AF - 36253City of Fridley
AT THE TOP OF THE TWINS
i �
i �• COMMUNITY DEVELOPMENT DIV.
r � y � PROTECTIVE INSPECTION SEC.
E �. i
� � i"'1 � CITY HALL FRIDLE� 55432
�"'°� � ��� 612-571-3450
SUBJECT
BUILDING PERMIT
NUMBER REV. DATE PAGE OF
910-F1.5 in/z/n� � �
JOB ADDRESS 6501 Channel RU3C1 N. }$.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. (� Pt. 7 1 Erco' s Addition
2 PROPERTY OWNER MAIL ADDRESS
F'ML, Inc. Box 483, Hastings, M[�i 55075
3 CONTRACTOR MAILADDRESS
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
Michial Mularoni & Assoc. 4721 -
5 ENGINEER MAILADDRESS
6 USE OF BUILDING
Four-Plex
7 CLASS OF WORK
. [
8 DESCRIBE WORK
Construct �
9 CHANGE OF USE FROM
NEW ❑ ADDITION
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ZIP
�� 1 �'
ZIP
ZIP
S., Mpls. 55
ZIP
PER °
_ 1727
RE -NO.
�pq4y
� �
APPROVED BV
SEE ATTACHED
SH EET
E
PHONE LICENSE NO.
PHONE LICENSE NO.
PHONE LICENSE NO.
❑ ALTERATION 0 REPAIR ❑ MOVE O REMOVE
TO
STIPULATIONS See notations on plan. Draft stop to roof sheathing and into overhang
on upper £loor. Provide attic access frcffi each unit. La.nding must be 5 feet in
length. All corridors and.stai.rs must be 36 inches minimum width. Water heater
must be accessible. All apartment entxance doors must have dead bo�.t locks with
no double cylinders. E'ront stairway must be 1 hour constructi.on. Doors off front
s�tai.rway and utility rooms must be 20 minute rated, self-closing and have smoke
gaskets. Provide pull boxes alarm ��i� system and sensor :in laundry room. Provide
outside development bond and sign landscape plan.
M�7 �� �������� SEPERATE PERI�ITS REQUIR'�D FOR 1�V�RIf�Ga
����S��'�1�l�313-3NOHd31�1 ��A1'ING, PLUMBIfdG ANI� S1GNS,
sar�!1l�� �e�o� II�� �ui��ip a�o�a�
TYPE OF CONST.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COIJIMENCED. NO. DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE FiEAD AND EXAMINED THIS APPLICATION '4
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S�-SO��.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
RUCTI OR TH PERFORMANCE CONSTRUCTION. $'rJGO. SO
PLAN CHECK FEE
� � `� � None
SIGNATURE OF CONTRACTOR OR AUTHOR12ED AGENT IDATEI WHEN R3ii
�DATEI
OCCUPANCY GROUP IOCCUPANCYLOAD
STALLS
CU. FT.
OFFSTREET PARKING
GARAGES
SURTAX
$75. 05
$1,360.00
�TAL FEE
$1,995.55
THIS IS YOUR PERMIT
�
� . , CITY OF FRIDLEY •
Canmercial and Industrial
� Hu ldinc� Permit- pl,ication
Effective Aug. l, 1981
�� ��et
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,
�uildinq Address: .'
N: G� � �y � �- � 5' � /�.� ��� - -�" %
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�ERZY �QiNEI� s � . . H Ni : _
. . • . . L N.
i
ENG1NtEN: . � AppRESS: iIP: PHONE: ' ..1 ICENSE N0.
U L . M: .
Lo7 AREA: • LO7 GOYERAGE:
�LEASE CHECK. IF REQUIRED:
9
a
5
. 1'I{lY E : '
N ..
