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CORNERS WITH ELEVATIONS) BENCH LEVELS AND/OR TOPOGRAPHY SURVEYS LOT SPLIT SURVEYS AND/OR TOWNHOUSE SURVEYS BOUNDARY SURVEYS (METES AND BOUNDS, AUDITOR SUBDIVISIONS...ETC) ALTA�ACSM (AS-BUII,T) SURVEYS CERTIFICATE OF SURVEY �CRESEARCH CITY, COUNTY OR STATE WRITE LEGAL DESCRIPTIONS Date a� o� Land Surveyor The charge for services rendered is: �� 7)� Paid: ash Check Payment is due upon completion of survey or within ten days. Make Check out to: Paid in full on � a- �a Gary L. Backer, Thankyou, GB 6917 - 83rd Ave. No. Brooklyn Park, Minnesota �,RV �' 55445 Tele: 763-425-6427 REGiSTERED UND SURVEYOR 10948 . � ��� � � +���,� � ' >�` � , � ��L � �, 4 !+'FR'ls �.� f� � F' N ��; � ��.. 1 ,fy�jl� V � � 1t � , '„ e� .� � T� ` . 3 �,� Y 7f _ ,� %�N� � �� � �. 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BUILDING PERMIT NA 71 o s .: : <�� , � ' `� / �/ � � �� �, �� , ` _� � ,�' � ,, • � �S - >r �,i, ... /� �.� � i- s ��-,. .a� _...c ...� _ ;.R.r( � - .,,, / v,r�/ OCAT ON F BUILDING NO. ����.(L �,�"'�Qt �.��rCr� //lL�19/ �6 � �n ��; Part of Lot Lot .—�_ Block �� Addition or Sub-Dfv3sio����°� � Coraer Lot _ Ine�de Lot —� Setback �—� Sideyard �� � A Sewer IIevatian —_ � Founda.tioa IIevation i DESCRIPTION OF BUILDING To Used • �L��� Front �f Depth � Height � Sq. F't. Cu. Ft� Front � Depth I%igh,% � Sq. F� Ctt. F� Z�►pe oP et4on � Fst. ....� ��To be Completed In consideral3on of the iasuance to me of a permit to construct the bwllding descrlbed abave, I a to do th� proposed work ffi acc�rdance with the descript3on above set forth and in com ce wi a� one of ortliaances oP the dtq oP FrirIIey. - 1 � �J �'�� . In consfderation of the payment of a fee of $_,,L�s._� permit is hereby granted to to oonstruct the building or addition as d�crlbed above. Thia permit is granted upon the express condition that thep�o n to whom ft is granted and hia agents, employees and worl�en, in all work done in, around and upon said building, or any part ther�of, shall conform fn all r�apects t4 the ordinances of FrYdley, Minnesota regarding lacation, conatruct�on� alteration, ma3ntenance� repair and moving oP buflaings ordinance.a dty ]imits and this permft may be revoked at any tinae�up�n vio�a�e� of any of the Provisions of said n i � Suilding inspector NOTIC� 'llds permh dea eot cover �hs comlrodi�, �Stall�fm fe� trirtee, plumbtng, en hupne, rewu ee watsr. B� wre to ss� da &rildie8 I�te� hr apud� p��s hr fh�ss �nn. ., 1• ,.� � � oe s .� . � �� da � � �� e p � � � � � � .� �• � V � � �O � � � o. _�. � � � � � � � a � 00 0 0 A � 0 W _ H W � J H � a V I \ � ��� � � � � .a � �, � � °: F � ��� °��� � ����� a���� d �3 �o��Q m�%�M a��� � ��� � � �x� � > ���� � a o. Y A��•� �,��� , .� � ���� ��A � � ���� � � � '��'oo� . �� h � ���� o �, � ��� m � � � � � I� ► � � z � � � � � ��� � � � � � U � � o � a�i O� . � � � SC b F W � i � � E I s�s v�a Qsa �as �a � o °o °o, � °o o °o o° u°� � CD W te] CV 00 N 4� 1[� CV : : : : � : : : : . . . o � : : : g : ' $ o � : ' d g . . e � : g ees : : � .t; � � : � ,� aa � .