AF - 37063N° 641
Bullder
� �
viva�e ot Frtaiey, �.
BUII.DING PERMIT
ORice of INSPEGTOR OF BUII.DIN(iS
FHd]ey,
LOCATION OF BUILDING
, _ _�? 7 --�- �7 r.
� ' y ( 7 e�( _ c _ Part of
No. � � ��-= �` G�- 8treet '� -� � �
:� �°"a
Additlon or SutsDivislon
''•, DESCRIPTION OF BUILDING
' 1B_
Front . Depth Height � Stodes Manner oY Coastructlon
�
To be ueed as To be completed � Estimated Cost �
.. .
Permit te hereby granted
the building � Eescrsbed in the above statement. 'Thie permlt ie granted
upon the expresa conditlon that the peraon to whom it 1s granted, and his ageata, employees and vcorlmien, ta all
the work doae (a, around and upon said building, or any part thereof, ehall conform in all respects to the ordf-
nances oP Fridley, ffifna., regarding tLe conatructioa, alteratfon, maintenance, repalr and moving of buildfnge
withla the city ]lmita, and thfe permit may be revoked at any time upon violation of any of the provleione of said
ordinancee.
" - Inapector of Buildings.
AGREEMENT AND SWORN STATEMENT
In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above permit, I hereby agree to do the pmposed work in accordance with the description
above set forth and according to the provisions of the ordinances of Fridley, and, being 8rst duly
sworn, I hereby state and say that the facts atated by me and contained in the above permit are
true as therein stated.
Subacribed and aworn to before me at Fridley, Minnesota,
day of A.D. 19_�
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5431 Ut.IVEASITI' AVE��lUE N.E., FHIDLEY, MI�NESOTA 55432
TELEPHOI7E (B92)571-3450
' Seyt'ember 12, 1980
�
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'rir. Dick W. Afarquardt
b588 l'.entral Ave.nue N.E.
I'ridley, P!N 55432
Re: Hard Surface ll:iveway at 6585-92 Central Avenue N.E.
Dear :Ir. Marquardt:
YoU have recently ^eceived 7our 1980--1981 license reneval apnlicatioa for the
rental property loczted at the aUove address.
The City has compie�ed a recent field inspection of this property and noted
t}tat }'ou still do not l�ave a hard surface d�ive�aay. City Cod? Sec:ion
205.0&5, 3A, states "A properly maintsined hard surface drivecaay and parking
c[alls are raquir�d for each dweilin� unit."
7'neretcre, this letter is to serce as notic� to you that we are requiring
your driveway to �e nard surfaced by the ahpiration date of August 31, 1°81
for your 19�0-19E1 iirense. �
Your cooperation in this matter will be appreciated and if yeu have any
questions, please feel free to call me a[ 5%1-345U.
Sincerely,
i
% �
�, �/ ,
STFVFN J. OLSON, R.S.
Enviro:nnrntal L�fiicer
SJO/mh
0069A/0711A
• �����r° �� ��,��"_��
� E431 UIdIVERS�TY AV[MUF N.G, PFlIULCY, i.SINNESUTA 55432
,'� __...' .
� .., Tfll[PHON[ (fi12)571-3450
� �
4'
� � April 16, 1581
I Mr. Dick W. Narquardt
65f;3 Cci�tral Avenue Id.E.
� Fridley, ���J 55432
Re: Second Plotice Pertaining t:o the Installation of a Hard Surface
Drive�vay and Farking Stalls For thz Residential Rental Prorierty
Loczteu at G5�f3-Q2 Central Avenue N.E.
Dear (ir. N�arquardt:
In Septeinber of 1980, the; City notifie� all o�,;ners of rental residential
fiousiny units of the requirement to provide a hard sur'face drive�vay and
parRinc,� stalls in acco��dance with Section 205.065, 4, of the Fridley
Zoning CoCe. This impruvement is reyuireu to reduce street �nd storrn
se�ver maintenance due to sand, rnr,ks, leaf litter and miscellaneous
material �;�ashing into thern; and for pedestrian and vehicular iraffic
safety due tc the skidciing and slidinq cn material from ur;paved drive��rays.
Since our previous notice, we have not been informeci of your plans to
cnmpiPte this arork. Therefore, tt�is letter is heiny sent as a reminder
of the requirement to provide and maintain a har�d surface driveway and a
minirnum of ttivc off-street par-king st:alls for each dwelling unit, located at
the above listed adcress. Since thie 1981 construction season is cononencing,
ii is oc:vantzgeous and appropriate for you to no�v schedule tne accomplishment
of this necessary work.
Yow p�sit.ive responst- to this needed i�nprnven�ent will assist us in
evalurting your application to rcner; the rental lir_ensc for the upcoining
yecr. 6Je request that you pr�ovide th�. City �:��itf�� your plan to coniplete the
subjcct work. Please rr-turn your� r�esponse no leter• than f�lay l, 1951, to the
attcntion or tlie Coc'e Eniorcement D�partnient.
We are confiuent of your cooperation in this matter. If any questiens or
probl�ins ai�ise ur if I can be uf airy assi�tanr,e, please feel free to call me
at 571 -;;4�0.
�
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SinccrclY, ; �'�
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� 57' �/' _�1
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i r �� �� �..i;. `-j`/ /'t �r- ��, / N
STe�E�� J. OLSOIv, ft.S. �.-- ` Qt
Envieonmenfal Officcr *+ .. /'-'�° „
SJO:m,jli
on�,�����i2��a
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' �ma�'Jsr'ui r.
I�
CITY OF FRI�LEY
6<31 UNIVERSITV AVENUE N.E., FRIDLEY, MINNESOTA 55431
tober 26, 7982 TELEVHONE � 612�571-3450
Hr. Dick N. Marquardt
6588 Central Avenue N.E.
Fridley, hW 55432
Re: Home Occupation
Dear Mr. Marquardt:
It was brought to the City's attention that you rrere operating a home
occupation from your home. An on-site inspection on October 22, 1982
determined that a sign stating "Lose iJeight Now" was being displayed on
your lawn. There:ore, the City is informing you of the definition of a
home occupation as it is permitted by Chapter 205, of the Frid:ey Zoning
Code.
