � � � � � � � � � a� w o+ o� w o 8 g g � $ M M 4 � \. � � � � m o � m .� � � � , ;�� 14v I � � ro � � ., �'�� R� R�. $ � �� o �� ,��x � � : � � . 8 : : W�,�o�+ 8 8 8 8 � � � � � i � � I �� .�� "~ � � o� � � d��; � °: M a d' ��o � m , � 5��'Q .. aA �Mry� � b��m �� V p� �� Aw � x � �M �� m ` �a��. � � ��M � �A� �� o � �� a � � � � H z � C �n � �. � �� v w � � O � :� �� SUBJECT pE � City of Fridley � 13710� 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. � i y �� PROTECTIVE INSPECTION SEC. i � 1 = i �� /""1 � CITY HALL FRIDLEY 55432 NUMBEF REV. DATE PAGE OF APPROVED BY '�"� � ,�� 612-560-3450 910-F15 g 19 76 � � 10B ADDRESS 5269 Capitol Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 $ C3Y],SOA�S Stunmit Manor South Addition SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Henry Hesselgrave 5269 Ca.pitol Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sussel Co. 1850 Como Avenue, 5t. Paul 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK �O NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 24' x 24' Gara e 9 CHANGEQFUSEFROM TO STIPULATIONS p�er to remove existing garage. Owner to obtain �ntrecking permit or moving permit. SE�ERATE PERMiTS REQLa�RED F�I� �ffRING, NEATIi� PIUIWBIf�G ANf� SIGMS. . —IIVI�ORTANT-- N��' rHE FRIDLEY EIVGR, DIYISION t��,q�p�� CURg R��dAL AND REP(,ACEfvjENT �IT DRlVEWqY OP�'NINGS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. 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 WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4►262.40 y�2.�-3 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � y�23.O4 PLAN CHECKFEE TOTALFEE � � $25.17 SGNATl1REOFCONTRACTORORAUT oR¢ D GENT (DATEI WHEN PROP RLYVALIDATED THIS IS YOUR PERMIT .� �� G� � °�� -��'�,� SIGNATUREOF OWNER (IF OWNER BUILDERI (DATEI BLDG INSP �ATE � �� I � . �� •' — � ' � k � � ' � �o � � � � I�J `�� -------- � � � -��. . _J�,� � .� � ; � � .� � � �;� � �e , �� -1 � ...� � '� . � `�� .� � _ �, � � � - � � � � � ,. � . � � ; �, i 1 a. � e � �� SOSSEL 6ARA6ES A DIVISION OF THE SUSSEL COMPANY, INC. Permit by '��" -S S c � Legal Description Lot � Blk Add'n Value Type Const. �� SL B: SUSSEL ❑ By Owner Approx. 'Oln 2-STARTINGS POINTS ONLY � S. P. L. . S S. S. P. L. � R.P.L. Alley ��N� W � House F. Street • Other �qu.are With T -�✓� � ROC�S ° ,. ' Mesh �od Rem. - By��L-2 5-Bag Mix �-Baa Mix Tamping a (.U. rade Point , iduit D'Maintain 8' Total Wall Height including Blocks , . , ❑Maintain 8' Wall Height on Top of Blocks ❑ Other �O H. Dr Offset / 06 �� .D. Location' /' �Windows 7 ,'�?,r,� ��,�/ Att Gar Roof Tie-in Drawn on attached Ex'sting gara�e: No ❑ �tached ❑ Att c d Y � ' Size of existing: xZ� Existing garage will � . � ❑ Left as is, ❑ Converted to L.S..- sy owner ❑ Removed By: Owner ❑ ,�v� /'4,� �sr-c�Sussel�_ lunk Must Be Removed By Owne, Ip'SPsov��pf�x. dist. garage to house and all prop. lines Stakes visible - ,Yes ,�o �` Survey available - Yes�C] No O Special instruct' ns fr m � 'ow�er: « �1 P —3 WORK C�RDER � HOME PHON • r 2 .�' NAMF/7C��/` �L`�'�`'��'��BUS�. PHONE: , JOB ADDRESS--� �-� � ( �✓��TV � s T /l�C �— BLDG CODE AREA �/��L �� SALESMA�97�7'�'�Gt'2� CONTRACT DAYE '� �SIZ�E2 �� FOR OFFICE USE ONLY CONTRACTOR JOB $� } � ; I .�-� ` ' �' � � i f ,- s ' t t t. 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'. } 1 f _ � ;• � � s_ � fI . ,. �'...i- � �.. __J__ ' � i ,� ._� j . � �. .A ,._1 . . � i i � V , !. , 1 + r j�� 1 i �.,� , (,..