AF - 36114� �ob ��Q�� �r�.
December 3, 19?9
City of Fridley
6l�31 Un�.�rersity A�e. 1�.E.
Fridleg, 1►�iT 5543 2
Attn: i�tr. Jerrp Boardman
Ref: Lo� !�R Second Revision
Au.ditors Subd3vi5ion #21
Dear Mr. Bo�rd�an:
This lot is a filled lot with clean,fill suitable for
building. It was already f311ed when I moved next door
to it in 1965. The lor�est point on the lot is the
frontage on Central Aver�ue.
Please contact me if you have anp fvrther questions.
Jerry Westlund
12161� l�ississippi Drive
Charnplin, 1�T 55316
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� � sue�ecr PERMI
City of Fridley ' � �
ATTHETOPOFTHETWINS gUILDiNG PERMIT -18285
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' � RECEIPT NO.
i j V �.��
COMMUNITY DEVELOPMENT DIV.
r i, � PROTECTIVE INSPECTION SEC. y9� ��
i 1(�
l•--_ � �����,,, CITY HALL FRIDLEY 55432 NUMBER REV. DpTE PAGE OF APPROVED BY
i � � 612-571-3450 910-F15
11/7/85 � �
JOB ADDRESS 6700 Central Avenue N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
OESCR. 4R Second Revised AUditorrs Sub. #21 SHEET
2 PROPERTYOWNER MAILADDRES$ 21P PHONE
Dennis Weinard
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Herb Knutson Construct.ion 11501 - 134� Avenue North, Da.yt�on 421-8257
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAIL AODRESS ZIP PHONE LICENSE NO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
�] NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE
8 OESCRIBE WOAK
Construct a 46" x 26' Dwelling and a 24' x 28' Garage
�EPARAT� i�E�I��TS RE�UIE��� FOR
9 CHANGEOFUSEFROM ' �
STIPULATIONS provide a hard sur�ace drivetiaay. Provide City with copy of verifying
survey before capping. Provide sod in the �ront and side yards.
SEWER LOCATION: Sewer will be serviaed into manhole near SW corner of lot; it is
shallow, there�ore, check invert prior to setting basement floor elevation; lift
piunp may be required (:see notations on survey).
WATER LOCATION: MUST BE TAPPED. W�,ter main in Central Avenue.
iHE CITY OF FRIaLEY DOES NOi GUARANiEE THE t���-����
ACCURACY OF UTILITY LOCATIONS AND ELEVATIONS. �efore digging call loca! ufiliiies
THI� pAiA IS FOR lNFOR����1TlOf� PURr�OSES ONLY, �ELEPHONE�ELECTRIC-GASEfc.,�
AND PER��N� U�ING Tf-11S 1NFORMATION SHOULD
V��I�Y IT ON iFIE SITE. RE��I�E� ��, L��,
SEPAfiATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY OROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. TAtOQC�. Fx�e
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION 1256+612
OH WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R^�.
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 $74,850 �`3%.43
DOES NOT PRESUME TO GIVE AUTHORITY TO VIO�ATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW FiEGULATING CON-
ST U TION OR THE PERFORMANCE OF CONSTRUCTION. y�3SS.00 $425.00
PLAN CHECK FEE TOTAL FEE
A $ 89,50 $909.93 + License
SIGNATUREOFCONiRACTORORAUTH AiZE AGENT �onTEi WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
<. / /
SiGNATURE OF OWNER (IF OWNER BUILDERI IDATEI - BLOG INSP npT
LOT SURVEYS COMPANY, INC� �NVOICE NO. 16174
� F. B. NO. 303-OS
LAND $U8{rEYO$S SCALE I" =Z0' 20'
0 - DENOTES I RON
��I� REGIBTEBED UNDER LAW3 OF STATE OF MINNF�pTp
� Denotes Wood Hub Set 7801- 79rd Avenue Nocth ggp.g093
For Bxcavation Only -
E� Demotes Snrface Ih'ainage Mi�u'e'polie, Minnesou 68428
D De�ces rr�osea Elevat,ton 6uraelJol� �ttt�t�t �
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Top of $lock Gerage Floor
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Snbject to C�trel Av�ue over the Best 50.00 feet thereof.