Section 205•02 deflnes a home occupation as, "Any gainful occupation or
profession engaged Sn by the occupant of a dvellir,g at or from the
d�elling wher, carried on within a dwelling unit and not in an accessory
building, e.E. garage, and which is clearly incidental and secondary to
the residential use of the premises and does not change the character
thereof, provided that no signs other Lhan those �oroally utilized in a
residential distrlet are present, no stock in trade Ss stored outside the
building, over the counter sales are not involved, and entrance to the
home occupation is gained from within Lhe structure. Such use includes
prof'e�sional offices, minor repair services, photo or art studios,
dressmaking or teaching and similar uses; however, a home occupation
shall not be interpreted to include towist homes, restaurants or siailar
uses. Teaching shall be limited to Pour (4) students at any given time.
No home occupation shall be permltted Lhat results in the need for more
than tvo (2) parking spaces at any given Lime in additlon to spaces
required by the occupant (family). Occupatlons requirir.g the hiring of
e¢p:oyees other than members of the immediate family shall not qualify as
home occupations."
11r. Dick M. Marquardt
October 26, 7982
Re: Home Occupation
The City must require that you bring your property into compliance xith
applicable City Codes by dlsco�tinuing the displaying of the lawn sign.
A reinspection will be conducted on or about November 8, 1982 to
determine complSance. If LAis letter results in any questions or
problems, please feel free to call on me at 571-3u50.
Failure to abate this violatlon may result in this matter being turned
over to the City Prosecutor for his legal consideration.
Sincerely,
� ,�
�%l,
�.i
STEVEN J. OLSON, R.S.
Environmental Officer
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6��INE HEAT�N� HOUSE HEATING TEST RECORD
AIR CONDITIONING
AND ELECTRIC. INC.
�� �\ .,• APT. FLWR CIT �!� o- - SUBUPB
ADDRESS %��� yS �'
OCCUPANT � . �� OWNER
HEATLOSS TEH G.INST. � j��� �� 3
INSTALLED BY
SOLD BV
� Gas line By
Eteclrical Work By f.�
TVPE OF HEAT GA_ FA H_ STEAM_ SPACE HTR._ UNIT HTR.__ OTHER
GAS DESIGN
MAKE OF BURNER _
MAKE �� Model
Model
Max. BTU Rating _
Sariai U � MAKE OF FURNACE _
INPUT �
Model
THERMOSTAT
Valve �d
LimU
Limil $etlln9 .
Fan Setting _
Pilol7ype _
Pilol Make _
Pilol Model _
CONVERSION
S '�
Haa� Plug Vent Size NONE
KIND OF LINER S��
Dralt Hood Reguialor
F{Iters ! � � 1� Number
Chimnoy Locatlon Inslde Outside
. , � . n ChlmneY Constructlon �' �'"'`
Smoke Bomb
PibtTlming ` ` '
� DoorPressun _
L. W. Cut Off Dala Tested
Pressura ,. Percent CO, S —
� � '.�� Company Tasling
Inpu1CFH � Percenl0� �a'
�.i 1(� z' Gercent CO %� Name ot Tesler _
Slack Temp. �_�
Form 235
6��N�HEATING HOUSE HEATING TEST RECORD
AIR CONDITIONING
AND ELECTRIC. INC.
ADDPESS � /� C�N��Cri I /7UC
OCCUPANT -r���.ar AR4U/7R �
HEaTLOSS � OA EHTG.INST. /O'.�7'S3
SOLD BY_�.�,>�
Elecirical Work By j� I II.VE
TYPE OF HEAT GA_ FA �_ HW_ STEAM_ SPACE HTR._
APT. FLOOH
OWNEH
INSTALLED BV _
Gas Lina By
UNIT HTR._ OTHER
Wirin9 _
Tast Tag
Llghting
crrr Qi �e susuae
�(7 GAS DESIGN CONVERSION
A7AKE IJ 2 Y� N� MAKE OF BURNER
Model �9SC' A✓0�'lOy� Model
Sorial y��y S�i /5 i��� Max.BTURating
INPU7 �/�7/,QQa MAKEOFFURNACE
Model
Th{ERMOSTAT
Valve �
Limit S'}'f
LimilSetting _
Fan Selting =
Pib[ Typa,�
Pilot Uaka�
Pilot Model
� ��
Heal Plug Venl Slza S
KIND OF LINER SIZE ��� NONE
Dratt Hood Hequlalor
Fltan Stu � Number
Chimney Locatlon Insidei /� Outslde
�O �a�(C CL�E ChlmneyConstmction '7' Yi.v�
PilotTiming `/? ���
L W. Cul Olf
Prossure Percent CO� �.
InputCFH y�, ODU percant0, �z
�
StackTamp. �IS PercBn�CO /�
Form 235
Smoke Bomb Widng �ie�
DraX . O� TastTag �/
Door Pressuro � Llghting Inst.
Data 7ested )�- a 7 3
CompanyTesting ��—��'N(s
Nama of Testar M•> Q�
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City of Fridley � SiBJEC�
�
^T'HE'°'°"ME'W'NS , BUILDING PERMIT `
� . !
�
� �y._.___ COMMUNITY DEVEIOPMENT DIV
r � PHOTECTIVE INSPECTION SEC
i
�
� �
` � "1 � CITV HALI FRIDIE� 556J2 �uMBER AEV nniE P•GE oF
•.---�' �'' 612-571-3450 910-F15 6/22/94 � /
JOB ADDRESS 6588 Central Avenue NE
1 LEGAL LOTNO. BLOCK TRAG70RADDITION
oesca. 4G Auditor's Subdivision 4121
t PROPERTYOWNER MAI�ADDRE55 ZIP 7M0�
Terry Marquardt
J GONTRACTOR MAIL ADDRESS Z�P PHOI
Coty Construction Inc. 1001 6 St Hopkins hIN 55434 933-3
a ARCHITECTORDESIGNER MAILADOFE55 ZIP PHOI
5 ENGINEER MAILADDRESS ZIP FHOI
Residential
] GLASSOFWORK
J NEW ❑ ADDITION ❑ AITERATION ❑ REPAIR
R _
8 DESCRIBEWORN
Reroof House & GaraQe (28 Sq) Tear-off
9 GHANGE OF USE FROM
TO
I PERMIT NO " .