Dl!'EN51oN]: LEMGTM S`� MIDTH �� SQ. FT. Z,O ��
' IffIGHT � �; �re% LUBIC
AC[ESSORIf BUILDINGS:
�� �� LENGTH �� MIOTH � � SQ, FT. ��
lEI6HT CUBIC
��SO.�FT. ZD�� X : �� COA/SQ. FT. • YALUATION �0 � (o � , �/�
Q�HER �'�� x,i �D e Gp� COST/SQ. FT. * tlALUATION' �� �jq �. ��j ` TOTAL VALUATION��s���
YPE OF BUILOING CONSTRL�TION _ '1�,(� �Z �� OCCUPANLY 6ROUP CLASSIFICATION R� I
S:
. PERMIT: COMp'ERCIAL. tNDUSTRIAL OR ) . $ -�-�,�o
. ALTERATIONS/ADDITIO.NS/REPAIRS: � See Fee Schedule Ofl iteverse Sfde �,/�
$` / � �S.d e V�
. SEWER AVAILABILITY CMARGE (SAC) ■ �
. ►LAN CHECK (65z OF PERMIT FEE) � ' s
. STATE SURCHARGE (5.50/E1.000.00 VALUATI�I) • � TOTAL FEE �' ������
I CIAL ASSESSMENTS: 1. IF LATERAL ASSESSMENTS HAYE NOT BEEN PLACED ON THIS PROPERTI', AN AGREEMENT MUST 8E SIGNEO. AGRtEING TO
ASSUN� SUCH LATERAL ASSESSNENTS BEFORE A PERMIT MILL BE ISSUEO.
2. PARK (lOx RESIDENTIAL, 3x INOUSTRIAL) (REAL PROPERTY OR CASH)
3. PERFORN'ANCE GUARANTII (FILEO • NO YES I )
i AMOUNT
AGREEM� M
I CTAL ASSESSNENTS:
AGREEME NT NOT NECESSARY
2_ QAh � �
.,... � .... � ....
' ITE INSPELTION: SIGNATURE QI1TE REGISTEREO ENGINEERING S�AMP
i
-tMBING EXTERIOR DEYELOPMENT CMECK
.Y.A.C. LEWL OFSCRIPTION CNECK
-E«I� PERFORMANCE BONO CMECK
iRE DEPT. EASEMENT. ROY. SP. A6REEMENTS
�NAL APPttOYAL
J1l0ING INSP. iUBLIC MORKS DIREC70R C1TY MpNA6ER
=RTIFICATE OF OCCUPANCY ISSUED py�� �
N .
0
w � r
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Building Pe,smit Fee Schedulea
TOTAI+ VALOATION
$1.00 to $500.00
i501 to $2,000
52.001 to �25,000
525,001 tc $50,000
$50, 001 to $100, 000
5100,001 and up
fi'
�- �,,�i
i
F�S
�10.00 (Mi.nimian Fee is $15.00 plus surcharge)
510.00 fo= the first $500 pltrs 51.50 for each
additional $100 ot fraction tbereof, to and
including $2,000
$32.50 for the first $2,000 plus 56.00 for each
additional $1,000 oz fraction thereof, to and
includiryg $25, 000
5170.50 for !he first $25,000 plus $4.50 for
each additional 51,000 or fraction thereof, to.�
and includinq $50.000
$283.00 for the first $50,000 pius S3.00 for
each additional $1,000 or fraction thereof, to
and including $100,0�0
$433,00 for !he first $100,000 plus $2.50 for
each aaditianal �1,000 or fractiaai thereof
PLAN Q�CR: 65 percent of building pesmit fee
SAC Charqe: �425.00 per SAC uait
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CITY OF FRIDLEY
d��l UNIVENSITY AVENUE N.E.. FRIDLEY. MINNESOTA 6b�32
TELEPHONE ( 812)b71•31b0
?B?�081R? C�"f IFIC�lB OP OCCOP�Ct
CI7T OF PAIDLBT, lQYI�iBSO�lI
Date January 3 � �g 83 �lding Permit Ho. 17271
liame of Ovaer Frank M. Langenfeld Construction (FML Inc. ) �
Address of Owner Booc 483. Iiastinas, MN 55075
Addre�s of Buildiag 6501 Channel R,�ad N.E., Fridley, NIl�T 55432
portion to De Occupied All
Occupancy Group Classification ����������
Tbis oerLifies that we have iaspected the building at the above location�
vhicb is aituated oa Lot(a) part of 7& 6 , Block 1_,_,
of Erco's Addition Addition in Fridley, Minnesota
and find that Lhe building does not totally comply vith the requirements
of the Suilding Codes of the City and State of Minnesota relating thereto.