� -R11RCHASER'S INITIALS. _ . _.1-_ r .,.__,. .�_ ! .oiRe�T1oN.� � _ .__ � CITY OF F�IDLCY APPLICATION FOR RESIDENTIAL ALTERATION, ADDITION, OR REPAIR BUILDING PERMIT OWNER' S NAME : �/G'G�d� �S$`�,t'��-� BUILDER: �� 5 �' � � � ADDRESS : �� % �.'�� Jjf`��ADDRESS : %�.S�O �0he.e� � c�`2'� %,� NO:. STREET• LOT: BLOCK: ADDITION: CORNER LOT: 7'� INSIDE LOT: SETBACK• a�'i` SIDEYARD• � Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: �Q.��¢1� �:-�-�. �} `� Front:_ �- �{ Depth: �� Height: Square Feet:_ S`��_Cubic Feet: � `%(pd Front: Depth: � Height: Square �'eet; Cubic Feet: Type of Constrv.ction: �/-d-�-�-� Estimated Cost: $'f��lo��'�{j� To Be Completed: �� The undersigned hereby ma.kes applicativn fox a permit for the work herein specified, agreeing to do all woxk in strict accordan.ce with the City of Fridley Ordinances and rulings of the Departir.nent of Buildings, and hereby declares that a11 the facts and representations stated in this application are true and correct. DATE : a/ � 9 � �� S IGNATURE ° � ,° ' (See Reverse Side For Additi.onaZ Information.) � � �� - . �� ?� �A�� e �� 9 � ,: � t. , I3UILD1"NC PI:RMIT FI;E SCIi}�llUL� SECTION 2. The Inspector oi Buildings shall, before issuing pEnnits for the erection of any building or structure, or for any addition to any e�cisting building or structure, ox for any altexa�ion or repairs to any e�cisting building or structure, upon applica�ion 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: iVEW CONSTRUC'�IOl�: S3.xxgJ,e Family Homes and Garages: $�.00/100Q cubic feet PLAN CHECK: 25 percent of building permit fee. ADDITIONAL INFORRIATION For the purpose of computing fees for building pertnits, �Che cubical contents of any building or addition, is determined by multiplying the gr�und area covered fxom a point six (6) inches below the floor line of the basement or �he cellar to the average heights of the upper surface or �o the average.� height of the roof surface of the main gable of a pitched xoof. For repairs or alterations to an ex isting structure, the fee shall be at the ra.te ;�f $3.00 per each five hundred dollars ($500.OQ) or fraction thereof in the cost of all proposed woxk. Tn no case sha11 the fee charged for any permit as set forth in Section 2 be less than $�.50e VERIFICATIOI�' OF FOUNDATION NOTE: Permits for eonstruction will be issued a minimum of 24 hours from the ti�ne of application, to allow for proper xevieor of the proposed structure and of the construction site. A Certified Survey of the lot, sha��ing the location of the foundation, once it has been constructed, will be required before proceeding with the framing. �ERTIFTCATE OF OCCUFANCY Application for a Certificate of Occupancy shall be made ten (10) days prior tv the use ox occupancy of any structure for which a building pennit has been issued; and said strtacture shall not be used or occupied until a Certificate of Occupancy has been issued, .. _ � �SUBJECT �C�G p F City of Fridley 13'713 AT THE TOP OF THE TWINS P E R M I T • i � � � R PT NO. � ; L____ COMMUNITY DEVELOPMENT DIV. T�� q r � PROTECTIVE INSPECTION SEC. � � � � � _ � �� '��'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ""� � ,`� 612-560-3450 910-F15 8/20/76 � � JOB ADDRESS gg� 5269 Ca.pitol Street N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 8 Carlson's �IDI�3_'t �YlOr $011'�l�s Additi.on SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Henry Hesselgrave 5269 Capitol Street N.E. ' 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Gasage 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR � MOVE ❑ REMOVE 8 OESCRIBE WORK �nireck 14' x 24' Garage 9 CHANGEOFUSEFROM TO STIPULATIONS �ove all debris from site by completa.on da.te. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. PT. 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 WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $SO.QO NONE 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � SS.00 PLAN CHECK FEE TOTAL FEE $5.00 SIG T EOFCONTRACTORO UTHORIZEDAGENT (DATEI H FiOPERLY VALIDATED THIS IS YOUR PERMIT � t�-'-�o�� ,� � °.Z� -%� . � � 6d�A UFE O WNERUF OWNER BUI RI IDATE) BLDG INSP pATE �T - �� '�� : AT T6#� Tt2P 9� TN� TtlliN� , � �y �� r j t,-- --� GOFstaU�ilTY D�V�6R�lERdT DI4', � �� i PtB�'i�CT�NQ P�`9��PIAW C��% � �` � �/'—'1 i CEiY k'�6t,L ��IpL�V ��4�� L......I�.� �.J 6E�'��9'3��A Job ,�,ddress � �� Lega1 Lot� o e B10 Desc, Pxoper�y Owner Contracto�c �r „ , Description I Front of Bldg, f � s SU�J�GT WRECKING PERMIT APPLICATION W�V. ��,�.��L.7y/��1 � I 1 V� % . . . �.. � � �� .. � Depth �— ]�aelling Units Add.res s Height - ��—� T�es Paid �--- ��'� 6 S�. �� Tax Permit No. Receipt No, �,.�er}.one lc (J Phone C��D � pt No. Estimated Cost of Wrecking �� iTa Be Comp7.eted � l �I' - % G - Utilities Notified: State whe�h.er notified and date . Minneagolis Gas Company Engineering Department 372-4850 Northern. States Power Company - Customex Business O�fice . 330-5540 Northwestern Be11 Telephone Co. Business Ofiice 332-4112 Approved By Water & Sewer Departmente A11 Bi11s Are Paid Services Are Discannected IV� /V�I The undersigned hereby makes application fox a permit to wreck the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Department of Buildings, and hereby declares that all fac�ts and �cepresentations stated in this application are txue and correct. �� U �� j�C� , �� Q�,�� v Cont ctor /�^� -,o_��,� �/'�,�` /� ��J � 1..�'` ��c� C��c.� __ � — [�E� �— % l.� Date BY , .� ' � � �. �'r.`_ .�/ . .: .. . . ...�! I {; / /�... . _._��! �'I �r_... .. � j : 't� J-� r� � !� i �, � �.»..; � �j � ': � � 1 '.. ' % i i. '•'yti l � lt ',% j'� / � l r�� r ; �;. 1' • `'J� ; i �` :; ' � � -� • p��mse ��, F'w"' l�"� �...+., q rrw� � ��C� ��W L� 4�W ii� �� i°R�U w��aaK+ ftasa l'aea 8431 Ut�11VERSITY AVENUE N.E.� FRIDLEY� tAINNESOTA 5.5432 TCLEPHOME ( 613)5�1•3A50 . � � �"� �fl� ��m� �. � M � 1 `* � � /� G.� � � � � ,: � � . ` � A �' r ..! s � 0 OBSTRUCT'IO�v': � {� � � ��„ ��. � �.�� n , , 0 Lot 0 0 Block Addition rA� � � � O ��, � � �-� ;� �'o��er�y Oct�?er-.�ddress �� '`'' a � , w.-a , `,� ,�,,�.:: <.-`'�_, <--' , FECOFD OF CL��i�ii.1;;IC%�TIc�ti�: 1. � /�� d �'�' 2. . � �. 4. S. G. 7. `Vttll�7q�,�, • , � • � �r.� ..i. �� F �• � : n7 ��'� � .. �: . �. � : � ,, '••�e r,�„ , � N y U � o �0 °z � O � P m � � � 0 (p � Ky � .H � 9 � � � � � � K � `' � "� � T wp,� N ��y? 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O W � � O� F�+� G N M 9�p LL � � � C � W a m �I M r�f �q a � � ~ � f° a m �''" o m � y d z y M�m y o�ro � o � ��a� � � � � `� � o ►�i � � � a�so� m m w � y I r µ�ro tt ;-• � z � • o r o $' � � ', '�' �° � ,� �` � ' � � �; � � "' x m !