'- 22631 �
RECEIPT NO.
��i3a`i
nvvnovEa B�
SEE ATTACHED
SHEET
LICENSE NO
LICENSE NO
LIGENSE NO
❑ MOVE ❑ REMOVE
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMRS AFE REOUIRED FOR ELEGTRIGAL, PLUMBING. HEATING,
VENTILATING OR AIR CONOITIONING.
TNI$ PERMIT BECOME$ NULL ANp VDID li WORK OR CONSTRUCTION ZONING $O. FT
AUTHORIZED IS NOT COMMENCED W�TMIN fi0 OAVS. OR IF CONSTRUCTION
OA WORK I$ SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAY$ AT
ANY TiME AFTER WORK IS COMMENCED NO DWLG UNIT$
I MEREBY CERTIFV THAT I HAVE AEAD ANO EXAMINED THI$ APPUCATION 1 STALLS
AND NNOW THE SAME TO BE TRUE AND COARECi. ALL PROVISIONS OF LAWS ypLUAT10N
AND ORDINANGES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2� lOO
'NITM WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTNORRY O VtOLATE OR CANCEI TNE pERM�TFEE
PROVISIONS O� ANY OTMER $TATE O Al LAW PEGULATING CON� P�S�i.00
5 AUCTION OFFF��� TNE PERFORMA E CANSTRUCTION
� � ' � PLAN CHECK FEE
License SC $5.00
S�Gmar OF .n'ua[�,i0a0 . N¢EenGEN� iOaiEi µ� }y� pqOPERLV P4
1 /
4__ t� � �����
OCCUPANC�
LU FT
�FFSTREET PPRNING
GARAGE$
IURiA%
�1.�5
AGCMARGE
Fire SC $2.10
OTA�FEE
$62.15
PERMR�]
�� l
NF,W
ADDN
ALTER
�
CITY OF PRIDLEY
SINGLG FAMILY AND DUPLGXGS R-I AND R-2
l3uilding Permit Applicatiun
CunstructionAddre�s: �'.S�Sb� �=����d � ���/c_ ���
Lebal Deticripliun: ��,�f,� luir!��-- �s.e���� �--
Effective I/1/94
�a���
Owner Name & A�Idre.tis: 5.�.� �%%9T� Ae.oT -------- `eL 1/ _ �?/ __�;.� _
,� ��% /�
C�mtracLcir: �� �i)�%/�c./'ii;-� -<� � MN UCGNSE Jf /3,� (o
' __//— -- --- ---------- ---- - —
Address: jc� � �<'� �T —/Y�i„(%..�f 'rel. tl y.s�� ,�36
Attach to this application, x Certificate of Survey of the
lot, with the pro�seci conswction drawn on it to scale.
LIVING AREA
GARAGE AREA:
DECK AREA:
OTHER:
DGSCRIPTION OF IMPROVEMENT
Length Width _ Height _
Length Width _ Height
Length __ Width Hgt/Ground _
- . � ."i , �, ,> �; � ;i
__ _._ —
Corner L.ot ( � Inside Lo[ O Ft. Yd Setback Side Yard Setbacks
Tvpe of Construcuon: �c �� p f� ��. �+i` _ EsUmated Cost: $�_
Approx. Completion Date: _ ,�,� �?�^ � i� _
Driveway Curb Cut Width Needed:
DATE_ �� `/:�� �y APPL[CANT:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surchar�!e
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Chargc
ToTn�
STfPULAT[ONS:
� �,%�l
� „l./C
� _ _/�O�
$
$ � . � L�
�
�
$
$ -- -
$ �•.�t. � �_.
Sy. Ft. .2� T�3
- = Sy. F�.1
Sy. Ft.
--'—�-
�l.�d _ � �' t. _ _ �
(Cost on Back)
Ft. + 6 Ft = Ft x� __ _$
Tel. # 93'._S 3� 3 6
��j _
C[TY USE ONLY
Fee Schedule on Reverse Side
.00I of Permit Vxluauon (1/lOth%)
$.50/$1,000 Vxluation
$800 pc:r SAC Unit
$5.00 (State Licensed Residentia( Contractors)
Alt. "A" or A1L "B" Above
$450.00 Conservation Plxn Review
Fee Determined by Engineering
Agreement Necessary � � Not Necessary I I
I3UILDlNG 1'IiRM1T FGE SCHEDULE
The Chief (3uilding OCticial shall, bcfore isswng permits for the erecUOn of any building or stiucture,
or for any addition to any cxfsting buildin� or structure, or for any alteration or repair to any existing
building or swcture, u�xm applicauon thereR�re, require the payment by Uie applican[ for tuch permil
o( fees to the amount hercin below se[ forth and in the mannen c�rein providul to wit
"COl'AL VALUG
$1 to $500
$501 to $2,0(Hl
$2,001 to $25,000
$25,001 to $50,000
�50,001 to $100,W0
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
f�l�:l�S
$15 (Mi�iinxim I�ce is $15 plus surchargc)
$15 for tirst $500 plus $2 for each additiona! $100 or
fraction tt�ercof, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1,000
or fraclion thercwf, to aud iocluding $25,000
$252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to and including $50,000
$414.50 for fust �50,000 plus $4_50 for each additional
$1,000 or fraction thereof, to and including $100,000
$639_50 for first $100,000 plus $3.50 for each addirional
$1,000 or fraction theceof, to and including $500,000
$7A39.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and includi�g $1,000,000
$3539_50 for the fust $1,000,000 plus $2 for each additional
�1,000 or fraction thcreof �
DRIVEWAY llEPRESSION ESCROW
(Conerete Cu� Strcets Only)
Alternate "A": Removal and rep(acement of curb and guUer only - Driveway width pfus 6 feet times
513.50.