Permission is hereby given for the occupancy of said building, in part, in
the manner and for the purposes herein specified above. This temporary
certificate is valid for a 6 month period from the above date. A
final certificate of occupancy is required to be in eomplianee With City
and State Building Codes and Will be issued when the tollowing items have
been eompleted:
1.
2.
3.
�.
5.
6.
Co�plete landscaping.
Install local alarm system as noted on plans.
Bathtub scuttle doors to be installed in �11 units..
/- 3- irY
DATE
DARRII, G. CLARIC
Chief Building Official
,a-
�
�'�
CBIiTIFICATB OF OCCIIPANCY CHECBLIST
Dgte December 29 � 19 83
Building Permit No. 17,271
Name of Or�trier Fran3c M. Langenfeld Construction (Fl� Inc. j
Address oP O�raer sox 483, Hastings, ND.�T 55075
Address of Buildirlg 6501 Channel Road N.E. ZotliAg:
Legal DeseriptioA oF Property I�art of I�ot 7& 6, Block l,. Erco's Addition
STIPIILATIONS
DATE COMPLETED
�� ,� .�. � � ,D�.u.e � �,- - - ��-�t
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�. . .�. ��
D�1TE APPROYED
1.
2. � 30
3, ��3 - �'3
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.
�FICIAL�S SIGNATURE
Fire Department
.. c , n /l
Police Department
Plumbing � Heating Insp.
Electrical Inspector
5. ��` City Planner
6. Chief Building Insp.
7.
� � . � . Director of Public iiorks
: ; . . '
` �Land Dcv+elopmeri� P�1ans _. ,3 : , , : ,
,
� . � _, � ��_ - ; �
.� _ _
$. , r� - Q��adi,�g t Sedim�t-�r4sidn Cont�b�. �
P1an
� [j S�.b�mr�ater M�n�g�xn�nt P1aa ; '
r -
� Final. ��ite:- Drainag'� .P�.an
�
. . .. _ .. ,
� ,.., �Er'lod� Flain D�v�lopment ,;; �_ ,
, ,.. �
� , . [� Use andror �iPPrcpriation . . - �
f o� riu%1xe �rTater�s
� �Briiige or £�xlvert 'Cor�stru�tior��
`;QWetland Al�er�tiqn ; - =�:
5 E. 4 , � Ri�arian �mp��av�ment-Sho�+al:ine .
� - ,� 5e'tb�t+�l� ;� = � , �� � � �� � � � �� � �� ` � � - �
� (,`jPri�rate.'brai�ac�e System � �
� ;. [�Oth�r ::(explain. ia Stemarlta�
_ ..�
�„v i3� . _. , ,�.`:� ;..: . - �h f � .. • . ,... ~ •
F r Name o� Projec't: 9`\�� ����-�
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:Pu��pvs� � o� P�o��c�: � * �,� p��c,-�C� tiJ L�.. � :
1 _ t�--: �
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� _ � _ _ .N - a,�.-�`a�-.�-- ��Z�� � �� "� '�`P�
�ci�a��:on a� ��a3�a�� �,dd���� �� �-� i.��� � �, a o�r,_�a ., .
; Nt�na,�i�lit�-�� "��iwm�hips �t� �� ��� i �i�t�ct�ab�
� ���.�: , , ------�
�,.
