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AF - 36116II� � �' �I �: l�ic. t t �. � ° Lou�blin 5387 Altanc� 8oad Fridley, t4i.�n. 5S�a32 Juae 6, 197a G� �-�Z ��S ` L 3 ldaive� o�` the Requirement to Hook Onto the Sani.tary Se�er mnd AZl�a3n� �c�ns�ruction of a C�espool Dear I�o 0' Lou�h].in s ,, ;�,�� The� City Council., at tkie �eti.ng of J�e 5, 1972, authori�ed the tv�i�er of t�ae require�at of hookiag on of your p��perty, L�t �, 8e�t��ct Land Susve� 2do. 3 ne�r C�atral Aveaue aad b9th A°�e�ue ar�a, to th� a�it�ry s�er and allo�3.sg conatxuction of a cesr�po�a �a�Clx �� golla�i$ etipnla�i.ane: 1) Tlaie waiv�r is temgorar�+ tmtil thQ �d�oining ere� ie ready, to receive the sa�rer sereice. 2) dnce fihe C�tv propo�ea to prtnride a��we� �ezv3ce in tia� ��ea, � that the pssperty owr�r �ou1d not opgoge th� imprmvem�mmt and woulcl be willing to accept their proport3onats share of t�h� cast of �he i�rov�--- �nt as �n aesessmaat aad �rS.11 coanect to the asa:itr�ry eewer wh�t made availabl� next to the property. 3) ?he tempor�rq cesepooY �sa�d �e �r��rly maiata�.n�� �o �vcaid aay goeai6ility of gollution into the tiice Cre�k. 4) The property would book onto the waterline oa �h� W�st ��dle of Ctatrsl Avenue when the house is con�tructed s�n this propast�. 1'�•� Yvmarg very truly � - �' ' ' I �`� ' . , - P1A3T�i M. QU��HI, PoEe Cit� &agine�r-Dir�ctos oi Fl�iag City of Fridley r aT TNR. TOP Oi� TME TNrIMi � � � , �.L ---___, co�wN+irr oEVS�on�xeNT av, � � � n�aTCCr�v� we�scTroM oar. � .---- � cm ruu.� raa.Ra ��� �._....�..• Z.� �nt-sso-s.w Job Addxes�. /� �' � I ,:^ � i��.. ,. �. .e Contractor -' �o Kind of Buil ing � Completion ate �O i '°J 7 ►i �IWI I i i i i � I m w � H !p o i� o �0 pu �O �f i� � 'A a� � . �� � _ � .� �' 0 w .� W � I ... � � � .� GT PLUMBI�If, PERP1IT APPLICATIOi�d 1 R�v. p�T[ ►�YE - 2 is 3 i � i L� � Ad ress � A ress � �Y" s I °' � � Use o , ��a�9 one �jt� r,sLimacea cost - —_ _—____... _.�� ��- —�---- e �1 Plumbing Fixture Rates: N0. RATE TOTAL ! Number Fixtures %� x 2. 00 { S ,�y�C i� Future Fixtures �_ x $1.50 �� New Fixture-Old Open. x 1.SQ { S f Catch Bastn x $3.25 � '--- � Water Heater-99,000 BTU �_ � $3.00 �.G`C� I � Ground Run Old Bldg. x$3.25 -�_ � Elec. Water Heater _� X $2,00 � Gas Fitting Fees: � lst. 3 �ixtures �T X $2.00 �l- Cs � I - ��_, � Additional Fixtures X $ ��� � --- _.� Gas Rang�-199,000 BTU __ x $5.00 Repairs & Alterationa See Description: Code State Surcharr�e _50 � TOTAL FEE $ � �..� � �The underei ne , g d hereby inakea application for a permit f�ox fihe work herein epecified� agreeing.to do all work in strict acco�da.nce w ith the City Ordinances and rulinF of e Department cf $uildinge� and hereby declare that 1��t �aets and xepreae�Catione atated in thia a pli ion are ru and correc . � � 'S �Lgnature ate ----`�l � �S �- a ,3 - �. s� � t I. . 53-�-s-9i5.51 City of Fridley r aT rNe ToP o� r� TwiNv � � � rL-------� cow�wN�sr �vcw�eNr o�v, � ' � M►qTECT�vR wf�scrlpN OL��r, � � pTr �IA�.� nuOLRY �Mi� l i---- � 1......1`.� `.J W-bfO-�MO �b Address Contractor Kind of Bu Comc� e ian b851 Old Central NE Theodore Klohs Minne�asco 12 � I W I I � � I II � .� � il � — -- --'; �I 'I 3° I i I � ' �i sva 4VD i I •saa� I•enN�va m y� SNISV9 � !+�+ HO1VD K ia w eN��ao ;o 0 aooia �3 0 �� V I saaMa+gl i�� ,o ��q '1NflOd d HN�aa 'ti �A � SAYNlI MSYM �89iN18 ' I ►uva asivM � na � .� 0 0 w � 'a i� � I I W I � — � I � � � � I � � � � �• � �.,� � � � � � �o-��-�s �� ( i I� i PLUMBI�Vr, PERf1IT APPLICATI��d � 1 OA I V 1 L/ 1.� f Ad ress Same A ress 733 Marquette Av� Use 1 one � �i� 10.00 • Plumbin Fixture Rates: N0. RATE TOTAL Number Fix tures x $2.00 �� Future Fixt�rres x $1.50 New Fixture-Old Open. x $1.50 Catch Basin x $3.25 Water Heater-99,000 BTU—T x $3.00 Ground Run Old Bldg. x$3.25 E1ec. Water Heater x $2.00 Gas Fitting Faes: lst 3 Fixtures 1 X$2.00 2.Ofl r ' Additional Fix tures __� x $ .75 ! Install (1) Gas R n e �,pp Gas Range-19���00 BTU x $5.00 ! Repairs � Alterations �O� See at�e Deacription: Code ��`C` �5,� State Surchart�e '�'P� .50 � , ��a� ITOTAZ FEE .� �s5� !The undersigned hereby makes application for a permit for the wo�k herein specified� agreeing to do all wark . in atrict acco�da,nce w ith, the City Ordinances and ruling of the I�paxtment of �uildinga, and hereby declare that � a11°th� tacta and repreeentatione atated in this app�afii�,�true�an orrect. r . „�,� �% c�' aZ_ ��v� � 'Signature � te , . t . 0 �a - � - ���-�� 53-8Z�-s-915.51 �����. Number Fix tures x $2.00 �� Future Fixtures x $1.50 New Fixture-Old Open. x $1.50 Catch Bastn x $3.25 Water Heater-99,000 BTU x $3.00 -_� Ground Run Old Bldg, x$3.25 Elec. Water Heater x $2.00 Gas Eitting Fees: lst 3 Fixtures x $2.00 r Additional Fixtures �_ X $ .75 Gas Ra,nge-199,000 BTU __ x $5.00 Repairs & Alterations Install D er See Description: � Code 5.d0 State Surchart�e ��a� �q� �urcharge .50� .50 TOTAL FEE $ 5.5� The under�igned hereby makes application for a permit for fihe work herein specified� agreeing to do all work i�n strict accorda,nce with the Gity Qrdinancea and rulin� af the Department of $uildinga� and hereby declare that a11'the tacta and representations atated in this application are true aad correct. ► t , � __._ _ -- ---. - .