� � � $ ��_ I . . ! (� � � W cmf p � �!0 IU � µ �N � "�J O .5 � ro°i'oa ' , ' � � w� � - �°` o \ 1 m � a� � � �' • r ��_� � �� m � r� ��, n ' '� ��w� ` . � � � �� ' � � � �� G^'.. ' � � �WC I � � K� � � . �I 8 � g � I� M � � . � � . 'z`v v r .. A � O z � • 0 a � E �' 3 � W -< � O D T Z t7 `�'i � +n ►--� D C! y (� 'T7 � C � Z G7 v � m . . � City of Fridley S�B�E�T �=��E� �P 5 3 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �°° � � _ � �� RECEIPT NO. ' j L �� , COMMUNITY OEVELOPMENT DIV. f � � PROTECTIVE INSPECTION SEC. ��, // i� � � Y _•-•� �r'�',,� CITY HALL FRIDLEV 85432 NUMBER REV OATE �PAGE OF APPROVEO BY L 612-571-3450 910-F15 9�9�97 / / JOB ADDRESS 5269 Capitol Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 8 Carlson's Summit Manor South Addition SNEET 2 PROPERTV OWNER MAIL ADDRESS ZIP PHONE Henry Hesselgrave 5269 Capitol Street NE 572-8271 3 CONTRACTOR MAIL ADDRESS � ZIP PHONE LICENSE NO. Volk Construction 8731 19 Ave S, Bloomington MN 55425 854-0537 2154 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION ❑ ALTERATION �] REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (20 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS . Underlayment must comply with th.e State Building Code. SEPARATE PERMITS ARE FiEOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTI�ATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OFi CONSTRUCTION ZONING SQ. FT. CU. fT. AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED fOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCE0. NO. DWLG. UNITS OFFSTREfT PARKING I HEREBY CERTIFV THAT I HAVE HEAD AND EXAMINED THIS APPLICATION 1 STALLS GAHAGES AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS VALUATION SUHTAX AND OHDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT W1:668 �.53 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEfiM1T FEE SAC CHARGE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING cor,- �54.00 Fire SC �I..C)7 STRUCTION OR THE PERFORMA OF NSTRUCTION r-- PLAN CHECK FEE TO L FEE � � % License C $5.0 $61.50 SiGNATUAEOFCON'RACTOAOAAUTNOR�ZEDAGENT IDATEI EN OPE Y A�ID THIS IS Y UR PER111IIT � � I s SiGNATUFE OF OWNEP iiF OWNER BUILDERi IDATEi BlD �NSP pF7E tVE�V ADDN ALTEEZ [1 [1 [1 " ' C[TY OF FRIDLE'�' S[NGLE FAMiLY AND DUPLEXES R-1 AND R-2 BUIL.DING PERMIT APPLICi�TION ConstructionAddress: ,S�?� �°J' ��,�j�j�� ',��E/'— Legal Description: Effcctive II l/9 % .�� %� Owner Name & Address: �--�,�e� %��SS�'< �i�s��E Tel. � �vZ–��7� Contractor: J��/� ,�,v�T,��o,� MN I,ICENSE # �1/S�l Address: �3/ /� � f,�� p, ' �p�-k�� ,��a�' Tel. # �Sy o�� LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this applica6on, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEAZE\�'I' Lengt'1 Width Height �n� Width Height �n� Wid� Hgt/Ground Sq. Ft: Sq. Ft. Sq. Ft. Construction Type: ��/�T� dFr� .�,��o� Estimated Cost: $� p�C� ��- � cla (Fee Schedule on Back) ` ��; � Driveway C�rb C�t . Width Needed: Ft. + 6 Ft = �t x$ � _� . DATE: D APPLICAN'I'- � .�,, � T+el. # �'., ��-- �S'S� % Permit Fee �ire Surcharge State Surcharge SAC Charge License Surcharge ariveway Escrow ;rosion Control �'ark Fee �ewer Main Char�e TOTAL ��['[i'UL/�"C[ONS= $ c� $ �� $ , $ $ ,,r � ee� $ $ $ $ � /,�°� CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation {l/lOth%) $.50/$1,OQ0 Valuation $950 per SAC Unit $5.