� �, "�.' `� _ : � of Sea�iori Township _ Range. _
, � eal�. 483 t�6�4 if, assistan�e in complttin�j this form is required. Please
l� .�ttach ra�ings �- p.lans and•. ather d�t� as�; t�utlined in "Ri�e Creek Watershed
, 17istr3:�t Atz�es" and _Regulati.ons".Ma�.1 Qr :del3ver this form a1�ng with a
��;�10.0� administ�ative fee �nd app�opria�t e�ibits, to �h� ak�oc�e address.
�. `..'��i ��i��.d � inspe�tidn fee ciri tYia,s p�ra��.t sh��l be ciiarged to cover actual eosts
, rei���d to;: a fal.el.d ::inspeet3:on ir�G].uding :;�h�: 3nvestigation of th� area affecte
��r ,'tY�e:_ �roptised ;activity, an��.�si� . o£ t�i� piro,posed activity, services of a
.�Qn�s�l:�ant ant� iz� atic�itian, ;� .��� .wi,i� be. �h�rged' ft�r any. r�quired subsequent
'� irion3��r.ing' �� .t�e .,praposet� ae�i:�t�.ty_��i' „l�l�;�;.�i�: �'I2.88, Subd. 2. APPlying for
�h:,i�: permi� �a ' RCG+TD do�s no� ��ire��,ud� `�c�iY� agipl�ing for any necessary permits
� . ._
'�iia� ,triay be. �equ.r�e� from othe�.::�gc�u�rrim+�ntai� . agencies.`
, fi : . ,----�--�--. ,
.1k8-`78 _ ,
V�\�5io
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l. .. � U: r!'.��.. L^.. :1
October 3, 1983
First Federa/
SAVINGS AND LOAN ASSOCIATION OF HASTINGS
SINCE 1881 _------
City of Fridley, Minnesota
Fridley, Minnesota, 55432
Re:Letter of Credit
FML,Inc.
Dear Sirs,
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First Federal Savings & Loan Association of Hastings is issuing this
letter of Credit of $5,000.00 to Cover completion of. sod, land-
scaping and asphalt for the three four plexes to be built on lots
3 and � of 4,6,7,8, all in Block 1 of Erco's Addition of Anoka
County, Minnesota, by FML,Inc.
Vert Truly Yours
� `��,i ;�`f�'G������d�.�-
George B. Loban
Exec. Vice. President
,
�
HASTINGS • 122 EAST2ND STREET • PHONE 437�188
APPLE VALLEY • 14988 GLAZIER AVENUE � PHONE 432�8B40
� INVER GROVE • 8505 CAHILL AVENUE EAST � PHONE 4557553
ROSEMOUNT • KEN ROSE SHOPPING CENTER • PHONE 423-1191
SAVE WITH US — BUILD YOUR OWN FUTURE AND YOUR COMMUNITY'S FUTURE
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Fq(en No. �9•M—QUIT CLAIM DEED
tndividual (s) to Corporation
or Part�nhip
`��"� d
Mlanewta Unitorm Conveyan�
No delinquent taxes and transfer entered; Certificate
of 8ea1 Estate Value ( ) filed (��not required
Certificate of Real Estate Value No.
ca��%7 ,19
/ �
,/�, �' � // � '�
- � -
. .
/
, � �1 /_��. � � � �.�_
� _
STATE DEED TAX DUE HER,EON: $ �
.�
Date• / � / � , lg �
�
,i si T"s�`�'e�.
Miller•Devis CO. Mmneapol�b
!
��593�
(reserved for recording data)
FOR VALUABLE CONSIDEftATION, David A. Langenfeld and Margaret A. Langenfeld,
Husband and wife , Grantor(s),
tmaritel statusl
hereby-convey(s) and quitclaim(s) to Citv of Fridley
� , Grantee,
a municipal corporation underthelawsof Minnesota ,
real property in Anoka County, Minnesota, described as follows:
A 15 Foot Street, Bikeway and Walkway Easement over the South 15 feet of Lot 6,
Block 1, Erco's ]st Addition.