� - _ _ __�__--Z SUBJECT PER City of Fridley 12226 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T • i � ' � R COMMUNITY DEVELOPMENT DIV. ' � t: ------ �/ (% 1 �� r � PROTECTIVE INSPECTION SEC. i � � _ � � /�"1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED 8Y �'°'� � `�� 612-560-3450 910-F15 7/1�0/73 � � JOB ADDRESS 6851 Central Avenue N.E. 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oescR. Tract E R.L.S. �3, of Lot 1, Aud. Sub. �10 Rev. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Theodore Klohs 6851 Central Avenue N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Capp Homes 3355 Hiawatha Avenue 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING gesidential 7 CLASS OF WORK �] NEW 0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK �onstruct 23' x 54' Dwelling and ``tl' x 22' Garage �3 9 CHANGE QF USE FROM TO STIPULATIONS Provide a hard surface driveway. Provide a verifying survey before capping. Owner agrees to stipulations of letter dated June 6, 1972 sent to Mr. 0'Loughlin by Mr. Qureshi. NO SEWER OR WATER AVAILABLE (See Above letter) Copy of letter attached SEPERAi E PERI�I�S ��Qt11�E� F�QR 1NIRI�i�, ��T�NG, �'�.U��1�1G �l�D SI��S. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. WOOCl ET�B �' THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. GU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-I. 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 $32 691 $],6.3L�. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT � DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � $69.00 .SL]S.00 �y PLAN CHECK FEE TOTAL FEE � ��.d��e �Q ., �'-1 � (� ,Y $360.34 � SIGNATUREOFCONTRACTORORA THORIZEDAGENT IDATE) WHE PROP RLYy i1% ATE fTHIS IS YOUR PERMIT � * � , ,��,� / `� : .���� ` � � ��' '� � SIGNATURE OF OWNER tlF OWNER BUILDERI IOATEI BL'� . INSP qATE i1( / � . - � _ : �. . - �.a..:�.��._:�,...-a-.e_.o.�w - - .__� . I,.�, T .��.,...��- - .'�r' �-��.i'�� 3'-F � . <,� 1' , n r �'.'' ...,"�-�,�.,..�, t �� � �� � Sg r� . ��, :��-�� •,� � -;�� � ' ������� ����� ��� ��fi�:k � 2i,��['vT 1N: �, �'�:1T �1'iT i�[ . � � � _ -' �.�,•�c. � `� i .V�Q T!�13' 14e�j-t J3�7 �r ; �t 7v7+r �'? ' "� � . . . . , � ..� , . .c �p3._ i;:`. . 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F, �fl r��'f!T�S�Ar� �HT ?Ob4.FU `+t�Y1�M,Q..i�I��42 G��ti7,�k� �-t�lY�. �; ����A.?{_.�sz ---- � - ;i���.?dfi1�q "3hi� J�J`.�.aJ Rfi aTlt.}4tV,Ci�=YtIR'.�}iTUA 3'.'fr'� -,. 3adj�?�fF�l'�S71A+3,�i7�S , � � •, ' - -�t.n� �uiiTlsltre7�fl- WA 1a�0a �r�?.�Yr7�, Fi3�a�x� 1'�CP .9fl 2i1C�a�ti�;3� � ' , Q�:��'��? �a ��� d�c:-rau�Tac;c�a �� 3;r,awn���:a 3F;r �o «�it�ti�z. : ._�:,r__�___ _ _� __ - � � ai; �`` ".`_ ,��n., =�i�a�� � . ' f: � � y�1_ �� ., �. `� � ` � f :�,�,} t �;�-� .l�t�€� r i c�� � t� '�"' - v z , • F� � � � � � ��� � �a� . ( 4 � ��[;i � - � � � A �? � � � z:.� ��� �- ,—� °' \_�� �' � _ .. . �_._ � — �` � - �.,�� ,...._. �ac,..+.... ___.s.. � . :: �.;��h, ..� � ' , ir r.k " ',�. _: . � (.� _ - - {Fr�A�f c Fti� f � rxz}�(+ c b�—+.� �,` � .:�s .. , ._ . . . . . .. . . . . �•. _ .... , . ... �.��_. .. . -,.. . ... � ... � - � .. . _. , - �- i .. � . �_� 7 � �c�::S ,h;-r�,-: �... ._ .�:�. . � . . �' :. ...� � . . �1 a �,1C ' �`�'� -C�y�� �_.____---- A�.PLICATION FOR RESIDENTIALe ALTERATION, OR AllDITION BUILDING PERMIT CITY OF FRIDLEY9 NlINNESOTA OWNER' S NAME •'�.. e acQp �-¢� �� BiJILDER :_ C 1� R� �,nn P S ADDRESS • � � ( � �cQ C' e �v��'R '� 1 i� . �. i' ADD�SS • `3 3 S� t^F S�1 i,.o �9--�-�, �A � U�. N0: . ���j '� STREET:_ i`il eX f paJ �`�L tA-�,o,�-► �Q q'�J � �LtatT— �• � sr,ocx: aDDZTZO� : �� 4D Lr� s V ��- 3 ,� �� �-� 1 fl-�r c� A�� s., b U o I C� R�v , CORNER LOT; INSIDE LOT:�g�����; a,374'J. SIDEYAR.D; APp�F Applicant attach to thia form �io Certifica�es of Survev of Lot and buildiag location drawn on these Certificates. � � �� �. c� �"'� � � �-� r--b � u � � /�. -�_ /c � � �:�� � �, �ESCRIPTION OF BUILDING To �e Used As: praposed ,�-. �- � � '� � � '��, , �'� � � �� � w Front :_ � � Dept,h r S ��,Height ; S� e S� ' �' S Square Feet: Cubic k'eet• ��i A-c1�.�Q � ��,Froat: Depth• `Z '� Height• �O �°� Square Feet; Cubic Fe�t: Type of Const�;uction; l,.to�� ���,.,,�.�e Estim,ated Cost; �S" To Be Crnnpleted: �1 ,(�o� a 1 1 Q� y �-�; ��'�' ---, The undersigned hereby malcee applicativn for a permit for �he work herein apecified! a�xeei�$ to do all work in stfict accord�nce with tk�e City of Fridley prdina�aces and rulings of the Depar�e�t of Buildings, and p�ereby declares that all the fact� and re�resentag�on� �ta�ed in thia application are true and co�rect, a DATE : � � � � % � S IG�tATt1RE t � J . (� (Ses Rever$e Side Fox Additional Tnformation. ) i� � ", .�� �� .�� �,� a �,, f � �`� :-� ° : '-� ' � �°';� � ,� � „ - � � � � � "' q M � ���' p#�� � - � ,,� ((' ��° �` �1 , � �.. �� � .