° °�° .� � � � � � � � � � � v � � ..� �� �� �� � � � .d � ,� � � .� .� � o w d � � � o �� p�¢� � � "�3�3 a � � � � � � � ; � � �� a � a �� �� ,��xr�a � a�ar� � � O W O O a v a sr� c� v� �r °o o i°n i° o° DO CD G�7 GV � : � : : ,a�,� � : : � � : : � � � � � � � � �'��� 0 `" m v� �; ����� ��;��� � � �f v�i m E+ � °� c°� M � � � N d O v v � � � � � w� w � _°.�:a :�. � � z � I � z � � � � i T r 25 : � :� :� : � : W :� .�°� � �� a � a n�n � M M � H a o � av .a O � � G� � � � o � 0 �� i5' � �' � c�a U � �: x O � �1 z �; � 0 a � � N a � � � y � a a a � A O � ���^a � � � � Q C9 �O i � � � a° �► � � � I U � H � a o ', � v} �, s� �r �ss °o RG � � o LL� �-i � N fl} ; p� aa ia �e � : '� : v : � : . . . w � �� � � � � �� R� 1 U °� � : : � o . o o :�o O � � N � � .s ���s R' � � c0 b�AJ � O R} � � ai � ��� � � w � � � � a C9 C9 � e� � � H � 4 c���� � � � � �o.a � � m 'Li-�' H ►''�".� O e � H �,' U "«� a � z � � � w � 4 01 o�c �W G� p .^°r�� !�1 � � GQ � � � � 0 .+ .� - ��� /-f��-� CO� ��z�� ��7-��6,��'� n:s6 ' ' HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E, Coastruction No. Guide Windows Doors Reference Out. WaU Iat. Wall Ceiling Roof F1oor Kind Yes—No ( Yes—No 19_ Fl.{ '�-�, Rot�m � Length / Width Height � �'_Fl,� .,�`�s��,�' Room � Length Windows and Doors—Crackage and Area o�' Windows and Doors—Crackage �Vidth Hetght No. of Llneal f. Ares ��� Wldth Hatght No. ot LI No. ot pane of pane lighte oP crack eq. ft. .�� o. ot pane ot pane tlghte � o: � � � �'r � � �' A�„� �� 4a..� � '�,� � �� Coef. Btu Infiltration � � i 6� `� 1n61tratinn Glass �^� � �'� Exp. wall �; ' ' Net exp. wall � - � �� °`' � �'� Int. wall Ceilin� � Floor �' �° � � " Total Btu. � '° Required sq. ft. �.D.R. or sq. ins. W.A. Leader area � F7.� �� �. Room � Length idth � Hei Windows and Doors—Crackage and Area WSdth Height No. of Llneal Lt. Area No. of pane ot pane llghta ot crack eq. ft. _�. °�� �°�� �1 �� - . .._�. _. . _.... � In6ltration � � Calass p �1 6 Exp. wall �a�� �"'� � � a;'� r� Net esp. wall � � Int. wall Ceiling Floor �' / �;, � � Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. �' �, � Room � Length Width Windows and Doore—Crackage and Area Wldth Aelght No. ot Llneal ft. Area No. of yane of Dane Ifghte ot crack sq. ft. Infiltration Glass Exp. wall � � `; Net exp. wall Int. wall Ceiling Floor Total Btu. �_ P � Required aq. ft. E.D.R. or sq. ins. W.A, Leader area �� Glass F.sp._wall ,��u �' ��`- - ;� Net egp. wall _ Int. wall Ceiling � Floor , �-� ����;,, � Total Btu. NQNrIF.APOL.IS. NIIIVN. Insulation How j Width Area t. Area a eq. [t. Coef. Btu ' � ����� � � � ,��� ��y � I �`�' �,: -- - -- - - "�� � � � � -� - Required sq. k. E.D.R. or sq. ins. W.A. Leader area _ / Fl.l � ,�r,r �'�a,�Room ( Length � � Width r °°"'� Height Windows and Doora-Crackage and Area Width Height No. ot Lineal tt. Area No. of pane of pane llghte ot crack efl• tt. � :�`°.� .4 �,; r� .