The City of Fridley hereby accept this easement for Street, Bikeway, and
Walkway purposes.
� •�
'J; � `, "•�'1_,I//
' �� '.
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� � ,a' :�-11 -
.'T ,+ , _ ,r.
, .,,.
' .`''rr� �.; .. !. '� .
�.Id
� ' ' (if more sp
together with all hereditaments and appurtenanc
:'.it;x De��d 7'ax ���rnp iic:e
NO STATE DEED TAX REQUIRED
SIDNEY � INMAN�- CITY CLERK
Margaret A. Langenfeld
STATE OF MINNESOTA �� �. �.-�. � s—���� � .
ss.
COUNTY OF �� P� v E
The foregoing instrument was ackn�wledged before me this�day of tf'� 1�ru� ry , 19�'�,
by David A. Lan enfeld and Mar aret A. Lan enfeld husband and wife
�, . Grantor (sl.
;---- - ------ - - --- - -
, NOTARUL 9TAbIP OR SEAL (OR OTIiER TITLE OR RANK) �
. �A�,���N��A'tM/:'1M11NMf�.4�.'.n.tiM'��^n�:`•a +
• L ..y� . ..�.;.";�l,-±4y. 11���•�^.LuJ.�� • �
�r,. _. ty: �.. __ �i.:.i:: i . .
S •.• ^ �; '-° � • ,{. :;. i. r- � ' (
` 1'�.f l-'.I.!::1���..� � �:/.:2Tc.: 1� � .�
• VW1T�11iV.VV� : d5.'Y�9�'AlV�OV�P�.Pis'v6P4 ✓rbY� n �
i �
THI9 INSTRUMENT WAS DRAFTED BY (NAME AND ADDRESS): i
FML, Inc.
Box 96
Newport, MN. 55055
�
=-- --- - -
SIGNATURE OF PEC88pN TAICIIv'6 ACKNOWLEDGMENT
\J
Taz Statementt for the resl DsopertY de�cribed in thL inetrument should
be wnt to (Iaclude nune and addrea of (isaetee):
sue�ecr P O.
City of Fridley 2 9 5
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV. ��� �
� j V _•'��'
r � � PROTECTIVE INSPECTION SEC.
i = �
� r"'1 � CITY HALL FRIOLEY 55�32 NUMBEp REV OATE PAGE OF APPROVED 8�
�----'�•� ,'� 612-571-3450 9t0-F15 5/21/99 � �
J08 ADDFiESS 6501-03 Channel R ad
1 LEGAL LOT NO. BLOCK TfiACT OR AODITION SEE ATTACNEO
oesca. 6& Pt, 7 1 r � SHEET
2 PiiOPERTY OWNER MAIL ADDRES$ 21P PMONE
Jack Kozer
3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO
Westurn Ro fin & - _
1 ARCHITECT OR OESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL AODRESS 21P PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION � ALTERATION � fiEPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOF;K
Reroof 4 P1ex 26 S Te r-off
9 CHANCiE Of USE FROM TO
STIPU�ATIONS
Underlayment must comply with the State Building Codem
TYPE OF CONST OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTiiICAL, PLUM9ING, HEATING,
VENTILATIHFG OR AIR CONDITIONING.