•¢ � ( ���'�' � F'-- /,� ��� w _ — �� �-- . � � 4� �d � e. . � BUILDING PERN[IT F�E SCHEDULE SECTION 2. The Inspector of Building� sha119 before iasuing permits £or the exection of any building or structure9 0� for any addition to any exist3ng building or structure, or for atay alteration or xepairs to any existing building or atructuxey upon application therefore, require the paymenf by the applicaz►t for such peranit of fees to �he a�ount herein below set forth and in the nqa.nner herein pravided to-wit: U1�TIFORM BUILDING CODEm Z'ype l, 2& 4�$2.15 fo� each one thousand cubic feet, or fractioA thereo�� in such cubical contents. Type 3& 5-$1.85 for each one tl�ouaamd cubic feet. . ADDITIONAL INFORMATION �or �e puxpoae of comguting fees for building pea-n►ite, the cubical contents of aYa� building or addition, i� determined by multiplying the ground area cov�red from a point six (6) inches below the floor line of the basemen� or tk�e cellar to the �ve�age heights of �he upper surface or to the average heigY}t of the roof surf�ce of the main gable of � pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3,00 gex each five hundred dollars ($500.00) or fraction thereof in the cost of al], pxopoaed work. T.n ao ca.se sha.11 the fee chagged for any pe�°oait as set €vrth in Section 2 be less thaa $5.00, VBRIFICATION OF FOUNDATION NOT�; Pe�nita Eox eon�stxuction will be issued a minimum of 24 hours fram the time �� applicatian, �o aII� £or proper xeview of the pxoposed structu�e ax�d af tY�e cox�s�ruct�.on sit�. A Certi�ied Survey of the 1ot, shocaing the 1o�atioa of tlze foundation, onee it has Ueen cor�structed, wili be required befoge proceeding with the fxaming. GERTIFICATE OF QCCUPANCY Appli,a�ttiort foz a Cextificate of Occupancy shall �e �aade ten (10) days prior to t'}ia use ax occupancy of any structure for �hicl� a building permit has been iasued� and said ���ucture shall not be used ox occugied until a Certificate o� Occupancy haa beean iasued. .. � � � � � � , �-r� � 3 � S. - �� . . June 6, 1972 , Mr. E�+ett F. 0•Lougblin 5387 Altura Bnad - • Fridley, Hinn. 5543Z � Bet pafver of the Requiremeat to Hook Oato the Sanitarp Sewer and Allowing Constr�:cticn o! a Hesspool Dear Hr. 0'Loughlint The City Couacil, at the meetin� af Jvae 5, 1972, authorized the waiver of the require�at of hooking on of youz property, Lot E, 8egiatered Land Survey No. 3 near Central Avenue and 89Lh Avenue area, to the sanitary sewer and a1laWing construction of a cesepool with the follawiag stipulatione: 1) Thie waiver ie temporary �til the edjoining area is ready to receiv,e the sewer service. 2) Once the City proposes to pravide sewer aervi�e in the area, that the propezty owner would aot oppose the im�rovemeat and would be willing to accegt their proportioaate share of the cose of the i�prove- m�t as an assessment and wi1.1 conaect to the sanitary sevs�r when raade available next to the property. 3) The temporary cesspool would be properlp maintained to ae�oid any poesibility of pollution into the Rice Creek. 4) 1he property would hook oato the waterl3ne on the West aide of Central Avenue when the house is canatzuFted on this propertp. Yoars verg truly - �'��-• ' � ' ��:�,,. .•'..- ' NASIM M. QURESHZ, P.E. ' City Engiaeer-Director of Planniag I� a ob . � ---- - �� �:��:�� � F 1� �.� � t a ` R b I "� I i �:i� . �: ry �� � . � . � s � �'^ (v , —"" r7 Y G ! � C,�L / [� • L • , � • �-- --r----�— ---T----—�-----� 66.02�'° 50 ���� � i I � I � �� -��. � . i t I �; 1 . � I � I 4� � `� � I� � I � � �"�� 0 o f �� � i �,; ,� �: V p ' � � � � � : :� � i :r i ^. •"' I � � � � . � � (11 I • y: � . _. I i �. : .. � . j f ~ •~ t � � ( - � 1 ° = I l I :. , � � o � ' I I � � - `�� � i . � � ��" � � �� . � � W I t..�p,o'�- _ I � . h �; � I I I � �' I `� � �' . I � .���� � i� I . ! � : �,. , �, � � ... � •-�5T6 �%��•� �r .. � i��.s , . . , ; ,� �r� ::°:�� . ;u.!. ;�,�. �.^:I �i)r: •. J .� � �� ; �"D.o2 `�' - 31 S./4� �s : ,, 20g.07' ', � � . . h ,,,- �, � c o o y ��� i o � � � �.� , 88 � ���vs � 3 j � �l '� , � �� . ��. . , • . � '�, j1� ��� s, ;'�' i ~ ;•i6.02•; � i' ,'� �-�--� � �' 2 O 8 . 07 � ' ; Q s' • E . ,, • � w ° F �, ' � N t V � d , " , . Rn � °� . h � . t d � �� g "� i ' � 6T.03' � . 3 ' � , � 0 V � . 0 � B al �� y, � � h � � � � � V ; � ao d- ; � �� se oi �.%- � 6--..a - _ •. A ' N , N. � i . . .??3 . ., .� • . � ;' . . r, .. ,,. --- 526.17�-- .� � - :;. F ,, . - - 6/ . ?� �� _ a ilos, � 6- �, i � ':_ : cc n�' �� �� : .. i � .•- 4c•�i ... ,:.. � .� i 50- i '� � Lin� Para//c/ 1�i��i /I/oi'�� L�i�� a f L I B�o I nereoy certify that in accor�'iance witr *he provisions o` Char." �/ 3�' amer�ded, I:":a✓e surveyed the following d�scribed tracts of lanc� �� � ♦� N!innesota to wit: Tne West b42 feet of Lot Une {1), kevised Auditor'.s Minnesota, accorc3in� �o the r�.ap or p:.3± thereof �n file and Oi� record in and for Anoka Courty, i�'innesota, except�:r.