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boundtrbe of tl�s �bwa dsscNhed Im�d ard lhe bcatla� W atl bulldinpa and Na-
Ibt: anao�d�nm�fs� H+nY. hom a m aald Imd.
SunsYsdEYuetlds--ZS.C�_tleYOt OCtObBi' �g 85 a_ s �d � �
� a v►.�n, M(nn. peg. No. 8743 � py,J
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NEW [ ]
ADDN. [ ]
pLTER. [ ]
City of Fridley
� R-1 AAD R-2 �
Building Permit Application
Effective 4/1/84
Construction Address: �`700 � �`LD CC �TKZ� L
Legal Deseription: I
Owner Name & Address : � � � � � S � � � N �3 �r' � Tel . �
Contraetor • ��-- �.C� �q�„�,�s � c�- Tel . � � �-� -��•�S"7
Address: 1 ( � 6 l - l � � �,� �,�, � `� rn�
,� t -�,�----
LIjIING AREA :
GARAGE AREA:
DECR AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot� with the proposed construction draWn on it to scale.
DESCRIPTI08 OF IMPROYEMENT
Length �- � Width �� Height Sq. Ft.
Length �y Width 2-�l Height Sq. Ft.
Length° Width Hgt/Ground Sq. Ft.
�
Corner Lot [] Inside Lot [] Ft. Yd. Setbaek � O _ Side Yard Setback
Type of Construction: �� o O r Y� '� lnn E Estimated Cost: $�5'`�s� �
'�C� `30 \��5�� ��'��`��
Approx. Completion Date: �
Alt. A Alt B
Proposed Driveway Width If Ne� Opening Is Desired: $ $
See Back Page for Explanation
DATE: `i - C -�S S � APPLICANT: �°�__ _ _ _ _ _ Tel. � V� �--�`�r%P
Permit Fee
Plan Check
State Surchar�e
SAC Charge
Park Fee
Se�er Main Charge
�r�.
STIPULATIONS:
CITY IISE ONLY
$ 3 �►c�
$ �1 ��
$ ��—'�'3
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$ '�
$ �_
$ O�a ��
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Fee Schedule on Reverse Side
25� of Building Permit Fee
$.50/$1,000 Valuation
$�125 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
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EX9EiiI0t: ENVELOPE AVEP.AGE �4T" C�P[TTA3'IO1V - .
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OVdT�'13_ D`c�tl hi� s S 7'��E� �l (.v E�N K�lL.13 � �
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SITE ADDRE3S �
C(Jlv`!lt.AC'!�H_ J�NJrsvN Gd ti S f•�, DATE �O -t�S - 8�' PIIOP�E
Determine working square foottaa.,�e of: each.
l. 2bta1 e:.tpoaed wall areA......_ �I��.Z� sq. ft. x_, .�_ �37,Oo
2. �btal roof�ceilii� area...... IZ..S� sq. ft. x .� . 3a.6,�
'Ib tal ex��osed wa.11 area Above floor_ IZ4�
8.• �: t.9.1. iPci.11 WlY1C1US'i I3.T'G£r.. � � � � � � � � � � � � • • � � � � � . � � � � � • . � � � . � � � � � � � �� -/�• U
�� Zbta.l door a,xBA���...�..•.�..•...��������������•••.���.�.�.���• 37.%
C ., 21D t�11 911tj.121�; (3,OOT 8S@;1• . . . . . . . . . . . . . . • . . .. . . . . . . . . . . . . . � . • . • �3�. C�
d. Total fii•a�,alace wall area .....................................