THIS PERMIT BECOMES NUIL AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT CU FT
AUTHORIZED IS NOT COMMENCED WtTHIN 80 DAYS. Ofi IF CONSTRUCTION
Ofl WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WOiiK IS COMMENCED NO. DWLG. UNITS OfFSTREET PARKING
I NEREBY CERTIFY THAT I NAVE READ AND EXAMINEO THIS APPLICATION STALLS GAFAGES
ANO KNOW THE SAME TO 8E TRUE AN� CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX
ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO
WITH WME7MER SPECIFIEO MEREIN ON NOT. TME GRANTING OF A PERMIT �2228 �1.13,
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CMARGE
PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGULATING CON- $2 m 23
TqUCT N OF THE PERFORMAN OF CONSTRUCTION $83. 2rJ Fi re
_ ` PLAN CHECK FEE TOTAL E
� Licen $5 0 $9 .59
S� N4TUAE OF CO �pACT OA 4 iHOp�2ED nGENi ATE� N RO VALIOATE 7 IS IS�� MIT �
i
S�GNATUAEO�OWNEA��FOWNEQBU4DEAi �DAiE� BL �NSP r��TE
�w�°�
ADDN
AI..TER
Effective 5/10/99
I l CITY OF FRIDLEY
[] SINGLE FAMII.Y AND DUPLEXES R-1 AND R 2
BUII.,DING PERNIIT APPLICATION
Construction Address: �� I - d
0
Legal Description:
��
�,� �
� �
�
Owner Name & Address: ' Tel. # �� (Z �-� -- D�.��
Contractor. � MN LICENSE #_���j �p(�
r
Address• Tel. # j� /2 - S�%-���
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construcrion Type:
Length
Length
DESCRIPTION OF IlVIPROVEMENT
Width
Width
R 7_ �i/_
Heighf - Sq. Ft.
Height Sq. Ft.
TT . 1/� � w w.
Driveway Ci�rb Cut Width Needed
DATE: `� I
Permit Fee $ C��. � �
Fire Surcharge ,�a,� $
State Surcharge � 1 / $ <
SAC Charge $
License Surcharge $ �. � (�
Driveway Escrow $
Erosion Control $
Pazk Fee $
Sewer Main Charge $
��,
TOTAL $
STIl'ULATIOI�TS:
� Estimated Cost: $ �% �� �
I .
I
��_ � �
'-i%I �ti11�.�. '�
� -
�
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
Tel. # �.Q12 - �`�� 03 C�
$1050 per SAC Unit
$S.OQ (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not 1Veces�ry [ ]
BUII..DING PERMIT FEE 5CHEDULE
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 struc�e,
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 $500,000
$500,001 to $1,000,000
$1,000,001 and up
I_��
$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 fracrion thereof, to and including $100,000
$993.75 for first $100,0(� plus $5.60 for each additional
$1,000 or fractiQn thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet tunes $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for prop�r
review of the proposed structure and of the construction site.
A Certificate of S�rvey of the lot, showing the locaxion of the foundation once it has it has b�n ����a�tt�d w�lll
be required before proceeding with the framing.
sue�ett
City of Fridley
AT TNE TOP OF THE TWINS � � � L D 1 N G P E R M I T
r
� .
� �
� • COMMUNITV OEVELOPMENT DIY.
' j L ��'•�'� . .
r � � PROTECTIVE INSPECTION SEC.
� . ,
� j �"'1 � CITY HALI FRIOLE� SS�32 NUM�EA
�""�� �'� 612-571-3450 91Q-F15
10B ADpRESS 6501 Channel Road NE
t LEGAL LOT N0. BLOCK TRACT OR ADDITION
oesca. 6& Pt. 7 1 ErCO' S Add1 ti
2 PRpPERTY OWNER MAIL AODRES$
Koser Kompany 860-86th Ave. NW Coon Rap
9 CONTRACTOR MAIL ADDRESS
Owner
I ARCHITECT OR DESIGNER MAIL AOORESS
5 ENGINEER MAII AODRESS
REv
IATE GAGE OF
7/19/99 / /
29898
NO.
U���
AVPqOVEO 8Y
SEE ATTACMEO
$HEET
21P PHONE LICENSE NO
ZIP PHONE LICENSE NO.