Alternatc "I3": Ketnova! and replacemen[ of curfi and gutter and install a 3 fr>ot wide
approach with 6 inch depU� - llriveway width plus 6 feet times $15.75.
VGRIFICA"fION 01� I�OUNDATION
Pern�iLs for co�tstniction will be issued a minimum of 24 hours from Qie time of applica[ion to allow
(or proper review of the pro�sed sWcture and of the con.sUuction site.
A Certiticate of Survey of the lot, showing thc locauon of the foundation once it hae it has been
constructeci wil( be reyuirul before proceedin�; witli the framing.
N_ 597
� CITY OF FRIDLEY � �' � j�3�
PUBLIC WORKS DEPARTMENT
TAPPING APPLICATiON AND PERMIT
FOR INSTALLATION OF WATER & SEWER SERVICE
q This form to be mmpleted before a tap is made to any existing water or
sewer line. �
/� /� .—
r .�. /U� 01,.,.L AAd:ti.... ! l�r . /4/ . .�\. i �\ � %
Address
Owner _
Plumber
BE PAII� BEFORE TAR�iS MADE — WHERE
HAS NOT BEEN LEVIED AGAINST PROPERTY
II) Water & sewer connection permit must be registered before this Tapping
Permit can be issued.
Ci[y supplies all material and labor fot 1" or under watet tap. Con-
tractor supplies all material and labot for water tap over 1", and all
sewer taps.
WATER TAP: Materials Used: S ��=� �� !�
Street Patch: x • S �� FYF
i��c.ti�T/ OA �
TOTAL: 5
SEWER TAP: Street Patch: x .
III) If this property has not paid a full Lateral Charge for its share of the
water and sewer system, additional charges will be placed against it.
This will be in addition to the normal conneMion and tapping permits,
meter deposits, etc.
ASSESSMENTS TO BE LEVIED:
Watet
Lateral: S '—
Sewer Lateral: S �
TOTALASSESSMENT: S —lJ�
�� � (.��(%�r�� t i
Clerks Signature��
Supt. of Public Works \ �'�'� � %�
M/P 3/76 WhitaP.W. Canary Finance Pink Prop. Owner Goltlenrotl Plumbar
GN ���`; wr1T�� 9-I`1-o� ���. .�j`-17-�i
MINNESOTA DEPARTMENT OF HF.ALTH MinneSOta W611 antl Bofing � Q� 0 fl � I
WELL ON BOFING LOCATION Sealing No. � H
�o��ry�ame --- WELL AND BORING SEALING RECORD Minnesota Unpue Well No. Ir — v u —+
ANOKA M��nesotaSrarores.Cnapie.r03i or�W�sennestlNo. I— J
�
Townsmp Name Townsnip No Range No ��. Seam� No v•aci.or �zm -� �g i Daie Seaiea Daie Weil or 9onng Cons�maea
FRIDLEY 030 24 �! 13 �� ` SE` NW" Thursday, September O6, 2001
Numencai Sveei AtlErass o� Fne Nomber antl Qry oi Well or Bonng Localmn
6588 CENTRAL AVENUE NE oepm eem�<seai��9 75 __n o��9��ai oeo�� �-no record �
S�ow eratl location ol wall or bming SkeMn ma0 0� we�� or pormg ppUIFER�S� STATIC WATER LEVEL
n seclion qritl wi1P "%' locauon. sbowing propeny Single AVUder ❑ MuiliaQUder
6nes.roa45 antlbwlaings Mpasme� [� Es4male4
N WEWBOFING �
__ _ _ __ _ _ _" � Wate� Supp�y Weil Q Monil We�l
' ❑ Env eore �o�e ❑ Ome. _?? _ M1 � oeaw ❑ aao�e iana su�ace
� C�SINGTVPE�S�
�10G6'[
W --�-- ---- - -- --a-- � �i � Sieei C %'iev�c [ nie ❑ Ome� 818Ck T&C
kmik a
"_�' "*_ "�'" "i" � 3".r75� l� � � CASIN0131
Diameler Dep�� Sei m overs¢e hoM� qrmylar epBCB initielly gmutetl9
�.-- r �Swr�� � in Irom 4 io �5 n ❑ Yes � Na ❑ Yas ❑ No ❑ Unknown
PFOPERTV OWNER'S NAME m Irom lo tl ❑ Yes O Na ❑�es ❑ No ❑ Unknown
PropeM ��6�5 maAnq a�Orecs �� O�Merenl lnan weu �ocano� ad0�ess �M¢a:ea aoove m �mm �o M1 ❑�es � No ❑ Yes � No ❑ Unkmwn
6588 CENTRAL AVENUE NE SCREEN/OPEN MOLE
FRIDLEY, MN 55432 suee� i�or.+ 75 �o n opa� Nme imr� to n
OBSTRUCilONS
WELL OWNER'S NRME C7 RptlslDrop PiOe ❑ C�eck Valvels� ❑ De�ns ❑ Fill ❑ No ODslmctbn
7C
wenowrersmWwpamrounoinr.niinano2aeMOwirersaeer.s.iikre�eaaoore Typ¢a�ppslr�ciions(DescriEe)jjp aF�'Y+Sn"n o;�, R o kyF„
SAME _ Obstruclians remove0? Yes ❑ No DescrlCe
PUMP
lype �epn WT_—�II Int D� m
6EOL001GAL 11�TERI�I COLOR MARDNESS OF FROM TO � RemoveE ❑ Not Present ❑ Ol�e�
FOHMATION NETH00 USED TO SEAL ANNULAR SPACE BETWEEN ] CASINGS, OP CASING �ND 60RE HOLE:
11 not Nrown. InEkNa a�lirrutaE Mmelun bp han rieeNV well or ponnp
�NO Mrule� Space Evigts
Sand Yellow Soft � � �
❑ Mnuler space groutetl wit� hemie pipe
Clay Blue Hard 26 84 ❑ ces��q van«Hno�marw�a�
Rock Gray Hard 83 87 '". �fO"' �o n ❑ ven«e�ea ❑ An+,wea
Clay Gra Hard 87 1 i i '^� �'O"' �o x. ❑ Petlonroe ❑ aemwsa
Sand Grey Saft 117 113 Typealperlorela
Sand Yellow Soft 113 775 ��a�
Drilled - 1982 GROUTNO MAiER1�L�8) (OIIB IMB OI ClTM� � W IES.� OM 6Hg Oi EBO[WIR! � SO ICA�
Sta6c Water - 63' c�o�e�o Ma�anei Neat Cement ��o,,, ��o .5 n, 0.0009ya,� �
Johnson Screen Enviroplu 5 75 0.1341
9 Iram lo M1. yar6s Oepe
hom to It. �Yrda Gps
GEOLOGY FROM: 68 1 CENTRAL VE NE
Irpn ro—_ n. yarQa Osqa
RENApK3, 90UIIGE OF D�T�, DIFFlCUlT1E3 M! SEALIN6 OTNER WELLS RND BOFINGS
Well �ocated In Pump Room On West Side Of Basement �her unseele0 an0 unuseC well or �oring m prapenY� ❑ Yas No Now many9
LICENSED OR REOISTERED CONTN�CTOR CERTFICATION
WeN Depth Measured From Top Of Casing 6' Below Grade m��s.an o� oo��q+.es seeieo ��� acco�m� w�m M���sou ao�as. cnao�a� azs. Tne mram.ia� �,�,w�sa �� m�s nvon ��e
ttue to IM EeW OI mY k�qwletlpe.
State Inspector Was Not On Site During Well Sealing Myron L. Malenke / Malenke Water (763) 493.3650 27600
Canhacta 6uwress Nana � � � Lcwix a Rpahefia� fio.
M. L. Malenke �/�,� ..� „/ � September O6, 2001
AuMOnzeO Reprasemafiw S� Iwe . � aa
13 030 24 24 0018
LOCALCUGV H iV��OZ NameWPersonSee�rtiDWeNwBOmp
CITY OF FRIDLEY
6431 UNIVGRSITY AV�NUE NE
FRIDLEY, MN 55432
PF.RMIT O.: 2004-01383 �
-�
DATE ISSUED: 08/23/2004
(763) 572-3604 MAX: (763) 571-1287
ADDRESS : 6�88 CF.NTRAL AVG NG
PIN : 133024240018
LEGAL DESC : AUD SU6 NO 021 (2ND REV)
: LOI� 4G f3LOCK 0
PERMIT TYPC : 6UILDING
PROPERTY TYPE : DUPL.GXES
CONSTRUCTION T1'PE : GARAGE, UE7'ACHED
VALUATION : S 24,640.00
NO'I'L: CALL GOPFIGR S fA'I E ONE AT 651-454-0002 FOR UTILITY LOCATIONS. RGMOVG EXISTING GARAGE.
PROVIDE HARD SURF'ACE DRIVEN'AY. SEE NOTATIONS ON PLAN. CONS'I'RUCT A 30' X 26' DETACHED GARAGE.
APPLICANT [3UILDING PERMfI' FI:G 39125
SAMIR AWAUANE PLAN CHF.CK PGL 25431
6�88 CENTRAL AVE NE PIRL SURCHARGF. 24.64
FRIDLEY. MN i5432 STATE SURCHARGE, VALUE 1232
TOTAL 682.52
PAID WITH CHF,CK == 2398
OWNF,R
SAMIR AWAIJANE
6588 CBNTRAL AVE NE
FRIDLEY, MN 55433
AGREEMENT AND SWORN STATEMENT
"I'his permit becomes null and void if work or construction
authorized is not commenced witin 60 davs or if construction
or �i•ork is suspended or lbandoned for a period ol' 120 days
at any time after work is commenced.
I hereby certif'y that I have read and examined this
2pplicntion and know the same ro be true �nd correcL All
provisions of laws and ordinvices governing this type of �iork
will be complied with whethcr spccitied h�rein or noL Thc
granting of a permit does nat presume to give authariry ro
violate or wncel the provisions of��iy o[he s[a[e or local law
reeulating construction or he pe �Orm2nc of construction.
Applican —� .�. Date � �
� / Q �
Rldg Insp Dat��
SGPARA'fl; PERMI"fS QUIR 'D FOR W'OIiK O"fIIF:R "I'I IAN DF.SCRIBED ABOVE.
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NEW
ADDN
ALTER
I1
yL�1 ]
1
�
� CITY OF FRIDL�Y �� �-�� �
643'I University Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 4/1/2004
(763) 572-3604 Bldg Insp
(763�571-1287 Fax
` � �\
i . ���
Construction Address � � � �i' - 9 � ( J �✓'� ` � � �
Legal Description: ��� c ✓1/�J�li��f.
Owner Name & Address S!` r`� A W i T� E !v S$$ Tel. #
Contractor: (��r ✓�� t� MN LICENSE #
Address Tel. #
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certifcate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
length -5 V Width �_ Height Sq. Ft. �
Length Width HgUGround Sq. Ft.
F-E^�ot�E f �,�'.` "rn:! :-, ar2p� .F
Construction Type: �n;�o�; 'K'tr �,�,� � Estimated Cost: $� �/ la �/v •��
Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x� _$
DATE: C5 '" /�� p`� APPLICANT: ^�, K�.t.. }1 c� '� Tel.
Call (763) 5723604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ �7C t � , ,-� �
$ -���'�. �1
$ ��� , �r�i
$ In�.>�
$
$
$
$
$
$
$ '�r:co�,�
� � � l% L`f�,'� TT
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 [ ]
��9�Z/� ZZ �� ���8� .