6• �'�8.1 W8.�.1 f'i"c11IL111C; firBS � I�,V@I'�@ �� � � . . . . � � . � � . � � � . � � . � � � � � �.�..�.�L i'�%(�
�. � TCit.B.�. net tivall �.rea 9.�iOV6' f100T.���•••.��.��.��.����������.��• �� .�S
g. Zbtal rim joist erea ......................o.�................. /�,�.��
. 'lbtal cx�?o�ed fdundation axea �.3(� • 4
�1� �.�0�1 IOIl!'1(i`cl.GlULl (1Ci01' :':?'C:]y�.����. •�• •��������••. .�������
i. `ibtal f�:und.c�.tion windocr axea (inclu�,es sliciin� door��......... �3-�}4
�. Zb tal ne t fc�unda tion dr@A above �&L�B� • ... • . .. . . . . . . . . . . • .. . . •^ 1 B4• S Z
k. Zb tal rra.11 framin�: urer� ( average 10�� . . .. . . . .. . . . . . .. . . ... . . .. s�,
1. `Ib tal ne t wal l f'rar,ung area . . . . . . . .. . .. . . .. . . .. . . . . . . . . . ... .. . %. / �
Dstermirie "U" v�.lue of each wall segma��t
a. R5• �' X"Q" • 3� Z. = 33, 7 Z
b. 3� 7 X"Q" , 14 = S. Z 17
c._ �a'.0 X"U'r �4'�' - j6,?L
d ----^ X "0" -
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e.� cs��.6s x���� ,og - �,��
i. °l68,r9S 7C"Un ..04,3 = 41
,66 ^
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h. — - X �� a ..,�_, _ — -
i. 63•�4 R'qTn ,-�$-Z a ZZ.S!
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k. .,�P.,_7S 7� "[T" . O+c� = t5''S Z .
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�.����.'rrts_s��a����l���.�.���.���.�������.����.�..���ua.+�k s � �/�Ql
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If item, �3 is '�he eame as!_ vr less thaa �.�i �. � 8� have �net the intent oi SBC �C?06 ( c 2.
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�' , SURVEY/NG & ENO/NEERING CO.
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(612) 474-0981
5300 HIGHWAY 101 SOUTH, MINNETONKA, MINNESOTA 55343
EXPLORATORY SOIL BORINGS FOR:
Jerry `Yestlund on
Lot\�D, SECOND REVISION
AUDITORS SUBDIVISION #21
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SURVEYINQ & ENQINEERIN(3 CO.
June 17, 1983
�Jerry Westlund
`�2164 Mississippi Drive
Champlin, Mn 55316
0
Gentlemen:
(612) 474-0981
5300 HIGHWAY 101 SOUTH, MINNETQNKA, MINNESOTA 55343
1_ �
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�. _ .
RE: Lot�, SECOND REVISION
AUDI S SUBDIVISION #21
At your request we have conducted a preliminary investigation of
sail conditions in Lot 4D, SECOND REVISION At7DIT0RS SUBDIVISION #21.
The investigation consisted of exploratory soil borings taken to aid
identifying soil and water conditions, The borings were taken at the
locations indicated on.the attached layout. Surface elevations are
based on the North American Datum.
INVESTIGATION H�ETHODS:
A total of two test borings as shown on the attached layout were
taken on June 16, 1983 with a truck mounted auger drill. Mineral
soils encountered in the borings were texturally classified in
a�cordance w�th the U.S. Bureau o f Chemistry and Soils Classification
System. A copy of that chart is attached. The borings were
probed immediately after completion for the presence oi ground
water.
RESULTS:
The borings encountered sand underlain by firm silt. Water was
encountered at 11 and 18 feet in the borings.
RECOMMENDATIONS;
The soils encountered are suitable ior the support o� single fa,mily
residential construction.