�.o- G-,�� 3 t . . :"i:'• > .... . . � ., ,. _. - � _ � . � � . . . � oef. Bhi ._ - � Eoef. E Btll l ,( / �` � � Infiltration �'re 6 �a �t�. ''� Glass ' � „'� < � .- Eap.wall ..� �°.,`,.�'-- �,,, P; �' Net eap. wal� � - � �'� � - Int. wall Ceiling � Floor �. � i1r'- � �;, ",� - � Total Btu. Requued sq. ft. E.D.R. or sq. ins. W.A. Leader area _ Fl.� �,/,� Room I Length Width � Heigt - Windows and oora—Crackage and Area �'� No. opa e ot pane Ilghte ot cr ek ar Lt. �.'I ra +� 0 r +i. e d _ �� �. - � '� .�� Coef.l Btu Infiltration o` �i , � , -. Glass � ,� Exp. wall �;' , °� � Net exp. wall Int. wall Ceiling � � �, °° Floor 7otal Btu. Required sq. fe. E.D.R. or sq. ins. WA. I.eader area � . � :T D•36° � v HEAT LOSS CALCULATIONS DEPARTMENI' OF BUILDINGS NIINNEAPOLIS. MINI�i. Weatherstrips A.S.H.V.E. Construction No. Insulation _ Guide II Windows Doors Reference Out. Wall Int. Wall C,eiling Roof F1oor Kind How � Yes—No I Yes—No 19_ .a-Fl.� �`,C'�oom � Length Width `'j Height Fl.� �" �'� Room Lengt6 Width Windows and Doors—Crackage and Area Windows and Doors—Crackage and Atea �Vidth Helght No. oP Ltneal ft. Area Wldth Haight No. oE. L1nea1 ft. Ares No. oP pane of pane llghte ot crack eq. ft. No. ot pane of pane lighte of crack eq. ft. ' � ` - � � � ` � � � � Coef. Btu ( Infiltration 'f � � It►filtration / � Glass � �� t�� � Glass � E.�p. Wall ` _ j►P __Fsp._�vall `� - � � - ��� � � �Vet ex#�. yva7l = ---. � � Net egp. wall �; Int wa11� � ' Int. wall r � Ceilii�� -;� .� a� %� � � � Ceiling �o '�" � Floor Floor Total Btu. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. #t. E.D.R. or sq. ias. W.A. Leader area Fi.�e-;- �� Room � Length ,(� Width �/ Height -�—�__ �.� ��,�e,f f� Windows and Doors—Crackage and Area Windows and W1dth Hefght _ No. oY Lineal tt. Area Wldth ] No. ot pane - o[ pane lighta of crack eq. ft. ,, � 6S � � f r,.� • '- �._No. of D ne a �� � �• i �� (� � � r � �k_ � Coef. Bha Infiltration ` � � Calass � Exp. wall �'° Net esp. wall � � Int. wall Ceiling i (r_� 1� / / °�' � Floor Total Bfu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl• .,,,��°:,-�;? Room � Length � Width Z Wiadows and Doora—Crackage and Area Wldth Hefght No. of Llneal ft. Area No. ot pane of pane Ilghte ot craek eq. ft. �� C✓ '� � = ' - � co� Infiltration ,� � Glasa � � � t Exp. wall °�. _ � �'1� Net eap. wall � � Int. wall C�ilin8 � C°' �,/� C Floor '� Tatal Btu. � ' Required sq. ft. E.D.R. or sq. ins. W.A. l.eader area Glass Eap. wall � , Net exp. wall Btu e�R �- � � Length� �°°� Width ` � Height �� -Crackage and Area No. o! L1nea1 [t. Area ltghte ot crack eq, ft. � -�- "� � � '_ - r �', � � °`"� - - � � �: Coef. Btu � `� '�,�i� (� � � � � [J � �`c° =� � Int. wall _ " Ceiling � ;,�,! � � �(� � � � Floor - _ -_ ?otal Btu. "� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ' � Fl.� �'P�° - I Length Width `� Heigh ° Windows and Doors—Crackage and Area Wtdth Helght No. ot Lineal ft. Area No. af psne ot pane lighte ot crack eQ. tt B� I I I � � �`' Infiltration � � Glass Eap. wall �° c �'a�� �.�•-- .�- +� K�_ � Net exp. wall Int. wall '� Ceiling � �!'