STIPULATIONS:
BUILDING PER11�1T FEG SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or strucmre, or for any
addition to any existing building or swcture, or for any altera[ion 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,OOlto $50,000
$50,001 to $100,000
$100,001to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FELS
$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 induding $140,000
$993.75 for fust $100,000 plus $5.60 for each additional
$1,000 or fraction thereof,to and including $500,000
$3,233.75 for the fust $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
CURB CUT ESCROW
(Concre[e Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 fcet, tunes the annually detemilned
rate
Pernuts for cons[ruction 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 Survey of the lot, showing the location of the existing foundation will be required before
proceeding with the framing. New Houses Only
�o�
\[[""m��erican
� j' llt'� z'J S
'I.0 Univcaity Avcnue NE
%^,aley, ,b(N :5�72
l6i?) 502-0579
FAX i 61 _) :71-3904
TO �=�.M�\? �i�/�cl 1+!'�.1�.
CoS �6-9 z C'e.r-�e / q�c <—r�i C�
E" f� d�c.{ t ��'� N. � S�l �3 Z
WE ARE 5'cN01NG YGU = AKacnea " Undet separote caver via
❑ Shop c;awmgs
C Copy ci leKer
C Frints
= Change order
G Plans
❑ —
����ca o� �a�a��a����_�
a. rc o� o
l�L� � v� I,O��ZCG (��
rr[wna�
i a —
following items:
�: Samples C Specific�tioas
THESE ARE TRANSMITTEO at cnr_keti 5eiow:
_� For acoraval
= For yc�.:r usz
i5( As re:ues.ed
] For review and commea(
= AcC��� as sucmitted
= Approvea as ncted
= Returned for correaions
=� Resu6mit copies for acorcvai
= Suhmit_copies `ar dis,rioutioa
� Re!um _c�rrccCea pnnts
= rOR 'cICS DUE t? = PRINTS RE'LIRNED AFTER LOAN TC US
RE!AARKS –T I��S 1'L �. �t'�'�cT -�-o Cc��,-Cf –� C,.. 1 ( �-
—� > � �C �r ( Cl S � ! ✓ e 7 (.� 7 � ; . � - C'� < ...� � � a � r ��--i
�
-�..� Su,,,.,: A...��..a..,.� ., - �
1 � �/ �� � xc. t/-'� � / I l s(o -S c> r
h.:�1- Li C� �.+J.�u� ) Sv hc�iJ��ic I /�.; _ Z I i-•" 'iclCl r11
��� ~� i L'il�R.1 M.J`� �f�r�1T, I�`Aj.
COPY TO '
SIGNED: � � ' -L L� (
!t <n<.o.ur.� o� nat .� nor.a. tmaly rpfJy u� .t onu. ',��� T/.. I�� i
�e�-th
\ merican
� urveys
Samir .�waijanc
G�SB Cc��tral Avc
Fridley, vin. ��432
Gordon L. Chr(steitson. L.S.
INVOICE
7130 �'niversirv Aaenue NE
Fridley, MN �5d32
(612)�02-0�79
FA.�C (612) �71-8904
���.o. oazoo
8-27-04
LAND SURVEYING SERVICES
Lot survev N 80 Yeet Exc the W 1 �6.3 feet of Lot
4G Auditors Subdivision �i0. 21 p
�� �
� J�
�
� �,U
; , G ,%
� /��
,
Total S620.00
[3oundary. lbpography. Ln�_inccring, Construction. Gtodctic;G.P.S., and Forensic
r•'7 '
Building PLUMBING Pe��t No.:
Inspections �SIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY Date Rec'd: '1 1 1� s�
DAiE �--� I 7�' �% L` YOUR E-MAIL ADDR�SS
r y.
517E ADDRESS � .S "7i d G ��� `(� � � � %'� �l � Y� .' �* L.
THIS APPLIC4NT IS�. '}�OWNER ❑CONTRACTOR
PROPERTY n.4Me S " v,r �-' �,
! OWNER/ ppDRESS li') � L 1 ���CITY /�R 2� G' J/ STATE./�' ZIP � S�l j�
TENANT PH01�E: � ly.^ %,� 5-- f-' C Y�� �
CONTRACTOR �:�qE
SUBMIT A COPY OF STATE LICENSE k EXP DATE
YOUR $TA'PF. ADDRESS: CITY STATE Z1P
UCENSE W1TH pHONH FAx
APPLICATI ON
PERMIT TYPE � SRJGLE FAMILY ❑ TWO F.M1IL}' ❑ TON'VHOUSE
TYPE OF WORK: � �EW' ❑ REPLACEMBNT
DETAILED DESCRIPTION OF WORK
PER MS ] 6B.665 [he permit fee is a minimum of $15,00 or 5% o( [he [otal cost up to 5500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, e�cluding [he fixmres. (This should reflect only [he cost of labor )
Labor cost under 5300 =$I5.00. Labor cost between $300 to S>00 = cost of Iabor x.OS =
FOR PROIECTS WHERE L.4BOR EXCEEDS SSOq FEFS ARE BASED ON $IQ00 PER FIXTURE, EXCFPT WHERE NOTED. FIXTURES: (MDICATE TOTAL � �
NUMBER OF L"ACN BELOW')
B.4TH SINK/I,AV FLOOR URAINS SHOW'EA WA7ER PfPING
BATHTU� GAS PIPMG nvcrnntr�ur�entce) S�4'IMMING POOL N'ATER SOFTNER ($3?)