Of necessity, the area of the borings,in relation to the area of
the site and the depth of,.the borings are limited. Suggestions and
� recommendations oi this report are opinion�s based-on-data obtained
from the borings. -
ADVANCE SURVEYING & ENGINEERING C0. �
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� ORI N G � LOG
P R O J E C T— E�pLORATORY � SOIL BORINGS FOR : B O R I N G T. H. #1
LOCQTION
Jerry Westlund at
, Lot 4D, SECOND ftEVISION AI�DITORS. , See site plan
�..
SUBDTVISION #21 DATE 6/17/83 SCALE 1"=3'j
Elev. Depfih � Description of Materiais �
0 . BPF WL Tests or NoP�s r
t
Sand, Damp
5
5,5 San y oam
Sand
7.5
8
11
13
�anay 1oam, 131ack
White fine sand, Moist
Fine Silty snad, I�oist
Firm Grey Clayey Silt
0
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,
, � ' .
Gray Clay, Firm Water encountered
19_ __ _ ,: , . _ '� ,; ;
.: at 18 Ft.
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SURVEv�NG d ENG!/YEEq/NG CO. � � "�
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P R 0 J E C T— EgpLORATORY SOIL BORIPdGS FOR :
Jerry Vaestlund at
� ,. Lot.4D, SECOND REVISION AUDITORS
; SUBDIVISION #21
1
� Elev. De th � � �
p Description of MQteriais
0
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3.5
4.5
E�+a
14
Sand
Sandy loam, Black
Sand, �Iottled
Silt
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BOR! NG T.H. #2
LOCATION `
See site plan
DATE6 1? 83 SCALE 1"=3'
.. BPF WL Tests or Nates
Water encountered
at 11 Ft.
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CITYOF
FR[DLEY
CIVIC CENTER •(}331 UMVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE 1612) 571_z-35p
Febzuary 13, 1986
Herb Knutson Construction Inc.
11501 - 134� Avenue West
Dayton, NAT 55327
Re: Final Inspection at 6700 Central Avenue N.E., Fridley
De ar S i rs :
A final inspection was conducted on February 12, 1986 of the above address
and the following itens were noted which must be completed before the
structure can be finaled out:
1. Provide a temporary front step to the dwelling by March 3, 1986.
2. Reinstall the sheetrock in the upper part of the fire wall between
the house and garage by March 3, 1986.
3. Provide sod in the front and side yards by June 16, 1986.
4. Provide a hard surface driveway by June 16, 1986.
5. Provide permanent support posts for the roof overhang near the front
door by March 3, 1986.
6. Provide the City with a copy of the verifying suxvey by March 3, 1986. �
We will expect the above items t�o be completed by the scheduled dates when
reinspections will be conducted to determine compliance. The dwelling is
approved for occupancy. If you have any questions on these items, please
feel free to contact me at 571-3450.
Sincerely,
� G. CLARK
Chief Buildinq Official
DGC/mh
��� '� r,��°,,::
3, �
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,
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHOIVE (612) 571-3450
June 4, 1986
Herb Knutson Construction Inc.
11501 - 134� Avenue West
Dayir�n, MDT 55327
Re: Final Reinspection at 6700 Central Avenue N.E., Fridley
Dear Sirs:
A reinspection was conducted on June 2, 1986 to detenaine compliance with
our letter to you dated February 13, 1986. The inspection noted that the
following items are still incomplete:
1. Provide permanent posts for the roof overhang.
2. Provide sod in the front and side yards.
3. Provide a hard surface driveway.
We will expect the above itans to be completed by June 16, 1986 when a
reinspection will again be conducted to detezmine compliance. If you have.
any questions on these items, please £eel free to contact me at 571-34'50.
Sincerely,
D G. CLARK
Chief Building Official
IiC/mh
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CITYOF
FR[DLEY
CIVIC CENTER • 6�331 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
July 29, 1986
Mr. Herb Knutson
Herb Knutson Construction Inc.