� (State Licensed Residential Contractors) Alt. "A" or Alt_ "B" Above $450.40 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [] Not Necessar5� [ j � [tUli,Di�v(� i'E[t�iCi' FFE SCE{EUt`t,!?. "C(ic Chief Building Ofiiciai shall, before issuing �erniits for the erection c�t� any buiiding or struciure, or 1<�r atry addition to any existing buitdi►lg or structure, or for any aiteration or repair to any existing buildin� ar structure, upon application therefore, require the payment by the applicant f�r such permit of fees to the amount herein below� set forth and in the manner herein provided to-�vit: TOTAL �ALUE $ i to $S00 $501 to $2,000 �;2,OU1 to $25,000 $25,001 to $50,000 $50,0�1 to $100,000 FEFS $21 (Miuimum Fee is $21 plus surcharge) $2i for first $500 plus $2.75 for each additional $1� or fraction thereof, to and including $2,000 S62.25 for first 52,000 pius $12_50 for each additional �i,000 or fraction thereof, to and including $25,OQ0 $349.75 for f rst $25,(�0 plus $9.00 for each additional.� 1,000 or fraction thereof, to and including $�0,000 ��574.75 for first $50,000 plus $6.25 Tor each additionai �1,OOQ or fraction thereof, to.and including $1QO,t�iO $104;001 to $500,000 .$887_25 far 5rst $100,000p1us $5_00. for each addition�.l $1,000 oi fracrion thereof,.to and �inciuding $500,000 $500,001 to $1,OOO,p00 $1,000,001 and�up $2887.�5 for .the firsf -$5(�,000 pivs $4:25� for each .additional . $1,OQ0 or:fraction diereof; to and including $.1,000,(�0 :- � $5012.25 for the fust.$1,000,0� plus $2.75 for each additional $1,0� or fraction thereof DRIVEWAY DEPRESSION �ESCROW (Concrete (�,irb Sireets Only) Aiternate "A": Removal and replaceme�nt of curb and gutter only - Drive�vay width plus 6 feet times $13:50_ . Alternate "B": Removal and repiacement of curb and gutter and instali a 3 foot wide approach with 5 inch depth - Driveway width plus 6 feet tisnes $15.75. VERIFiCATION OF FOUNDATION :'crtiiits for construction will be issued a minimum of 24 hours from the time of application t� aliow for prop�r �cvieu� oi� ttie pro�osed stiucture and of tlie construction site_ �:�e�-titicate of Survey oi� the lot, sl�awinR the location of the fc�undatio:l i��ice .iI has it has t�c:�n c�nstf-ucti:c.' ': ?�: r�ut�ircci hct<�r� 1��u;_�:�din�, ��•itfi� lhe fr.imin�. .. �� . k. � * n � � � � O Z D � � _ D r r W m -o O < v m v 'O m � C � Q � � � O Z w A v a Z v a m m rn I D � c � � N m � � � Z n _ � O � � m m �� 'a \ � w. � � c � � w m � � in 0 D a � °< m a � � o C 'O � r � C � � � � v Z � � � a � 'm � � � --I 3 � � m N � O O � � � � a � � �N � � O .� --I o = » � � � � �D � � o Z m � 0 A � � N � 77 0 o � z D D v � v � � z � � r � � � O z � � O � � Z m v � -� � z 0 � � � � � � � � � � � n � � o z �N . � � � <p n Uwl Uwl .�i� .w-� .w+ � 7 n � � � v� v 70 � m m.o �� O� c° o �c �= 2� w O v m m m� m m� y m� f » � w w �, � c�n v,. � � � � m �, i7 ♦ * f�D � > z, � � N y I� fR G � � � 7 pl 7 /D � z » � m �° -� � � 1] * � � � T -, . � � ° � '� � m c m a �. � m � � I I � I ( I I I I I I � � 0 0 � � � � � � � � � � � � O O O v O;`� V�I V tll .A V 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -o m c � 3 3 � � � a n O � ~ -o a Z -t � b � � � � � � z � O � � � � �, � \� 1 � � � a � � c N m a N � � � � � R � � a a � � m 2 ?; � � � a � � N y (p y �, o. � co , � � � 'm 0 �D : '�: .. 