CI,OTHES WASHER KI7'CHGN SINK WATGR CLOSET BACKFLOW PRLV. ($IS)
DISHV.'AtiHER LAUNDRY TRAY NATER HLAT[R f$35) FOR IRR)GATION
WATGR METE2 OTHER
PERMIT FEE PAOJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500
Permit Fee $�_. ?�umber of fi�wres � SI0.00 x$10.00 =$
Surchar e .50 Number of fiatures �u,. S15.00 x$15.00 =$
TOTAL DUE $ l�.5�; Number of fixtures (r'� �35.00 x$35.00 =$
State Surcharge = $ 50
Total = $
THIS IS AN APPLIC.4TfO:V FOR A PERMfT-NOT VAL1D UNTIL PROCESSED
I hereby apply for a building permit and 1 acknow9edge that the information above is complete and accurate; that the work will be i❑
conformance with the ordinances and codes of the Ciry of Fridley and with the Minnesota Construction Codes; that 1 understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
�� n —
SIGNATURF OF APPLIGINT >'—� �. �" �—"� � PRMT NA�1E DATE
PLEASENOTE: SEPARATE PERMITS ARE RE I71RED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK
City of Fridley
Building Inspections Department
6a31 University Avenue NE, rridley, MN 55432
763-572-3604
FAX: 763-502-4977
BU11C�i17g BUIL�IN(z Permit No.: �J 1 '�p( '
Inspections RESIDENTIAL APPLICATION Received By: �i� i
753-s72-3604 CITY OF FRIDLEY oace d�,�����
763-502-4977 FAX ! Eeeecnve i-� �oiu � MAi—T��O
D.4TE ^-� i }-OUR E-M.AIL ADDRESS ���C�.ItiY-���\ �-i1�1�'� Y�'.rt- ��1� \. C C Y 7l
sirE.nc��Ress C,-�jFS6�I��`i2� Cr� r-«` `iu�. �j -`c .
THIti nPPLICA'JT IS �ORTJER ❑CONTRACTOR
PROPERTI� O��'NER/ N4n7E�c ��� .,� c�
TENAM1T qDDRESS:�r7�� LC(� rc. ve ��CfTY ��� �C.tj STATE�ZIP 5s`l3a
PHONE lJ�a-��3- ��j�j�j
COSTRACTOR NAME�
SUE3M]T A COPY OF
\'OUK S'CATE L.ICENSE STATF. WCENSE p EXP DATE
AND CERTIFlCATE OF ADDRESS� CITY STATE ZIP
INSUR.4NCE pHOtiE FnX
PROPERTY Tl'PE ❑ SWGLE F.4MIL7'MEW CONSTRUCT101: SIZE
❑ TN'O F.AMILYMEN' CONS7RUCTION gTORIES
PERMIT Tl''PE � -ADDITIOn ❑ G.4RAGESHF.D ❑ N�'INDOU'S
❑ RASEMEN7 FINISH ❑ ROOF ❑ DR.41N TILE
❑ DECf: �SIDING ❑ OTHER
❑ SN9MMMG POOL
Tl"PE OF W'ORK: ❑ NEW FIGME CONSTRUCiION ❑ ADDITION
❑ MAINTE'��ANCE/REPAIR ❑ REMOUELING
DESCRIFS[ W'ORK BEING DONE �-. ��`^� �
SIZE OP IMPROVEMENT LENGTH WIDTH HEIGHT SV FT
ROOFING ❑ HOUSE ONLy BASHMENT REMODELING SUBMIl
NUMBER OF SQUARES ❑ HOUSE B GARAGE I Ex�sbng Floor Plan
GARAGES ❑ ATTACHED GARAGE ? Proposed floor plan
PROF'OSF.D SIZE�. ❑ DET.4CHED GARAGE 3 Lis� o�'struaural members ro be used
PROPOSED HEIGHT.
SIDIN FOR NEW CONSTRUCTION INCLUDING DECKS.
ffi.Vim�l ❑Soffit .4DDITJONS & PORCHES SUBMIT
�O Alummum ❑ Trim I Srte PIaNSurve} showmg the exating stmeNres
❑ Other ❑ Fascia and proposed pro�ect
_ Two scts ofcoos[ruction plans
N'�M1DnWS 3 Energy Calculanons
W FXISTINGOPEN[NGS �Y'es ONo LOCATIONOF WINDOWS FOR WINDOWS-PROVIDEU-VALUEAND
OR FOR NEW OPENMGS-DESCRIBE til7[ OP MANUFACTURE STICRER ON R'INDOW
OPENING CHANGES &
TYPE OF WINDON' TO BE INSTALLED NUMAER OF W7NDOW5
ALL t'CCJ AKL ISAJC.V V1'
TOTALJOBV
Pertnit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
vALV.411VIV,11vCLUU1IVG I�HECUJI�UML.46Vf(ANU'NAI��KIALJ:
(USING THE 1997 U.B.0 FEE SCHEDULE)
��� � `� OCCUP.A\Cl' Tl'PE
S .j��'�� See Back Paee for Fee Schedule
5 65%of Buildine Permit Fee
$ �� J .001 times the total job valuation
$ "� ii .0005 x Permit Valuation Minimum S.iO
S $5.00 (State Licensed Residential Contractors)
$ $2100 per SAC Unit (Plans to MWCC for detertnination)
$ fl+6ft= frx^�24=$
$ $450 Conservation Plan Review
S Fee Detennined by Engineering
S Agreement necessary O Non Neeessary O
S �i "b. C" Make checks oavable ro: Citv of Fridlev Attac
THIS IS .4N APPLICATIO!: FOR A NfRMIT-NOT \'ALID IR:TIL PROCESSED
I hereb�� apply for a building permit and 1 acknowledge thai the information above is complete and accurate; [hat the work will be in
wnformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes, that I understand Ihis is not a
permit but only an applica[ion for a permit and work is not to start without a permit on site; that [he work will be in accordance with the
approved plan in the case, all work �whic �re�q�uire��s review and approval of plans. \ {��,\
91GNARIREOFAPPWCA1i���rCA�J„ 'W.��'t�h?vv-�.pRIN'fNAMF����'c�2Ja \: A W�-�AAA�d)ATE � ��= � �O
ARE REOUIRED FOR
Page 2- Building Residential Application
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any buildi�g or
strucmre, or for any addition to any existing building or structure. or for any alteration or repair
to any eaisting building or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amo�nt herein below set forth and in the manner herein
provided to-wir.