11501 - 134� Avenue West
DaytAn, P�I 55327
Re: 6700 Central Avenue N.E., Fridley
Dear Mr. Knutson:
On July 23, 1986 we reinspected 6700 Central Avenue for the two remaining
Code deficiencies. The inspec tion no ted that the (1) sod has been installed,
and (2) permanent posts under the roof overhang were in but need to be
altered in length so as to support the overhanging roof in a l�vel, straight
line,
Would you please direct your workmen back to the site to make the necessary
corrections.
We will reinspect the property on August 8, 1986 for final approval of the
structure.
I= you have any questions, please f eel free to contact me at 571-3450.
Sin cere ly ,
�
DARREL G. CLARK
Chief Building Official
Dcc/mh
CC: 6700 Central Avenue N. E.
, � , -
�
CiTYOF
F[ZIDLEY
C1VIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
August 8, 1986
�
Mr. Herb Knutson
Herb Knutson Construction Inc.
11501 - 134� Avenue West
Dayton, l�IlV 55327
Re: Reinspec tion at 6700 Central Avenue N.E., Fridley (Third Notice)
Dear Mr. Knutson;
A reinspection was conducted on August 7, 1986 to determine compliance with
our le tter to you dated July 29, 1986 in which you were directed to complete
the following correction:
The pennanent posts under the roof overhang need to be altered
in length so as � support the overhanging roof in a level,
straight line.�
We will expect the above correction to be completed by August 22, 1986 when
a reinspection will again be conducted to de termine compliance. If you have
any questions on this matter, please contact m e a t 571-3450.
Sincerely,
DARREL G. CLARK
Chief Building Official
DGC/mh
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��2�� AUG 2 fi
1�91
Federal Emergency Management Agency
Washington, D.C:. 20472
Mr. Dennis Weinand
6700 Central Avenue
Fridley, Minnesota 55432
Dear Mr. Weinand:
IN REPLY REFER T0:
T-218-70-R
Map Panel Affected: OOO1B
This is in response to your letter dated June 18, 1991, requesting that the
Federal Emergency Management Agency determine whether the following �Sroperty
is located in a Special Flood Hazard Area (SFHA), an ares that would be
inundated by the 100-year (one-percent annual chance) flood.
_
Property_ Descz.iption: ` Lot 4-R, Seconct Revi�iori of- Anditurs Subdivision
_ , -
No. 21, Citp of Fridley, Anoka County, Minnesota, recor�ed as Document
_ No 701404, Office of the_C_ounty _Recorder, Anoka Countq, M3.nnesota
Street Address: 6700 Central Avenuel
Communitys City of Fridley �
State: Minnesota
On August 6, 1991, we received all information necessary to process your
request. After comparing this information with the National Flood Insurance
Program (NFIP) map for the City of Fridley, Anoka County, Minnesota, we
determi.ned that the property would not be inundated by the 100-year flood.
Therefore, this letter amends the map for the Citq of Fridley, Anoka County�
Minnesota (iJFIP Map Number 270013, Panel OOO1B, dated March 2, 1981), to
remove this property from the SFHA.
Piease note that this property couid be inundated by a fiood greater than a
100-year flood or by local flooding conditions not shown on the NFIP map.
Flood insurance is available at reduced cost for properties located outside
the SFHA. Also, although we have based our determination on the flood
information presently available, flood conditions may change or new
information may be generated that could supersede this determination.
A copy of this Letter of Map Amendment is being sent to your community's
official NFIP map repository where, in accordance with regulations adopted by
your community when it made application to join the NFIP, it will be attached
to the community's official record copy of the NFIP map, which is available
for public inspection.
If any structure on this property is covered by a flood insurance policy, and
if the mortgage company or lending institution agrees to waive the flood
insurance requirement, then the NFIP will refund the premium paid for the
current policy year� providing that no claim is pending or has been paid on
the policy during the current policy year. To receive the refund, a written
waiver or certificate must be obtained from the mortgage company or lending
institution. This written waiver or certificate must then be sent to the
insurance agent� who will process the premium refund.
