AF - 43914�i
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City of Fridley, Minn. ,
BUILDING PERMIT N° 3 fi 6 7
�te: .�'-..� ���.—.� .................
�,� _
owner ���'{ .Y.�Ot . . . . . . . . . . . . . . . suilaer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Addre� ................ ..................... Address ..............................................
. LO�CA►T[O�N OF BUILDING
No. . �%'.� 7 / , St1�����i2,✓'� �:!\.. ..�. . /.��. .<:� . . . Part of Lot . . . . . . . .. . . . . . . .. . . . . . . . . . . . . . .
�� ... Biack ........... .... Additton or Sub-Divlsion ........ ......
Lot ......... ... ............. .........
Corner Lot . . . . . . . . . . . . Inside Lot .?�'. . . . . . . . . Setback � ��� . . . Sideyard /. �.1. : ��. .� . . . . . . . . . . . . . . . .
DESCRIPTION O� BUILD[NG
To be Used as: t a// / t�
�a � e / a t1 � �4,0
,�� . . . . �om � � : �' � ne� .'�G �• '� x�nt � �' � � . sq. r-c. /. �: .7.�. c�. �. �� ./.�! . �
��� . . . . . . . Frptrt �G I: . ���` Depth �.�.- .°� � Height .0� : � �� Sq. F`t. .�� � . C�. F't � o /4Z � �+�
Tj►pe of Construction . �/t�^: "�-, . . . . : l�t. �. .�./�.��� . � . . . . To be Completed . . . . . . . . . . . . . . . . . . .
,���.� /� `� ���� -y� � � � �� �� / .�����, �3�
- � � �P� �y ' � �`�
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C-riZP � � r � � C� � � .
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In consideration of L'he issuance to me of a permit to construct buiiding desribed above, I agree to do
the proposed work in accordance with the description above set and in compliance with a11 provisions of
ordinaaces of the dty of Fridley.
.. ..t��.:�' ........................ .��..
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In consfderation of the payment oP a fee of $. .:3 �.�•., permit is hereby granted to ... .. .. .. .. .. .... ..
. . . .. .. .... .. .. .. . . . . . . . . to construct the buflding or addition as descrlbed above. This pernnit is granted upon
the express condition that the person to whom it ia gi�aated aad iiis agents. employees and worl�nen, fa 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, conslruction, alteration, maintenance, repair and mov3ng oP buildings with-
fn the dty limits and this permit may be revolced at a�y time upo viola.tion oE any of the prov3sions of said
ordinances. � �
' Building Inspector
/.f �� --- "
NOTICE:
Thls permlt does not cover the construation, Inatallakion o� alte�atlon fo� wiring, plumbing, gaa heating,
sewa� or wate�. Be su�e to see the Bullding Inspeotor�at..gep�rate parmlta for these Itema.
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I he�eby cextifp that t�is is a true aud cc�rrmct plat oY a survey oP t3�e
South lA0 feet of the No�th 1►54 feet a,f t�at part of f#overnmet�t Lot 1, Section
21�, To�nsiii.P 30, �S� ��s �Y�B '�Jesterlg' oi' Highwap No. 65 t�x �o�n aa oa.a
Ceatral Avernie� r3gk�t of Way, ae st�vi�ye� _by me this 12th day of . Novebb,�,__l9�
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CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
PERMIT .: 004-01026 +
DATE ISSUED: 07/02/2004
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 6044 CENTRAL AVE NE
PIN : 243024210004
LEGAL DE5C : UNAVAII.,ABLE
: LOT BLOCK
PERMIT TYPE : BUII,DING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING
VALUATION : $ 3,473.00
NOTE: UNDERLAYMENT AS PER STATE BUII..DING CODE. REROOF HOUSE & GARAGE (30 SQ) TEAR-OFF
APPLICANT BUII.,DING PERMIT FEE 97.25
TANBERG JAMES & SHERRYL FIRE SURCHARGE 3.47
6044 CENTRAL AVE NE STATE SURCHARGE, VALLJE 1.74
FRIDLEY, MN 55432 TOTAL 102.46
PAID WITH CHECK # 4026
OWNER
TANBERG JAMES & SHERRYL
6044 CENTRAL AVE 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 laiow the same to be true and correct. All
provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The
granting of a permit does not pre e to give authority to
violate or cel the provisions f any o er sta or local law
regulating ction or th ce constru 'on.
Applicant Date
Bldg Date
EPARATE PERNIITS REQ FOR WORK OTI-IER THAN DE5CRIBED ABOVE.
N�n► Il
ADDN []
ALTER [ ]
Construction Address:
Legal Description: _
�� ���
CITY OF FRIDLEY Effective 4/1/2004
6431 University Ave NE, Fridley, MN 55432 (�63) 572-3604 Bidg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMITAPPLICATION � �DO y�fbo'�b
��`C�r� � L /�`U L.=
�
Owner Name 8� A ss: ,�.J ���� . / �/��1� � Tel. #�� � � �/ S � ��/
Contractor. � MN LICENSE #
Address: T�I. #
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
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
c:onstruction i ype: tstimatea c;ost: �,
Call
you
Curb Cut Width Needed: Ft +
3) 572-�604 for Permit Fees if
card number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
= Ft x
application. Fax to
CITY USE ONLY -
_$ �J �
�� �
�
Tel. # �k� � � / ��.�
if using credit card and we will call
$ �%. �� Fee Schedule on Reverse Side
$ "� 65% of Permit Fee
$ _�`� .001 of Permit Valuation (1/10th%)
$ � ` $.50/$1,000 Valuation
$ $1350 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 [ ]
,..
$ �(��< < STIPULATIONS:
BUII.DING PERNIIT 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 $2,0(�0
$2,�1 to $25,000
$25,001 to $50,000
` $50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
�.�:
$23.50
$23.50 for first $500 plus $3.05 for each addidonal $1� or
fraction thereof, to and including $2,0�
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,0�
$391.25 for first $25,0(� plus $10.10 for each additional $1,0(�
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.� for each additional
$1,000 or fraction thereof, to and including $100,0�
$993.75 for first $100,�0 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,�0
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,0�,000 plus $3.15 for each additional
$1,000 or fraction thereof
CURB CUT ESCROW
(Concrete C�rb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate
Permits for construction 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.
VERIFICATION OF FOUNDATION
A Certificate of S�rvey of the lot, showing the location �of the existing foundation will be required before
proceeding with the framing. New Houses Onlv