� those portior.s described� as fo South of � line drawr�' parai ie� with the tior`l: lir.e af said Lot One (1 } and �5 line of said Lat Ore (1), fr�m 4he IJorthwes�. oorner �'' said Lot One � 1) ,d and East 66 feet of the tJorth i?4 feet tiiereof . 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L ♦ 3. �. ��t�'���d ���r� ��d ��e�i�P1������as ����rd�� °�� ��p��� �a��, ��������#t�� b��� ��°�� ����c��9 �� Pt�� � � �ss�d �t� i� �h� ���� ������e� �r� �. � ���:���d �� t��s c�f�'i��. , ���1t�� ����ii� �e�ard��g � dr��f� �'���d �r�� �� �°���� to ���g� ��d ��d°�� �f ������ ����� ��t#�i � ;� � s��P ��r����b �� ���i�� �a b� ta��� �+ ����� ��i� dr�f � �f�+�'i d ��� � �!i r� ���r��. ����� �� �� �v���� p�r�ia�i�� �� 4 �1r�u�� 115 �+��r� ��� e�f ����r����� ���1d �� ��3� ��� ��dt�. ���:����� ��� b�dr� �a�s�$ t����"��� �45 ����r� ���� �fi ab��r����� �����d f� ,. ' d � ���h�� �� �r�v�`� �� €���� ��� �#� �v�� �� � >���^e� �h�� ���r, ��u� pl��� �t���� �� ����� a� �r����7 � ��� �i���t� ���a� �� �� ����, ���a��� ��� '��s� �r������i�d c����l�� �� � �� ��a�� �i� ���+� b����. T����� � 6 �q �r��� �`��� �� ��������� ���� �� ���� �� �� i���'� ��t ��' Z ��t �r�d� ���r��. Y��� �����. i������ � ��� ��' �5� �€�u��� f�'� �i� Q���rt ��ei€�, w����+ i��v�� €�;� ��spr�����,� �� �F��� a�` d����a �AG� � �. P'���s� ������t�a v� s�p�i� ��� �i�r�� ��� �� ����� �� ��1� 1� �g b� �f�s`�11� ��d � �t �3i b� �d$ r�d�`ly ���s���I� �r �h� ���t��<���� ��►d �i�� v� �1��+� w��c� �#'�1 �e��r #� � � t�� � ,yeaw ���r�va1. �� ,y�� h�� ��,y �u���9�^ts ����r�a��ag ��� �,��t��� �r �� t� t�� � �� �.n�r �r�� �� � �►t��, p1 �s� ���� �a�� � c�� 1 �� u�. � �; e������ +��: ��a,���a ������, I�a�, ����3� ����^� �1�� �1 {� �� ���y� ,� ,���,,�t � ���l���� � � ���� � b ��� P�sb� f � E��'�'� ��►� ��� �� I- � - � . . . _ I HBAT L033 EgTIMATE , . • Y'- . FOR.y( 132-4121 Clty or Villoge c �I ADDRESS � � / d - o � � ��E Floor � Z Dafe��,� IM� ^e► Phone Heating bill to be paid by ' � Contractor FIRST NAME Make of GWA INITIAL LASi NqME Plant ❑ �W,� �+a FHW S V UH �/ � � � ❑ SPACE Firepot. Boiler No. � Size TYPe of Domestic Gos Equipment: . Installed Rodiatio� — Gas Ranges W. Htrs. Onput Remarks:_ �� � ��� �rYers ___Hot Plates Dcte Rec'd. Heat Logg /' �� 9' t-� Checked By to be � Installed by-z�� Sold by � Cen, No. —_=---- On Mcin Size �� � OK Service Renew �I � I � ���x��� �, m � � y � � � � � • M a� 7 p �� � � � o � Y � � � � � b� z O � �a o � �� a m�� z� y° � �� � � � M � � � � � � � �� � � x �, � � 8 a � � � � � €� � r .� � h � ',I � I I I i I I I I I I � '' � g � � � [[���] � O < x �. Ij z � � � � �. � z � � � � � 0 � m � � � 0 � � � � � o � A ----- --------- 4 ------------- C'- �� OF FRIDLEY ��� �� - �� ' -433 APPli�tion for Ins1�Da,�on of Water an$ Sewer Service This form to be completec� before a tap is made to sew �hqe: _ � Y existing water '-��' � � •°� � o •------- ....�,.P""__ Block ...____..-•---__..._.. Addition �a-�- �-----------:-..�1� �. Aadre,ss ._._��`s,-- --- -- _..---•---- __......_ -�-•---•--•----- ----------------- ...:�.._ .._ .._.. _........_. . Owner -------- �.s � _ . 1% _ , ---- Plumber ----------- ,-Q-�zr.,o._.-- _�_-_ --- - .--- _� ._.. _ ('this Portion of form to be completed by pe CF.rA1�GFS TO BE PAID g �luesting ta.p) ASSESS �RE TAP IS MADE --. �NT HAS NO'1' $El;• N' jrE� AGA TN.cCm U$ nr��E Sewer Connectioa fee �Street Aa.tch _... Water Conriecl3on fee Meter deposit Materials t�ed �Street patch ...._ �, / ` � Where applicable ��•� The above applies for a11 regular residential size ��c THE P1�p�p,�E�,E� � �NTS HAVE BEEN �D�G �N � T.��RE WILL BE NO CI3AR,GES O The City vvill �TS AND MF,°!`ER DEPOSIT f�aish materials for wa,ter serv�ce and the plumber will bill the GYty for sewer, not to exc�ed $3.� a foot or a maadmum of $60.00. �S�SMENTS TO BE Water Lateral � Credit for material Toial assessment Se a�� . 9� wer Lateral $_____..._._._......__.._..._. Credit for material 60.00 Total assessment $_�------�_ Clerk's signa,ture ���--�.�,,��C; � �/ � I hereby authorize the above �a,p ��� �� �`� �t �PY—PubHc Works �"" j�jp�tOp Of pub�C WOTk$ � ,��� �" �� . "��. ��,��� O�t��r 71, 1974 �9r. T6°i�d€ar� �i. t�lr,�» � T� � 6�51 Ce����1 �ridl�y� E�9�r�n�sat� �5��2 L��� r1r. �l��s : �g�f���n�� i� m�d� to ,y��r r�eque�� �f J�� l�oi��€ (Biu�grsss Car�s�r�cti�� Cr►�R��ayj r�gar���r� �n�or�ati��t c�nc�rning �� ��w��e fa�c�li���s i�s��l9ed a� y�ur r�s�d�nc�. The �����e �����i��es �ervir►g �F��s ��id�r��� e�e�sis� of �h� ��p�ie �ank$ }�t�n��1�� s��`�1t�n� d9s�r9bu'��o� b�x and t�le ���id. Ti�� s���ic ���k is a 1,2�� gallv� fiberc�'I��s �an� �ar��factur�d by �b��, T�+c. ar�d -is 1���t�d �p�t�xi��el� 1� �eet e�st vf �� eas� end o� th� t���s�, i'�� se�,�ic ��r�k �is ��p��i���iy 14 ���t i�n�. 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F � �� A�� �� � . � , � ,�_J _ ' -. � y�c _ .. � .E�� � . . .. . .. . - � � ���� � � , _ . - _ - . . _ � . -. - _� - � ,d.` � -�� - . � r f �' .. -.�..n----.-,•_-r-.�°"*-. _^----•^:,�'---".r_"= � - _ . . . . . . . . �. ,..^���.�.. _. _.,�. . _ � . _ . . � `i ' �.rti. .._.-...a,,;.,_ � � . . . . � � . ` � .F.-. --.