This response to your request is based on minimum criteria established by the
NFIP. State and community officials, based on knowledge of local conditions
and in the interest of sfifety. may set higher standards for construction in
the floodplain. If the State of Minnesota or the City of Fridley has adopted
more restrictive or comprehensive floodplain management criteria, those
criteria take precedence over the minimum Federal criteria.
If you have any questions or if we can be of further assistance, please cail
us at (202) 646-2764.
Sinc rely.
/ Chief
Charles�. Lindsey,
Technical Operations Division
Federal insurance Administration
cc: Community
State Coordinator
e
� - SuB�ECT �
c�ty of F��a��y
AT THE TOP OF TNE TiNINS Q U I L D i N G P E R M I T
;,
,�
; �L ___�_ COMMUMITY DEVELOPMENT DIV.
I � � PROTEC7IVE INSPECTION SEC.
� _ �"'1 � CITY HALI FRIOLE� 95132 NUTABEN HEv
�---.�: �.� 612-571-3450
910-Ft5
J08 AODRESS 6700 Central Ave NE
t LEGA� L07 N0. BLOCK TRACT OR ADDITION
oesca. 4� Second Rev Aud Sub
2 PROPERTY OWNER MAIL ADpR�$$
Dennis Weinand, 6700 Central Ave NE, Fridley, MN
3 CONTqACTOfi MAIL ADDRESS
Dennis Weinand, Same address
< ARCHITECT OR �ESIGNER MAIL ADbRESs
5 ENGINEER kIA1L ADDIiE$S
DAT6
6/28/02
ZIP
R
P�GE Oi
� �
E'RMIT NO.
32733
SEE ATTACMED
SHEET
PHONE
763-571-3047
PHONE LICENSE NO
PMONE LICENSE NO.
PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK ,
C� NEW � ADDITION ❑ ALTERATION O REPAIR O MOVE O REMOVE
8 DESCRIBE WOf;K
Re-roof / tear-off / 27 squares
9 CHANGE OF USE FROM
STIPULATIONS
TO
Underlayment must comply with State Building Code.
SEPARA7E PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, MEATING, TYPE OF CONST.
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL ANO VOID IF WQRK OR GONSTRUGTION 20NIN6
AUTHORIZED IS NOT COMMENCED V4!ITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANQONED FOR A PERI00 OF 12p OAYS A7 "
ANY 71ME AFTER WORK IS COMMENCED. `
NO DWLG. UNIT;
I HEREBY CERTIFY TNAT I HAYE READ ANO EXAMINEO THI$ APP�.ICA710N
AND KNOW TME SAME TO BE TFIUE AND CORRECT. ALL PROVISIONS OF LAW$ VALUATION
AND OROINANCES GOVERNING LHIS TYPE OF WpqK WIL,� QE COMPl,IEO $2,g94.00
W�TH WHETMER SPECIF�ED HEREIN OA NOT. TME GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OF C�AMCEL TN� pEiiM17 FEE
PROVISIONS OF ANY OTHER STA7E OR LOCAI LAW REGUTATING CON• $83.25
STqUCT10N OR THE PERFOfiMANCE OF CONSTRUCTION
ATUAEOFCON•A4CTQqpqqUTMOA�ZEDO NT 104TE�
�� ���� � � �
S�GNATUAE�OfOWNEA��FOWNEp8U�l0ERi �O�iE� .
SQ.
STALLS
OCCUPANCVLOAO
CU FT.