0- � m '° '' c, o � m o; °- a- � g o .� a � m 3 a v � � y O , pt w ? � b � � � �. ci a c„�' w a'! �' m o m O -� c1 3 � Q O O � '� a � � � j � c � o m m � � �+ m � � n. :� • � -� � ° ? ,~ o o �'• m � �� .-Q-► ? � O � O � (,� y N - � N' � � � v � r C � W z � 'il � � . m � m � z O � � m O � � 0 W v � � � � 1'1 ?1 ?1 '�l � f� 0 0 0 0 � 0 0 0 0 � ° A W N -� � tn . � c w V T A � rv a w � � � � w � C O o � � � < A Z �. 7��0 (11 y A � m w :,1 N � � Z z m -�o n � O z v < �->::: � - ; };° 7Do � � � z � C � m:::'::>;:;::; r00n ' :?:'i<:s::>: 7� `x?`?`:';'.: O :::'•: -rt � �m c� ,` �' m � -� <-n:;.::p.: O F:o:;:::>=,<> o0 c>::::>�:;:: m ��:::;�.. Z ~' tn � <:�; � w � � o � oo::;:::�j:; � s»;::::W::> Z y„»:;�:; e>>::; �1 �;>;::>. ...:;�'.' n �...0::. _ 'it y O I""' � � 0 � �� ',N fii � N � _ m � co �' o � 1 v '0 r n a 0 Z � O � � r C � � z � a Z v � � � � z � � m � � "'� � m Si < m O � � w 7 C pl � � m V SuB�ECT City of Fridley P2 9 3 7 7 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T i � � � RECEIPT NO. � ; y .____ COMMUNITY OEVELOPMENT DIV. �� PiiOTEC7IVE INSPECTION SEC. � ; r l_--. A;��,'� CITY HALL FRIDLE� SSI$Z NUYBEN REV OATE PAGE OF APPROVED 8Y t � � 612-571-3450 910-F15 5/4/99 � � 108 ADDRESS 5269 Capitol Street NE 1 LEGAL �OT NO. BLOCK TRACt OR ADDITION SEE ATTACHEO oesca. g 8 Carlson's Summit Manor South Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Henry Hesselgrave 5269 Capitol Street NE 572-8271 3 CONTRACTOR MAIL ADORESS 21P PHONE LICENSE NO Same a ARCNITECT OR DESIGNER MAIL ADDRESS ZtP PHONE LICENSE NO. 5 ENGINEER MAIL ADDqESS 21P PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WOqK � NEW ❑ ADDITION 9 DESCRIBE WORK Construct a 25' x 3'3" handic 9 CHANGE OF USE FROM STIPULATIONS See notations on plan. C� ALTERATION ❑ REPAIR O MOVE O REMOVE ramp (temporary) TO CONSTRUCTION WORR HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No worlc on Sunday. SEPARATE PERMITS ARE REOUIREO FOR ELECTFi1CAL, PLUMBING, HEATING, TYPE OF CONST VENTILATING OR AIR CONDITIONING TMIS PERMIT BECOMES NULL AND VOID IF WORK Oq CONSTRUCTION 20NING AUTHOR12ED IS NOT COMMENCED WITHIN 80 OAYS. OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONEO FOR A PER100 OF 120 OAVS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UN I HEREBY CERTIFY THAT I NAVE REAO AND EXAMINEO TMIS APPLICATION 1 ANO KNOW TME SAME TO BE TRUE AND CORREC7. ALL PROYISIONS OF LAWS yq�UATION AND ORDINANCES GOVERNING TNIS TYPE OF WORK WILL BE COMPLIEO WITH WMETMER SPECIFIEO HEREIN OF NOT. THE GRANTING OF A PERMIT �Z�OOO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL TH� pERMIT FEE PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTAUCTION �C 2. ZS S�GNysTUpE OF CON DAGENi �OAiEi s' - ' GROU � OCCUPANCVLOAO CU FT. OFFSTREET PARKING STALLS GARAGES SURTAX �1.00 SAC CMARGE Fir SC $2.00 TOTA F E 65.25 V A DA7 �IS IS� p� � � r�w ADDN ALTER [] [l [] ConsiructionAddress: Legal Description: _ Owner Name & Address: Contractor: CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUII,DING PERNIIT APPLICATION � EfFective 1/1/99 �� `�a� Tel.#-��%—�' %/' MN LICENSE # Address: Tel. � 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: �OTHER: DESCRIPTION OF IlVIPROVEMENT Length Width Height 5q. Ft. Length Width Height Sq. Ft. Length �� Width `�� Hgt/Ground � r Sq. Ft. --� 1 � n _ � _ _ .