- .�.T...�. . � _Q�� 4 �1..����' � ��....e.;.=.,___ �-_-.--�__._..•. �`---� ---�-. `�'7"" D 9 _r:--1�, � _s� __ �:: � �_,�. �a �a - c �: b - -�r �_'���.r, �.Y� _ �, _ _ e� {` , , ReceiYed by 'r� ,�'` ���i' ' Health AuthOtity r '':` �� �-�.. '`�� � ` � �-�_ ..�-> - ° C� `'� g' ��� �`j��� � T���� � c�-��- UTILITY AND DRAINAGE EASEMENT THIS EASEMENT is made and granted this 13`� day of October 1999, by and between Donald H. and Julie Findell, husband and wife, Donald H. Findell husband to Julie Findell and Julie Findell wife of Donald H. Findell, owners of the property at 6850 Siverts Lane, City of Fridley, County of Anoka, State of Minnesota, (the "Grantor"), and the City of Fridley, a public body corporate and poliric, located at 6431 University Avenue NE, City of Fridley, County of Anoka, State of Minnesota, (the "Grantee"). RECITALS The parties recite and declare: A. The Grantor is the owner of certain real property commonly known as 6850 Siverts Lane, City of Fridley, County of Anoka, State of Minnesota, and more spec�cally descnbed as: Tracts C and F, Registered Land Survey Number 3, according to RLS thereof on file in the office of the Registrar of Titles in and for said County of Anoka, State of Minnesota. (hereinafter called the "Servient Property") B. The parties hereto have detennined that it is in their best interests for the Grantor to grant and the Grantee to accept easements for surface water drainage and for utility purposes in, over and across that portion of the Servient Property descnbed as follows" The North 10.00 of that part of Tract C, lying westerly of Tract F, all in Registered Land Survey No. 3, Anoka County, Minnesota (the "Easement Tract") The parties hereto mutually agree as follows: 1. Grantor hereby conveys and quit claims to the grantee perpetual, exclusive easements, under, and across the Easement Tract for the sole purposes of sanitary sewer installation, maintenance, repair, replacement and operarion thereof. 2. The Grantee, or its representatives, shall have the right of free access to the Easement Tract for the purpose of the installation, maintenance, repair and replacement of items described above. 3. The Grantee agrees that the Easement Tract shall be used in a manner as not to cause any damage or destruction of any nature whatsoever to, or the interruprion of the use of, adjoining lands owned by the Grantor and others. 4. The Grantee agrees that the Grantor shall have the right to grant other easements in over, under, and across the easement tract; provided, however, that any such other easements shall be subject to the easement hereby granted; and provided, further, that the Grantee shall have first consented in writing to the terms, nature, and locarion of any other such easements which consent shall not be unreasonably withheld or delayed. It shall be deemed unreasonable not to consent to any grant, which does not interfere with the rights granted under this Utility and Drainage Easement. 6. The Grantor hereby reserves the right to modify and change the location of the Easement Trac6 providing that such relocated Easement Tract shall be in the same character and subject to the same uses as herein described in favor of the Grantee and equally suitable for the purposes pursuant to which these easements were created. 7. All rights, title, and privileges herein granted including all benefits and burden shall run with the land and shall be binding upon and insure to the benefit of the parties hereto, their respective successors and assigns. 8. The easements granted herein shall not be deemed a public dedication; the use of the Easement Tract shall be restricted solely to the uses set forth herein. 9. The Grantee shall cause any improvements constructed in, over, under, or across the Easement Tract to be maintained in good condition and repair. IN WITNESS WHEREOF, the parties hereto have caused this instrument to be duly executed as of the date first mentioned above. GRANTOR: Donaid H. Fiudell � I' / '� �i �- Julie Findell , i� , ; / / .• � .i� .� � � Attest: The foregoing instrument was acknowledged before me this 24th day of October,2000 by Donald�H. Findell and Julie Findell, marr persons. Don ld H. F dell husband to Julie Findell and .Iu e F wif ot� al . F ndell_ 13y: �� ��„� : .�<-�. �. .eS P� �y �! d . TV!trR.ltt�'w`.�.....r��•'11e.� .I� .. ���",� �B. '��^,j�1ySi�y • � ����t ,� r �� �iNlJSSlQ� �l��S ,' �.�, .,- . ��IfA.Ry 3t � IY, � �� ��'^1Ph2 ^ wr'\�n.�.C,�,� �� Y ��"Mw.rsO•�v� � This instrument was prepared by the City of Fridley, Minnesota, or 6431 University Avenue NE, Fridley, Minnesota. . � ,�. � � : �� �.:�� i.:� : . ;. : . I : . . . . . �. :. . : .. ,. .,: � . � � . r :. : - : - . . : � . : � . . � � � : : : :• . , . : .. : �: . � .. . : � . : : � : � . � , o � . � . � �. � �' : a . r [ . � : . : � jr• • �• I : , � : � j . . : l. . 1 , , . . . � - . . � : � �1 . �Q . � � , . . � � . . . . . . . �: . . �..r � . , f . • �. 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W! . . : : ?