�� Floor Total Btu. _ Coef.l Btu Required sq. ft. E.D.R. or sq, ins. W.A. Leader area � ��,�� � 11� .i ___ � � d� � �!� � m � ��� � e� � �� � � � � � �� �a �. � � � � � �� � � ",� � � � � � � '� � � � � �1 '� � � � � � � � � .�1 � � � t� ��� � �� � �� 0 a�� ��.. �u� w��� �� � �3� � � � � �p��+ a��� .� a s �u�� ���� V u vi � a~�v Q 63' y'O.� � . 10 a .,, c�, � �� �30� = ,' � c � .���� u � °"� c s'°R�o V r � y ��A c cs,a � 'b���3 � QJ 4 ►. "' � :r tC � A` � • � 69 Y � y C � 0 � � � � � « o �o v U v�i t�o � � .� ���88 �o��� p . . : � °o g � � 'o 'v r W i � � � � . � � " � �" �° � � � � M w � a < �� ��•� � � � � � � W - a a � � a` r� c! Cv I � ' O VJ � � � � � a w ����� o:�mmM N � • � � . � � .� � � � � � W � � � � � � � � � � � � ������ v � d Q � � � � � � � � � � �� ���` � S R a E t�i F � � U � G w . 0 x a" Z � a � � � � Y � ,O � v+ vi vb w ��sg O O F C!.1 d> ~ d � � �- V1 ,,�, a a q w " � � : a � °' $ � � � o � " Q� s e� V1 'x � � g � a � w �a a ;� � z � � �iS o�e �i ,� � N M � N x � � ae d '�O � Q � W � � ���w� � z � � � � 0 � � �o 0� O � � w � � � � �r � L .�e ° 0 � r � � .� � � e'f � � M Fo � O � � a co a 0 z � d ro � � � � � � a � � \ . � � � � O .� "y ~ � � r► � w e► w � � � � 8 � � N � � O M � M �.�j � � I � � V � � , N � � d W td �� m .o�► I� E�+ �i � �� ��� �� � � � �� � ii p � M � � � x � � � M ."'1 OG � � � '� V � � v � _:. , � � � _ � g. � i � , »r � � � � . � x ;4 � � ww � :� ��; � � Q � ' " � SUBJECT - � � � � c�ty of Fridl�y AT TNE TOP OF TME TWINS ��J I L D I N G P E R M i T r � . � � � `v __��__ COMMUNITY DEVELOPNIENT OIV. ���_�604 1 j � PROTECTIVE INSPECTION SEC. � � . , l--_-�; �'�' �-� CITY MALL FRIOLE� SS�32 NUNBEN REV O�TE P�GE Oc L 612-571-3450 910-F15 7/17/O1 � / J08 ADDRESS 6057 Central Avenue NE . t LEGAL �OT NO. BLOCK TRACT Oii AODITION oesca. 2 1 Blacl�an Addition 2 PiiOPERTY OWNER MAIL ADpR�S$ ZIP Bob Hagetvedt 6057 Centra.l Avenue NE 3 CONTRACTOR MAIL ADDRESS 21P Westurn Cedar Supply 9700 13 Ave N, Plymouth MN 55441 a ARCHITECT OR DESIGNEp MAII AODRESS ZIP 5 ENGINEER 8 USE OF BUILDING Residential 7 CLASS OF WOfiK ❑ NEW ADORESS "32005 R EI T NO. � •VVqOVEO Br SEE ATTACFIED SMEET 571-8638 PHONE LICENSE NO 763-541-0304 PMONE LICENSE NO. 20155566 PMONE LICENSE NO ❑ ADDITION O ALTERATION �7 REPAIR O MOVE O REMOVE 8 DESCRIBE WOfiK Reroof House & Garage (28 Sq) Tear-off 9 CHANGE OF USE FROM STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST SEPARATE PERMITS ARE fiEOUIqEO FOR EIECTR�CAL, PLUMBING, MEATING. VEN7I�ATING OR AIR CONDITIONING. THIS PERMIT 9ECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING AUTHORIZED IS N07 COMMENCED Y�!ITHIN 80 DAYS. OR IF CONS7RUCTION � OR WORK IS SUSPENDED OR ABANQONQO fOR A PERIQD Of 120 DAY$ AT ANY 71ME AFTER WORK IS COMMENCED. " NO DWLG. UN I HEREBY CERTIFV TMAT I MAVE iiEAD ANO EXAMINED TNIS APPLICATION 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS QF LAW$ yqLUATION AND ORDINANCES GOVERNING THIS TYPE Of WOFiK WILL Q� CpMPF,lEO WITH WHE7MER SPECIFIED NEREIN OR NOT. TME GRANTING OF A