TOTAL VALUE FEES
$I to $500 $23.50 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000 $23,50 for I" $500 plus $3.05 for each additional $100 or frac[ioo, to and
includin $2.000
$2.001 to $25,000 $69 ?5 for 1" $2,OD0 plus $14 for each additional $1,000 or fraction. m and
includine $$25,000
$2i.001 to 550.000 $3912� for I�' $25,pp0 plus 51 D.10 fo� each additional 51,000 or fraction.
ro and includin� �50.000
£90.001 to $100,000 $643Ji for I" $50.000 plus $7 for each additional $I.000 or fraction to and �
includine $100,000
$100,001 to ��00,000 $993J� for ]" $100,000 plus $�.60 for each additional 51,000 or fraction to
and includine, $500,000
$500,001 to $1,OOQ000 $3,233.7� for the ]" $500,000 plus $4.75 for each additional $1,000 or
fraction [o and includin� �1,000,000
$1,000,001 and up $5,608.75 for ihe 1" $1,000,000 plus $�.15 for each additional 5I,000 or
fraction
VERIFICATION OF FOUNDATIOn
Permits for construction will be issued a minimum of 24 hours from the time of application to
allo�v for proper review of proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Onlv
Ciry of Fridley
Building Inspec[ions Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
Building
Inspections
763-572-3604
763-502-4977 FAX
SITEADDRf:SS IrJ'
THIS APPLIC.4NT I5�
PROPERTI' OH'�ER/
TE\ART
CONTRACTOR
SUBMIT A COPY' OF
YOUR STATG UCENSE
AND CERTIFICATE OF
INSI IR.4NCF
PROPERTt'TYPE
BUILDING
RESIDENTIAL APPLICATION
VHONE
STATE UCENSE R
ADDRESS
CITY OF FRIDLEY
Permit No.:
Recei�/Blr:
l.G
Date Rec'd:
eFFecnvE i-i �oia l
_ YOUR E-MAIL ADDRESS S�ti-(�c��i�7-��.�,�5� � CU`�'s1
C2�� �v e_ %, i ,
OWNTRACTOR
e Y�� � «
❑ SINGLE FAMILYMEW' CONSTRGCTION
❑ TWO FAMILYMEW CONSTRUCTIO?:
❑ BASEMENT FINISH �,ROOF
❑ DECR ❑ SIDING
, r�
❑ SWIMMING POOL
Tl'PE OF �i'ORK: ❑ NEN' HOME CONSTRUCTION ❑ ADDITION
❑ M.411:TENANCE�REPAIR \ ❑ REMODELING
DESCRIBE WORK BEING DOtiE - Cc�� � \iJ � r�c!���-�S
SIZE OF IMPROVEMENT LHNGTH WIDTH
ROOFING ,79,�}IOUSE ONLY
NUMBER OF SpUARES �� `,U�y'/ ❑ FIDUSE & GARAGE
G.aRAGES , ❑ ATTACHED GARAGE
PROPOSED SI"LE � DETACHED GAR.4GE
PROPOSED HEIGHT.
SIDING
� \'inyl
❑ Aluminum
O O[her
❑$o01i
❑ Trim
❑ Fascia
N'ISDOWS
IN EKISilNG OPENING5�1'es ONO LOC4TION OF 0.'INDOU'S
OR FOR NEW' OPENINGS D�SCRIBE SIZE OF
OPENING CH4NGE$ d
T1'PE OF WINf�W TO BE 1NSTAl,LGD (� [ ��.�.�- C�%'FNI!MRFR OF v
EXP DATE
❑ DRAIN'IILE
❑ O1'HER
AT&'CVJ ZIP
BASEMEN7 REMODELING Sl1BMIT�.
I. Exisung Floor Plan
2. Proposed Ooor plan
3. Lisl of stmctuml members to be used
FOR NEW CONSTRUCTION MCLUDING DECKS,
ADDITIONS 8 PORCHESSUBMIT
I. S�rePIan�Surveyshowing[heexisungslmeWres
and pmposed project.
2. Two sets of cnnstmcbon plans
3. Energy Caiculations
FOR �l'INDOU'S - PROVIDE U-VALUE AND
MANUFAC7URE STICKER ON WINDOW
ALL FEES ARE BASED O'.V VALUATIOM1�, INCLUDIVG THE COST OF L.4BC
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATIOti $ �DCY� OCCUPANCY
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charee
To[al Due
4LS:
� j`j 3, L`j See Back Page for Fee Schedule
S 65"io of Building Permi[ Fee
$ ��'� � .00 ] times the total job valuation
5 �� � .0005 x Permi[ \'aluation Minimum 5.�0
$ $5.00 (State Licensed Residential Contractors)
� $2100 per SAC Unit (Plans to MWCC for determination)
$ �+6ft= Hx$24=$
$ $q50 Conservation Plan Review
S Fee Determined by Engineering
$ Agreemem neoessary ( ) Non Necessarv ( )
$ �'] , I 1 btake checks oa��able [o: Citv of Fridlev Attach
THIS IS 4N APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a buildine pertnit and 1 acknowledge that the information above 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 application for a permit and work is not to stan wi[hout a permit on site; that the work will be in accordance with the
approved plan in the case of��,ll work ��hic}yt�quires revieu� and approval of plans. , ,�
SIGNA7UHE OF
\��0..�',.,nr�eTr �
PLEASE NOTE: SEPARATE PERNA�'iC ARE I2EQUfltED FOR PLUM$ING, EtE��iRICAL AND MECHANICAL WORK
Page 2- Building Residencial Application
BUILDI'VG PERMIT FEE SCHEDtiLE
The Chief Building Official shall, before issuing permits far [he erection of any building or
structure, or Tor any addition to any existing buildine or structure, or for any alteration or repair
to am� 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:
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 proposed structure and of the construction site.
A Certificate of Survey of the lot, showin� the location of the existing foundation will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
Buildin� Inspections Department
6431 Universiri Avenue NE
Fridley. MTv' S5432
763-572-�604
Fax: 763-502-4977