�_ Consixuction Type: ��, ,Q Estimated Cost: $� p p o a�� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x �$ _$ DATE: �5 �/ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee 5ewer Main Charge TOTAL STIPULATIONS: $ �zZ� $ � � $ / �" $ $ $ $ $ $. � .�, �� CITY USE ONLY Tel. # c�'" �� °� 1 � Fee Schedule on Reverse Side . 001 of Permit Valuation (1 / l Oth %) $.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 [ ] BUII�DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure; upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: � TOTAL VALUE $1 to $500 $501 to $2,000 $"1,001 to $25,000 $25,�01 to $50,000 $50,001 to $100,000 $100,001 to $5�,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each addirional$1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,0(}0 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,0{10,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B°: Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for constcuction 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 Certificate of Survey of the lot, showing the lacation of the foundation once it has it has been constructed will be required before proceeding with the framing. � � r� a� S i� .i ' I I ,. . \ � I I 4 �. . .�._ .__.... _"...1_.._ . j �_-- -_ , __ , �' �l� ' ' � � ( , � . � . _- � -- —_ __ : . , i ; .. _ .. , , --- I :i ' � � I , :. ._ _ — ---�- -- - ----- �---- . � : . � ' - - � ; .,� , � , � � ; -..__ ; , , � - � _ ;� j , ; I ! , � i j ' � � i �, � : i _ - _ `� ' ' -� �, _---._..;._ i- ___, _.__ - -- _. -~ +*. ,: -� . i i I � � I *. �i � , ; � I � E j I , � . � .:� .;. � I � __ __ � ' . : ., i. � . _ . � _ _ __ , _ �_ . , . . _ _ -- ,,; �, ��ill� , , I � , � � ____�__. � , ; i 1 .�, ,� _.�_1.�.�� _ "_ .� _ ._ �. ,.. .:._.._.._. � 1 ... .. l . .. I .' .. ... � � I I 1 � � 1 , � _ " I : . . :.`. �� i' � . � � . I � i i i _ .-_.._ . _ ..._ ' __ _ . � . . � _ . � � � � f . ' � i I , I ,. i � I. ..I. 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' _— .! 1 ! ;. . ;I ! i �; ; ; � _. , '; I j , , _ _ _ -�--- ; . i � I i , i . _ � -- ' 1 � ' -- � , • . � ' � �� . -. � . � ___,_,_.._ _ , i" . �� " � � ' � i I ' � � j ._ _� � _ l :r-- — �-- , . ( --- -- -- � _ _ I. �__ �— -..... ., „ . . � , . �. � ��r� _ � I j _I- .",. _l _ � _. �--�---�--! ; , , � .. � _._ _�_ � � . �� . _ � ,- ; -. • -i,-.�' i j � ' —. � , , , __, _ Building • Inspections 763-572-3604 BUILDING RESIDENTIAL APPLICATION CITY fJF FRII�LEY Permit No.: Received By: Date Rec'd: °�� °�? DATE � 1 I l I I U� YOURE-MAILADDRESS T] � S� P��dj e� I vn@� CV� srrE aDD�ss S 2 E� � � p► �°��, S�'�'(' e�f �° THfS APPLICANT IS: � OVJNER �CONTRACTOR PRO�PERTY O'WNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYP� PERNIIT TYPE d�R�1r�lE I-�� 5 anDxESS:__ S'2 6°i � i�'� L 5�° rl �: crrY �'2 �� u.:.,1i STATE�11a°�' .�5�'Z I PHONE: � G� . �� - �2� � N�:_ RENEWAL BY ANDERSEN sTa,� r�cF 1920 COIJNTY RD. "C" WEST anDx�ss:_ ROSEVII..LE, MN 55113 crrY_ Pxox�� 651-264-4777 o .�I.yIN�,o F�:LICENSE #20130983 �� QADDTI'ION ❑ GARAGElSHED WS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TII.E 0 DECK ❑ SIDING ❑ OTHER ❑ SWIMIvIING POOL rYrE oF wo�: I ❑ ❑ ❑ REMODELING DESCRIBE WORK BEING DONE: �L ��.