PERMIT �2 f863 DOES N07 PiiESUME TO GIVE AUTMOqITY TO VIOLATE OR CANCEI TME pEfiMITfEE PROVISIONS OF ANY 07MER STATE OR LOCAL LAW REGULATING CON• STRUCTION OR TME PERFOFMANCE Of CONSTRUC7ION �83 . ZS PLAN CMECK FE „ License S�GNATUpE OF CON'AACTOp OA vUTMOpi2ED eGENi IDAfE� _ ,u�. ��� OWNEA �URDEN� �DAi6� . � � SO. fT STALLS $5. V OCCUPANCVLOAD CU FT OFFSTREET PARKING IGAFAGES $1.43 SAC CMARGE Fire SC $2.86 T9�TAL FEE / $92.54 )A D TNIS IS YOUR PERMIT �� � L � � NEW [] ADDN [] ALTER [ ] Effective 1 /1 /2001 CITY OF FRIDLEY (763) 572-3604 Bidg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: �0� ! �ev� �i' � l� �� Legal Description: Owner Name & Address: _�� �05 � 7��P�77� Tel. # S� f" 86�� Contractor: ��S�F� Cc-�iy� �'��� MN UCENSE#_ �a'/5.���,F;- Address:_ �>� r3�� f+s - t��o�- � S..s�/�// Tel. # 7� 3-.SY�-a 3o�t LIVING AREA: GARAGE AREA: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft DECK AREA: Length OTHER: Width �_ Hgt/Ground Sq. Ft. .._-- v i Q Construction Type: %������°� Estimated Cost: � l �-s �C��� Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$ DATE: � � �APPLICANT: i��vl �� Tel. # CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application � � 3- a�� Fee Schedule on Reverse Side - $ �v� .001 of Permit Valuation (1/10th%) $ / �3 $.50/$1,000 Valuation $ $1150 per SAC Unit $ 5� 6�j $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 � �'o�•Sy 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 $2,001 to $25,000 $25,001 to $50,(�0 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $5(�,000 $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 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 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. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. New Houses Onlv -�- , � NEIN [ ADDN ] � ALTER � s CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-Z BUILDING PERMIT APPLICATION ,��` 90�� Effective 1/1/2001 (763) 572�604 Bldg Insp Construction Address: �Pds � � ���``�"' L �-� "�� �`J�`� Legal Description: Owner Name 8� Address: L°�v' Tel.# J7l ���✓� Contractor: MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LNING AREA: Length Width Height Sq. Ft GARAGE /�1REA: Length Wdth Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: Estimated Cost: $ ��ve��vSV Gurb C�t Width Need�d:°2OFt. + 6 F# _��t x�/.�J�U =$ 3• � ��� DATE: D a` ��� APPLICANT:�L7� �������`' Tel. # S 7! �C�;✓ �� CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ Fee Schedule on Reverse Side -- -- Fire Surcharge $ .001 of Permit Valuation (1110th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1150 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [) Not Necessary [] TOTAL STIPULATIONS: $ 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 applicarion 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 $2,001 to $25,000 $25,001 to _$50,000 $SO,QO1 to $100,000 $100,001 to $500,000 . � $500,001 to $i,000,000 $1,000,001 and up FEES $23.50 $23.50 for first $5� plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,(�0 