OFFSTREET PARKING
GAFAGES
SUp7AX
$1.45
SAC CHARGE
Fire SC $2.89
TOTA�FEE
$87.59
�A THIS IS YQ�CIR P T� ^
� � �
OaTE
NEW
ADDN
ALTER
� � CITY OF FRIDLEY EffecWe 1N2002
� l 6431 University Ave NE, Fridley, MN 55432 (763) 572,3604 Bldg Insp
I I SINGLE FANULY ANO DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Constructio� Addre
Legal Description:
c�wner Name & Address: ��, ,�, l,� A J�, i ,� � h �,� , Tel. # �6 � -S�i � - ,? d y "7
Contractor. �, � MN LICENSE #
Adt�res�: 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 AREA: Length Width Height Sq. Ft
OECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER: .
Construction Type: — Estimated Cost: $ Z� � c�, ,P' �'I �
�
Driveway, Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DATE: APPUCANT: Tel. #
Call (763) 572�604 fo� PeRnit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ 0 �� �'�
$ � �
$ �� �
$
$
$
$
$
$
,$ v L a �
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 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 [ j
� _
STIPULATIONS:
��..���r��
����E���� ����.�c�►��c��t
�ity a�� �racile�
���-a
Re ed Sy
Date R�ei,red '
NOTE: fF PROPERTY 6S NQT OWNEl7/OCCdlPIED- A UCEAISED C17i�TRAC7OR Mi1ST 09TAIM TNE P�l2MR.
DATE ° (�
SlTE ADDRESS _ � %
7}fE APPLICAIYT IS: (qRGL� ONE�
I �tAAAE
PRQPERTif QWN�R/ qpDRl
TENKlYT
CIT'Y �
P110N� tl
. -
1 / �i
•� Q
! �
/' �' �
1��' �
�
N�E RNer C11V PIUI'Y1t�inn �'0 Uc�s� �
°� coH�►CroR Aacaess _ 8,290 MSin t I� F,� 3 �
� Fri le� II�R ���t ��s�ra�r � z�
PHONE � (763) %5ad-2199 FaY ��6 ----"
(Zfi�) 75�g
PERIf�lT TYPE
TYPE DF WdRl�
���� AFS�IPTtCN OF
� s�N�+� F,aM��v
r �
� R6PLACEMF.ldT' �
�S AR� Hl4SID aN 31D.Od P�R FDCi'L1RE, DCC�PT WE�L NOIED
RiXYURF.�: (INDlCATE'i07'AL NUIMBER OF EAt�i)
sarH s�t�v�nv a.00R �s sa�aweR bvASeR �+�
BATHTUB GA3 PIPING pVead City Li�) SVY9�i1N�i POOL VVAi� SOFitNER (5351
C7.OTFIES WA9HEii KlTi�1EiV SINK WATER (�.QSEi BAd(FiOW FREV. (S45f
D6SMNA8FiER l.AUNDRY TRAY SL WATER f�1�1i (� FOR IRRIGATION
' WA7ER MEi6R QTHER
Pertnit Fee� $ �.�� MINiMUM: $18.Op or g%cf cost of the improvement-whichever is
F+Ian Reviev�r S greate� on work I�ss tf�an $3�0
Surttf�arge S � .50
iOTAL DUE S .�C� Make checks payabie to: City �f Fridley
'PHt� 13 AN qpp{,�CATION FOR A PERMIT — PJOT VAUD UNi7L PROC85SEQ
I herebY ePP1Y fcr a pl�nbtn4 P� ar� i aclmowledge that the irdocmation above is oomptete and aoc�uate: that tMte woric wiU be (n conformanoe with
the ocdinanoes and wdes of the C1tY of Fridley artd wiUt ihe NGnnesot8 Construdiorf Cod�s; th8t I undersland this is not a permit but or�ly an
aPAiicdtiott for a pem�it and warlt is not b sfarkwitls�t a permlk that the wrnk wiil Ee in accardanoe with tha aPArov+sd plan in the c�Se of aU work whlch
�ouires revlaw antl aPProval of plana
NAME OF APPUCANT
S1Gt�ATURE OF APPLiCANT
DATE � Z CJ ,�
TOTAL P.HS