� . < : �,� : ; . : ; ' . . . . : . :�; ::. `�f . : .. . -- . . : rr . : , _ . . � N . .. :.: �` : .. . . '� i:• �� ' , • � .. • . • :� . .. . • , : • . : :� �. �... '• . . . . , � : ; . • : • _ . � : � . • • . . � � . . • • ---• . __ . . . � � . • . . . . � H . , . . � � X . . � ' � . • . : � ' � . • . . � ; � ' ` : , : • :,. • - .__ ,�� r`�':'=;: �};: P`Y,�l?����-�'� ���K � . � ` t K�% ' - Ji-l• � �5' �.?...�n. 'a;'c-: �� `;�N^ ..r. �r.' ,;.!i� ; :t� _ .,�„ ,.z..,E�2:-,''�-�.;; ;�s._ K, o • r ,'n:>>. :_. � _ �.�-4:..°;_''fi;.,• . � ?:;�.' �3'. �ta.,, Y,`; � i � ; •,�.`. ,v�� Y ":t r E � � � Y:. r �' w_ .5a. �l. �.,: . =d. � :'f e W,. r �'�+z ' :,'w'3';; :�r '. :: ��- ' �S"� � i>,w:a ::aY.� i� `� -' F� ' -r.cs Xl: .� �`S's � '. r:r; ��� � 5;'; f� .T;a�i.;" ' K'i' � ��� � _ � CIIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UMVERSTTY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287 Theodore Klohs 6851 Central Avenue NE Fridley, MN 55432 Dear Mr. Klohs: October 19, 2000 Recent changes in State Rules and Met Council requirements required that all individual sewage treatment systems (ISTS) in the City of Fridley be inspected, properly maintained, and meet the State criteria for conforming treatment systems. As a result of these mandates, the City of Fridley amended Chapter 402 of the City Code regarding Water and Sewer Administration to reflect these requirements. Public hearings on these changes were held by the City Council on August 28, 2000 and again on September 11, 2000 prior to approval. The changes in Chapter 402, as pointed out in the City's letter dated August 15, 2000, require that you have your sewage treatment system inspected by November 1, 2000 and then biennially after this initial inspection. To date, we have not received an official inspection form for your system. If you have not had your system inspected, please have a licensed inspector do so prior to November 1, 2000. If you are uncertain as to the effectiveness of the treatment of your existing system or conformance to the current system requirement and would rather forego this inspection and connect to the City sewer system, please sign the attached "Intent To Connect To City Sewer" document and return it to the City by November 1, 2000. If you have any questions or concerns please call me at 572-3593. Sincerely, � �jvV Paul Bolin, Planner C-00-191 INTENT TO CONNECT TO CITY OF FRIDLEY SEWER SYSTEM �, , property owner(s) at , request (please fill in your name(s)) (your address) that the City of Fridley waive the requirement of an inspection of my Individual Sewage Treatment System. I request this waiver as I will connect to the City Sewer system by August 1, 2001. If I fail to connect by this time, the City may proceed with all actions allowed for in City Code to make said connection to City Sewer system. Signed this day of , 2000, by (date) ( month) (Property Owner(s) signature(s)) SuB�ECT c�ty of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T i� � � ' ' COMMUNITY OEVELOPMENT DIV. ' j L �.��� r � � PROTECTIVE INSPECTION SEC i._--� �"' �,� CITY HALL FRIOLE� 53�32 NuMBER L 763-571-3450 910-F15 �oe nooaess 6851 Centra�. Avenue NE t LEGAL LOT NO. BLOCK TRACT Ofi AODITION oesca. Tract E Reg Land aurve 2 PROPERTY OWNER MAIL ADORESS Ted & Linda Kl�hs b851 Gentral A.venue 3 CONTRACTOR MAIL ADDRESS Luudberg R.emodeli�.g Coastrtiction 1oi32 heni� 4 ARCHITECT OR DESIGNER MAIL ADDRESS GINEER MAIL AODRESS PERMIT NO � � �� NEV DATE PAGE Of APPROVED BY 6/27/03 / / SEE ATTACNED y��� of Lot l, AS �i�10 Rev SHEET Z�P PHONE � 763-571-9488 Z�P PHONE LICENSE NO � ver, MN 55304 763-323-� ZIP PMONE LICENSE NO. 20039932 Z�P PHONE LICENSE NO 8 USE OF BUILDING Reside���ai. 7 CLASS OF WORK O NEW �7 ADDITION � ALTERATION � REPAIR p MOVE O REMOVE � 8 DESCFiIBE WOHK _Cons�zuct a 21� x 10'8" Addition to n�P��s,�o 9 CHANOE OF USE FROM STIPULATIONS See �zotatior.s on plan. S REQATE PERMiTS VIIIR NG H�A1�R� �LiUM�IN� a�a � ��� u TO ��R�1�'� ��ft�� �i�g� j�� �11 ic�� �il �iiT�ty� Im���ir��s 454-0002. R����I��'� �`� ���V SEPARATE PEFiMITS ARE RE�UIREO FOR ELECTii1CAL, P�UMBING, HEATING, TYPE OF CONST. VENTILATING OR AIR CONOITIONING. 7HIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING AUTHOfi12ED IS N07 COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANV TIME AF7ER WORK IS COMMENCED. NO DWLG. UNITS I HEREBY CERTIFV TNAT I HAVE READ AND EXAMINEO THIS APPLICA710N 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of �AWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK W�LL BE COMPLIED �n WITH WHE7NER SPECIFIED HEREIN OF NOT. TME GRANTING OF A PERMIT W3S�OOO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME pEFiMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION ����, �rj PLAN CMECK FEE OGGUPANCY GROUP SO. fT OFFS' STALLS LicEn e SC $5.00 SiG U)��C„(') -'p�TeqOAAUTHOAIjEDAGENT 10ATEi �.,,� EN PROPER�r o A .