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $1�,000 $993.7,5 for first $100,0(?0 plus $5.60 for each additional $1,000 br fraction t�ier�euf, icranat inciud'mg $St70,G�tl $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 $1,000,000 plus $3.15 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. Altema.te "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 $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Cert�cate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. New Houses Onlv c�ty of Fridle� AT TME TOP OF TME TW�NS � i � � • COMMUNITY DE�ELQPNIENT DIV. i ; V �'��� , . . . f � � PfiOTEC7IVE INSPECTION SEC. � i . � �"'1 � CITY HALL FfiIDLE� SS�32 �'.---� • •,, 612-571-3460 �U ILDING PERMIT NUMBEF REV OATH vAGE Of 910-F15 12/3/O1 / / 108 ADDFESS 6057 Central Ave NE � t LEGAL ��T NO. BLOCK TFiACt OR AODITION oescA. 2 1 Blactcman Addition 2 PiiOPERTY OWNER MAIL ADDRES$ Robert HObelvedt, 6057 Central Ave, Fridley, MN 55432 3 CON7RACTOH MAILADORESS Lloyd's Home Improvement, 1012 42 1/2 Ave, Columbia He e ARCMITECT OR OESIGNER MAIL ADDRESS 5 ENGINEER 8 USE OF BUILDING Dwelling 7 CLASS OF WORK 8 DESCRIBE WORK Deck 9 CHANaE OF USE FROM STIPUlAT10NS ADDRE$S PERMIT NO. 32344 RECEIPT NO. �� ��„ AVpROVED 8r SEE ATTACMED SHEET 763-571-8638 ZIP PHONE LICENSE NO ts, MN 55421 763-788-56C ZIP PMONE LICENSE NO. LICENSE NO C� NEW ❑ ADDITION O ALTERATIpN O REPAIR O MOVE O REMOVE See notations on plans. TO ������� �efore diggin� cala for all �tility IQ�ation� 45Q�0002 REQ!l�RE� �Y LA1�/ SEPARA7E PERMITS ARE REOUIRED POR ELECTRICAL, PLUMBING, FIEATINCi, ''r� vr �••�'• VENTILATING OR AIF CONDITION�NG THIS PERMIT BECOMES NUII AND VOID IF WORK OR CQNSTRUCTIOM zONING AUTHORIZED IS N07 COMMENCED VyITHIN 80 DAYS. OR If CONSTRUCTION OR WORK IS SUSPENDEO OR ABANQONEO FOii A PERIOO OF 120 DAV$ A7 ` ANV TIME AFTER WORK IS COMMENCED. ' NO. DWLG. UNITS I HEREBY CERTIfY TNAT I HAVE flEAO AND EXAMIN�D THIS APPLICATIQN AND KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS Oi LAW$ yALUATION ANO ORDINANCES GOVERNING TMIS TYPE Of WpRK WILL QE CpMPUED WITM WHETMER SPECIFIED MEREIN Oii NOT. TME GRANTING OF A PERMIT $3,450 OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqMtT FEE PROVISIONS OF ANY 07HER STATE OR LOCAL LAW REGULA7ING CON- ST UCTION OR TME PERFORMANCE OF CONSTRUCTION $9].2S - PLAN CNECK FEE � -� ( � Licen ' SiGN4 RE OF CON'RACTOp Oii 4U1N 2E0 eGENT �O�iEr ueu ai �o.,e� FT S7A�LS ROUP OCCUPANCYLOA CU f T DffSTREET PARKING IGARAGES SURTAX $1.73 SAC CHARGE Fir�ISC $3.45 TO�F E E 107.43 THIS IS VOUR PERMIT :• /�` -3 -a/ NEW [ J Effective 1/1/2001 ADDN [ J , CITY OF FRIDLEY ,(763) 572-3604 Bldg Insp ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: �� �� � U � ���z-����, �`��- �/ � I Legal Description: Owner Name 8 Address: �`�' �'��i` �( G Tel. # ,� .3� � � I �� �3 � Contractor. `��(:� 1� C�-�: c'� ��v`u�' 1 MN LICENSE #� U� l`� y� Address: r � � d `� d �� �.� - � � � E%^�:'�-�.�..