�, �� }° W I�rOckJS r,� I��aC ' SIZE OF IMPROVEMENT NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl O Aluminum ❑ Other O HOUSE & GARAGE 0 ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia �TirIh'DOWS IN EXISTING OPENINGS�Yes �No LCICATION OF WINDOV✓S ��5 a OR FOR NEW OPIIQINGS-DESCRIBE SIZE OF OPENING CHANGES & " ATE ZII' HEIGHT BASEMENT REMODELING SUBMIT• 1. Existing Floor Plan 2. Proposed flaor plan 3. List of structura] members to be used F� FOR NEW CONSTRUCTTON 1NCLUDING DECKS, ADDITIONS. & PO1tCHES SUBIvIIT• I. Site Plan/Survey showing the existing structnres and proposed project. 2. Two sets of construction ptans 3. Energy Calculations TYPE OF WWDOW TO BE INSTALLED Id'dS�.T . NUMBER OF WII�IDOWS � I ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: ([TSING THE 1997 U.B.0 FEE SCHEDTJLE) TOTAL JOB VALUATION $ a��,(� OCCUpANCy TypE Permit Fee PIan Review Svrcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Ma.in Charge Total Due � ��. '� See Back Page for Fee Schedule $ 6S% of Building Permit Fee � 6,� I (A005) times the total job valuation — Minimum $.50 $ 3 -� `.j .001 x Permit Valuation (1/14%) __ $ �i-C9C � $5.00 (State Licensed Residential Contractors) $ $1450 per SAC Unit (Plans to MWCC for determination} � ft+6ft= ftx$20=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) ATon Necessary ( ) � Make checks payable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMTP-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclaiowledge that the information above is complete and a.ccurate; 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 pernrit but only an application for a permit and work is not to start without a permit; that the work will be in accozdance with the approved plan in the case of all work which reqaire�eview and.approval o€plans. SIGNATURE OF APPLICANT� � �" PR1NT NAME TI � SCIS �7-.I � '1P DATB � I II vo . Page 2- Building Residential Application BUII�DING PERMIT FEE SCHEDULE The Chief Building Official sha11, before issuing perm.its for the erection of any building or siru.civre, or for any ad�.ition to any existi.ng building or structure, or for -any al�ration or repair to any existin.g building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below sei forth an.d in the manner herein provided to-wit: TOTAL VALUE FEES $1 to $500 $23.50 (Mini.m.um Fee is $23.5.0 gl�s surchazgej- $501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $�00 or fra.ction, to and includin $2,000 $2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each addi�ional$1,Q00 or fraction, to and including $$25,000 $25,001 to $50,000 $341.25 for 1�` $25,000 plus $10.10 for each additional$1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 1�` $50,000 plus $'� for each additiona.l $1,000 or fraction to and includin $100,000 $100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for ea.ch additional$1,000 or fraction to and includi.ng $500,000 $500,001 to $1,000,000 $3,233.75 for the l�` $SOO,OOQ plus $4.75 for each additionai $1,OOU or fraction to and includin $1,000,000 $1,000,001 and up $5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional$1,OQ0 or fraction VERII'ICATION OF FOUNDATION Perm.its for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed stru.cture and of the constru.ction site. A Certificate of Survey of the lot, showi.ng the location of the existing fou.ndation will be required before proceeding with the framing. New Houses Onlv City of Fridley Buildi.ng Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 753-502-4977