� /% f� IOATE� UPANCVLOAD CU FT. GAFAGES $17.50 SAC CHARGE Fire S � � � 5 , 7i� TOTALFEE $549.75 D THIS IS YOU PERMI l.J�� �� q�rE NEW [ ADDN ] ALTER [ ] Construction Address: �v� Leaal Descrintion- CITY OF FRIDLEY 6431 University Ave NE, Fridley, MN 55432 .SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1 /1 /2003 (763) 572-3604 Bldg Insp (763) 571-1287 � r l F �,; � � ``P ��°� � r � . ,1 . LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT � ,. . Length / Width � g` �� Height _�i� Sq. Ft. � Length �dth Height Sq. Ft. Length �dth Hgt/Ground Sq. Ft. � Construction Type:�jd�r1 A O�d:t'�,� _ Estimated Cost: $��� � � i Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: � a APPLICANT: �U � Tel. # 3��_ (� � Call (763) 572-3604 for Permit Fees if mailing in application. Fa 763-571-128 if using credit card and we will call you for card number. , CITY USE ONLY - Permit Fee $ f �Fee Schedule on Reverse Side Fire Surcharge $ �C� .001 of Permit Valuation (1/10th°/a) State Surcharge $ . $.50/$1,000 Valuation SAC Charge $ $1275 per SAC Unit License Surcharge $�. �l� $5.00 (State Licensed Residential Contraators) Curb Cut 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 $ , � STIPLILATIONS� 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 $50,000 $50,001 to $100,000 $100,001 to $500,�0 � $500,�1 to $1,000,0� $1,000,�1 and up FEFS $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,�0 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 ea�h additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,0� 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 CURB CUT ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined rate. Permits for conslruction 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 Onlv � r�'�� x : � r�^ s�''w �' ��" , � �' 3;. t�o: ' ,�-a* `_ +�ye�, �,�� '��; +a'i �� �� ��� e � � `�' �r s";`�±' : • , , 'v � � . � �t A ---------u- ,9' � ,�....1_.._.__��.______.._ �.}. , ---+-- �� I . �.� ��:� • .: ,i , ,-�� � . . . �. � � � Ib`w�µ z� c>o �'�t-a� _._,� .� .�.,.._ � �: - � 1 1 _ I ia�aE�TQ� � � .. .c �.,... ...1 y y� ��L CN � �� � �*4 „�; , . `, � � . f.. - -- , ' ��C'". f�r~'tot�14 aL.% , . '' �;9►Zi": f�riC��'[G.l• ' . ' ,' ' - f *Q � �t.tcr.���G��Df�'t�*�s�a. ' . ' � • � `,,: {G ,�i,1..I L'S pAL 6r " � ° �CHea.�tra� . , . . N • Z,• `cor+c. S�a� ' ' N. e^a a. . � . � . yr: � �� ,; I . tNSUt. F�-.. 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A�tcyo�S --- N�---- -- � u 11:.->=� -�_..-�I _� _��-- ll U' l: IJ _ �. < �, r �x�s'T. N�t�T��) f//iJ�' � ��,iz��coH'h�.� p. o R�c.,�e F 6 � p�°° % �� Y � Z" Goiy�� �SLS�y 2ox8 cot�►c.FT�t• — _-_-__--- �_—____a /oE %f��iL!l��. ��4z'r�,�+�'T�.- ! - �� �C.���9.¢ ��Z G�.S�-���araFx 1 � 'Pp�po��D aflu, j �o� .w�SPde.� zz� SF Il-t �LOG�P- _ 22 N S i� �-Y ` : L I 1 M n ii GR-r-, �--% r From:RUM RIVER LU�BER 763 862 7359 06124/2003 13:34 #433 P.001 N�Tcheck COMPLIANCE REPORT Minnesota Energy Code MNcheck software version 3.0 CC)UNTY : Anoka STATE; Minnesota ZONE: 2 . CaNSTRUCTIQN TYPE; Single Family DATE: 6-2�-2003 DATE OF PLANS: 6/24/03 TITLE; iClohs Addition PRQJEG°T INFORMA,TIQN ; 224sf 2story addition on crawlspace foundtion OOMP�' INFORMATION; Lundberg Remodeling&Construction COMPLIANCE : FA,SSES Require�d UR = 53 Your Home = 51 3.3% Better Than Code � I I j � Permit # � � I I � � Ch�cked by/Date � 1 I Area or Cavit� Cont, G1aziMg/Door Perimeter R--Value R-�`alue U-Value UA --------------------------------------------- CEILINGS: Rai�sd Truss 229 49,0 0 0 g WALLS: Wood Frame, 16" Q.C. 232 19,0 2.0 13 b�ALLS: Wood Frame, 16" a.C. 61 � 10,0 2,0 5 GLAZING: 6dindows or poors, �►bove Grade 60 0.340 2� CRAWL: Concrete 42" ht/ 34" bg/ �2" insul. 112 10,0 -----------------------g-----g---------------- ----------- CG]�LIANCE STATEMENT: The proposed huildin desi n described here is cansisten� with the building plans, specifications, and other caiculations submitted with the permit application, The proposed bui].ding has been designed to mest the requirements of the Minnesata Energy Code. 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Yes () No () The venting system is plastiGPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. me EY�stina ceme���tinn air is sized and installed to meet the current codes and manufacturer's specifications. When required to °"�`"'� a n�•� o e,� �nn air�,it will be sized and installed to meet the current codes and manufacturers specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) �e� ;n �Iline � n_��� ventinQiy�±,�, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () No () Is the common �ent and vent connectors sized and installed correcUy after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No () � .. .���.,:-.■��.���:�:�.�.,� _ - _ ..___ . _ _._�_� . � . r�� • � Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type � r -� r•► .- �.