[:� ��=� Tel. # � `� 7 g� � � �� LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the p�oposed construction drawn on it to scale. -� DESCRIPTION OF IMPROVEMENT Length Width Height Sq. F� Length Width Height Sq. Ft. Length 3� Width i �� Hgt/Ground b Sq. Fk Construction Type: � o��, ���..-�� Estimated Cost: $ �`7``� � Driveway Curb Cut Wdth Needed: Ft. + 6 Ft = Ft x� _$, r � � /�, DATE: � APPUCANT: rJ���°e�C� ���. i'F' Tel. # % � j � 8 � `5 C � � CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $ �o�� Fee Schedule on Reverse Side $ - 5 .001 of Permit Valuation (1/10th%) $ /. z�_ $.50!$1,000 Valuation $ $1150 per SAC Unit $ �0� $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 [ ] � G� . ,..3 BUII.DING PERMIT FEE SCHEDULE The Chief Building OfFcial shall, before issuing pernuts 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 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $1�,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $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 $1,000,000 plus $3.15 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 $15.50. 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City of F�ridl�� 3 24 9 9 � AT TNE TOP OF TNE TWINS g u I L D I N� P E R M I T ; � RECEI O. � • COMMUMITY DEVEIOPAMENT DIV. ��� , � j V �'��� l � � PROTECTIVE INSPECTION SEC � j �"'1 � CITY HALL FRIOIE� 53132 NUMBER pEV O�iE o�GE O� �PVROVED Br �"'"'�� �'' 612-571-3450 910-F15 4/11/02 / � JOB ADORESS 6057 Central Avenue NE � t LEGAL �OT NO. BLOCK TRACT OR ADOITION SEE ATTACHED DESCR. 2 1 Blackman Addition SHEET 2 PpOPERTY OWNER MAIL ADpRES$ Z�P PMONE Robbie Hagetvedt 6057 Central Avenue NE 763-571-8698 3 CONTRACTOR MAILAODRESS , Z�P PHONE LICENSENO Standard Water Control 53.37 Lakeland Ave N, Crystal, MN 55429 763-537-4849 1522 4 ARCNITECT OR DESIGNER MAIL AOOqESS ZIP PMONE LICENSE NO S ENGINEER MAII AODRESS 21P PMONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WOFiK ❑ NEW O ADDITION �] ALTERATION O REPAIR O MOVE - O REMOVE 8 DESCRIBE WOHK Install drain tiie 9 CHAN(iE OF USE FROM TO STIPULATIONS ��rmif �nspection � IlV�ll �� �rds 1'o Hor�co Ma�led wner To Po�� SEPARATE PERMITS ARE REOUIqEO FOii ELECTRICAL, PLUMBING. HEATINa, TYp� GF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OFi AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WQRK OR CONSTRUCTION tONING SO. fT CU fT AUTHORIZED IS NOT COMMENCED Vy1THIN 80 DAYS. OR IF CONSTRUCTION ; Oli WORK IS SUSPENDED OR ABANqONEO FOR A PERI00 OF 120 DAY$ A7 '' ANY TIME AFTER WORK IS COMMENCEO. ' NO DWLG. UNITS OFFSTFEET PARKING I HEREBV CERTIFV THAT I MAVE REAO ANO ExAMINED TMIS APPLICA710N ]. STALLS GARAGES AND KNOW TME SAME TO BE TFIUE ANO CORRECF. A�L PflOVISIQNS OF LAWS yALUATION SURTAX AND OROINANCES GOVEFiNING THIS TVPE Of WORK WILL B� CpMPIIED @ WITM WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT W3s8SO �1.9Z DOES NOT PRESUME TO GIVE AUTHOFiITV TO VIOLATE OR CANCEL TNE pEqMl7 FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW qEGULATING CON- @ STqUC710N OR TME PERFORMANCE Of CONSTRUCTION y��7.25 F re SC �3.SS PI,AN CHECK FEE T � FEE Lice C . U $108.02 S�GN4TUAEO�CON7RACTOpON4UTMOp�2E0oGENT IDAT6 HE PFO � VALI D TMIS IS VOU PERMIT _ (� � , I S�GNATUaE O� OWNEp��F OWNEp8U4DEAi IOATE� ' , B ��NSp ' � � qc1E FROM : FAX N0. : 7635371882 Apr. 10 2002 12:27PM P1 �a-�t° Fax Note 767'2 To � �„ I�� ��.,�s,�. ���: ,:1.:; ��,.��{ a From � I��� ���%l�� i�m�, f�� �� � I -� ��, � �� 'Fait� . Ta�er�se ... �� T_� / � :� .. ... . Q]' � . . � . . ... . ... ��y9 � .� :.... . . . .. .. .. _.. .. �� �� .. .._. _. .. . . �. :_.._..� _._ .... __. _. _ . ... _ . ... �� �� . � a � . .... ; P��. C�o..� .►� .. .��:. co� .,�,,�,x, b�on..�.. _ ... . .. . . . . . .... . .. _. �._ - �... �'' ... .__..__ .. NEw t1 ADDN (� ALTER ( ] Construction Addrass: Legal Description: Owner Name 8 Address: Contractor: _,j �GC�"� cmr oF FRio��r �c;�e �i�rzaoz 6431 University qve NE, Fridiey, MN 55432 (763) 5723604 Bldg Insp SINGLE FAMILY ANO OUPLEXES R-1 AND R-2 BUILDING PERM(TAPPUCATION �� �l°3'-5 �l /°�? � Tel. � � _ � /- i MN UCENSE� a�, Tel. � �.lo. � �%�- � �/ Atfiach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF 1MPROVEMENT LNING AREA: l�gth Width Hei9ht r Sq. Ft � '� GARAGE ARFA: Length Width Height Sq. Ft DECK AREA: Length Width HgtlGround Sq. Ft OTHER: Construction Type�rOl+ r`,�� �-2 Estimated Cos� $ 3 d, � Driveway Curb Cut Width Needed: �FL + 6 Ft =_Ft x$ = g DATE: APPLICA�IT; Tel. �%!�/.3 , 7�y 9 . / Ca(I (763} b72-3604 for Pemtit Fees if mailIng in application or Fa�c ta 763-67l-1287 if using c►edit �ard and we wiil call you for card number. CITY USE ONLY - Permit Fee $���,?,� Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/lath%) State Surcharge $ �-- $.50/$1,000 Valuation SAC Charge $ � $1200 per SAC Unit License Surcharge $,�`av $5.00 (State Licensed Residenfial Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee � Fee Determined by Engineering Sewer Main Charge � Agreement Necessary j j Not Necessary j] TOTAL 5 O' ��'� STIPULATIONS: ��� �d'�� J��I � 3�� D�i ��~ t� • ADDRESS PIN LEGAL DESC PERNIIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, NIN 55432 s�i-36u4 r��: : 6057 CENTRAL AVE NE : 243024210010 : BLACKMAR ADD : LOT 2 BLOCK 1 : ELECTRICAL : RESIDENTIAL : ADDITION/ALTERATION 571-1287 PERNIIT NO.: 2004-01792 �� ! 1 DATE ISSUED: 10/OS/2004 VALUATION . NOTE: ELECTRICAL PERNIIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL A SAVERS SWITCH. # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORPORATION 2300 TERRITORIAL RD ST PAiTL, MN 55114- � dL: HOGETVEDT ROBBIE J 6057 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 applicarion and lmow the same to be true and correct. All provisions of laws and ordinances 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. Applicant Date Bldg Insp Date � c��n � n � mc nr. n w wTmcv T T!!1T TiT Tr ,-. ELEC PERMIT FEE - MIl�T (RESI) STATE SURCHARGE, ELEC FLAT TOTAL PAID WITH CHECK # 118132 ��� � �... _ � �. �......aa a u iW � V i1�LiL 1' Vl\ rv v1� v 1 i1Gri 1 I1ti1V L�Jl.1CLI3L" 1J iyJ,s V V L" . 20.00 0.50 20.50