- HEATING CO: Signed By: Date : City of Fridley AT TNE TOP OF TME TWINS i� � � � ; v _____ COMMUNITY DEVELOPMENT OIV. r � � PROTECTIVE INSPECTION SEC. `""� ��"' �. J CITY NALL FRIDLEV SS��T i 763-571-3450 Su8�EC7 BUILDING PERMIT 33790 NUMBER pEV DATE P� 910-F15 8/11/03 / JOB ADDRESS 6�51 Centra� Avenv.e NE 1 LEGAL ��T NO. BLOCK TRACT OR ADDITION oesca. Tract E Ri�S ��3 of i�o� i, Aud. Sub. #IO Rev. 2 PfiOPERTY OWNER MAIL ADDRESS ZIP L�nda & Ted K�.ohs 6851 Central Avenue NE 3 CONTRACTOR MAIL ADORESS ZIP Rum R�vez� Lumber Co i014�. Woodc�est Dr�ve, Covn Rapids, MN 55 4 ARCHITECT OR DESIGNEFi MAII ADDRESS Z�P 5 ENGINEER 8 USE OF BUIIDFNG Resident�ai 7 CLASS OF WORK MAIL AODRESS ❑ NEW ❑ ADDITION O ALTERATION 8 OESCRIBE WORK R�side House & Ga�a�e 9 CHANCiE OF USE FROM STIPULATIONS TO ZIP RECEIPT NO. ��1��/ Oi APPROVED BY� � SEE ATTACHED SFIEET 763-571-9488 PHONE LICENSE NO 433 763-862-7300 PMONE LICENSE NO. 20036086 PMONE LICENSE NO � REPAIR O MOVE O REMOVE Per Sec:io� 1402, :�997 U�ifoxm Bui�di.�g Code, �equ_res that a we�.th�r res�st<ve b�rr�er be placed over e�:�eraor sheath�ng +�o pro�ECt the �nte�ior w��I caverin.g. Except�o�.s for this p�ovi�sa�.^. wou'�d be i� shea�hing �,s da �.pproved we�.therprc,of p�.rLe�. �r whe�. the sad�ng is �.n appraved weather barr�er. V�a���. s�dirg is not a weatnerproo� coveri�g un�ess �he �4:u�ac:.urer s�a�es th�s irr the:�r appi�cat�an gu�de7�i�.es. Ca�� for �:zspec�tion af w��p befo.�e coveri�g �r take p�ctures. ��.u�.k an.d ;:�ash ai� exteri�r ope:��ugs. ' � r, , : `�, , ,. � ,. , � (� I .'e ' '' '� r � � • . �'- . t TYPE OF CONST. SEPARATE PERMITS ARE REOUIHED FOR ELECTRICA�, PLUMBING, HEATING, VENTI�ATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING AUTHORIIED IS NOT COMMENCED WITHIN 8U DAYS. OR IF CONSTRUCTION OF WORK IS SUSPENDEO OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS I HEREBY CERTIFY TMAT I MAVE READ AND EXAMINEO TMIS APPLICATION 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PqOVISIONS Of LAWS VALUATION AND ORDINANCES GOVERNING TMIS TVPE OF WORK WI�L BE COMPLIED WITH WHETMER SPECIFIEO MEREIN OR NOT. TME GRANTING OF A PERMIT �19s8�7 DOES NOT PRESUME TO GIVE AU7HORITY TO VIOLATE OR CANCEL THE pEqM17 FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STqUCTION OF THE PERFORMANCE Of CONSTRUCTION �32f .2S SIGNATUpE O� CON'RACTOp Op 4UTMOA4ED AGENT iDATEi ` �DATE� � T ° T STA�LS � �� $.5 . �� iEN PROPERLY V IROUP OCCUPANCVLOA� CU fT. OFFSTiiEET PARNING IGARAGES SURTAX $9.93 SAC CHARGE F-��e SC $19.87 TOTALFEE $356.05 D THIS IS YOUR PERMIT '� \ �- �� ! �� ��p NEW I j CITY O� FRtDL�Y Efl`e+c��e 1/412002 !�,,J Ai?DN L Y � ALi'ER �J SIN�L.E, FAMp Y AA1D D PFL�S R T D R 2 �63) 572-36Q4 BWg Insp BUILt�ING PERMiTAFt�l.ICAiiON �ot�struc�oR �ddr�ss: �5 � �'Q,V'��� I�U C. N . � . � I.egai Descrip�on: c�nmer Name & Address: �.i r�d0. fi Ted Klnh � Te�. #� lQ'-� �S �) - 9y g£s ContraCtor. �U-�(\ � �C.r �� MN Li��t�i$� # a"Do31o08_10. Address: 1 D141 wc�cfcres-} D r� J� Tel. #"7(�3- S'�2► •�3 00 �„ �� `�S� `�Attach to tF�is a�plication. a�ert�ficate of Survey of t�e - lot, with th� pro�ased r,onstruckion d�wn on it to scale. lMNG AR�A: �AEtACE AREA: DESGRIPTION OF 1MPRQ1►EM�NT L�ngth � 1A�dth � Height �, Sq_ Ft Length r„ Width � Height __�__,_,� Sq. �t _.. DECK A�tEA: Length � Vlhdifi HgtlGround _ Sq. Ft OTHER: � y�a y� , �r�� t2esrd.Q Constructi�ri Type: Te� �-� S.�c��� Es�m�ted Cos'� ��_���87 7d Driveway Gurb Cu# Wid#t Needed: �Ft + 6 Ft = �t x$ =$ DATE• - 'rJ " ,� APP�ICANT: TPI. # �1 la�' ` c�SlOd '�Q U �a�l �rs3� sra�saa fo� P�m,�t Fees � mai g in application or Fax to 763�571.-1287 if usitYg credit card a�td we uv�11 calt you fc�r card number. Permi# Fee �i�e Surcharge State �urcharge - SAC Gharge L'ar:ense Surct�targe �civeway Escrow Esosion Gontroi Park ��e Sewer Main Charge TOTAL baiZO'd CiY USE ONLY - $ � � ' a� �ee Sch�dute on Rever's� �ide � $� • � .004 af Perm'rt Vatuaa#ior� {1/10t�iD%) $ - -- � - - $.5@l�'��� �lu�an - - - - -- $ , _ �9200 per SAC Unit $ S• DU. _ $SAQ (Staie Licensed Residential Contractars) $ AIt. °A" OC AIk "E�° AbOVS $ $450.00 Conservation Pta� Re�iew $ � Fee Determined by�E�gin�ering $ Agreem�rrt Necessary � � Not Necess�ry ( ] $ .���.0� -- �lL ST09Z98 O1 STIPUiAT[ONS: �� �3�QI� �0 .11I� WO?�� 6S:0T z00z-Z�-�Idd � From: City of Fridley To: 7846001 Page: 4/4 Date: 10/2l2006 9:29:38 AM City of Fridley 6431 University Ave NE Fridley MN 55432 (763) 572-3602 or Fax (763) 502-4977 Water and Sewer Permit Application �] New Connection ❑ E� sting �� � �� �Q ,� � / �° �s� � � l ❑Utility Line Repair/Relocation OWater and Sewer Connection Date: � (� � t? �o Job Address: �D� ,j l � �° �!/��L � V "�-- Name of Applicant (Plumber): � �/�h/ %a�/�,(�i; , � �� r Name of Property Owner: (�(� f C�(� �- S Ea�i sting Structure Permit # Permit Typa: Sewer Fee: `^�-� Water Fee: Meter Fee: Repair Fee: Relocation: State Surcharge: � SAC Charge: Special Assessment Fee: Total: $ �'�: �C5 Applicant Signature: Insp�ctor approval: Water Meter Repair — Weekend & H Water Connections Permit Sewer Connections Pernvt Inspection Fee for Water/Sewer Line Special Assessments Cost of Water Meter SAC Charge State Surcharge Water Tap a41o4ios , — c $125ihour $50 $50 $40 See Engineering See Utility Billing $1550 $ .50 See En�ineerin