21P PHONE LICENSE NO
Corrunerci al
7 CLASS OF WOFiK
� NEW O ADDITION O ALTERATION X(� REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replace window in 4-plex
' 9 CHAN(3E Of USE FfiOM
STIPULATIONS
TO
TYPE OF GONST
SEPARATE PEFiMITS ARE fiEOUIRED FOF ELECTfiICAL, PLUMBING, HEATING.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OF CpNSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED V�IITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO fOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UN
I HEREBY CEfiTIFV TNAT I HAVE READ AND �XAMINEO THIS APPLICATION
ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMP4�E0
WITM WHE7MER SPECIF�ED MERE�N OR NOT. TME GRANTING OF A PERMIT �ZH�I
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEpMIT FEE
PROVISIONS OF ANY OTMER STATE OR LOCAI LAW REGULATING CON-
TRUCTION OA 7HE PERFOF CE F CONSTRUCTION ��L3.JO
PLAN CHECK FE
S�GNATUA O 'RpCTOA OR A O�2ED AGENT IDA�E� M
S�GN4TU OWNEA��cOWNEABU��DEp� iD�TEi o nr. �..
OCCUPAN(
SO.FT
STALLS
ROUP OCCUPANCYLOAD
CU. FT.
OffSTREET PARKING
IGAFAGES
e50
C CMARGE
'I Y'A�SC
IS IS v�U�E�1T
��' 7.0
Pr�pai� Plan Check $
Estimated Cost $
Receipt ##
CITY OF FRIDLEY
R-3, COMN�RCIAL & INDUSTRIAL
BUII�DING PERNIIT AppLICATION
Construction Address _%�7� 1��cav� V�QQ � Q �L�
r�i
Owner & Address�
CONI'RACDOR & ADDR�S,S
Architect
TYPE OF WOR�C �[] New
�
Reg. ##
Zoning
Effective S/.10/99
Qt�
��, `��
� �1�
E�
� ��
•-.
BUII,DING CONSTRUCTION
[J Addition [� Alteration -Describe n � � /
OFC. ARE�A: Length Width
WHSE AREA.: Len.gth Width
0'I'�� ARE',A: Length Width
Height Sq. �,
Height Sq. �,
Height Sq, �.
APP�ICANT �,� C �{ �� � Tel # ��'lo� ��,�'�ate 7 �� '
VALUATION
Sq• F't• x$ Cost/Sq. Ft. = Ualuation $ )
Sq. F't. x $ Cost/Sq. Ft. = Ualuation $ ) _ $ ��%o � ,
Sq. Ft. x$ Cost/Sq. Ft. = valuation $ ) TbTAL VALUE
Building Use
Ai r Conditioning [] Yes []
Perforniarice Bond Am�unt $
Construction 'I� p���, ��
No Fi.re Protection Pravided L] Yes [l No
See Reverse for Schedule Received. [] Yes [] No
Permit Fee $�� �� See Fee Schedule on Reverse Side
Plan �e� $ •--� In Excess of Prepaid Amount - See Reverse Side
Fi.re Su�'�han�e $ .�� .001 x Permit Ualuation (1/lOth o)
state s,.�-rx��e $ .S� $. 5o/$i, o0o va�.uation (see sched., for >$i r�i�lion>
��n3e $ $1050 per SAC Unit (Plans to MWCC for detezmina.tion)
Erosion Control $ $450.00 Consezvation Plan Review
Park Fee $ Fee Detennisied By Engineering
Spec. Assess�nents $ Agreement Necessazy [l Not Necessary Ll
�'1Ve�Y �� $ feet x $13.50/foot
�O'rAL $ , �,
���� �� �
_ �--�,� ��
ATTAC� STIPULATIOI�TS
$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 $5�,0�
,�� . ��±
BUII.DING PERNIIT FEE SCHEDULE
$23.50 (Minimum Fee is $23.50 plus surcharge)
$23 .50 for 1 st $500 plus $3 .OS for each addn' 1$100 or fraction, to and including
$2,000
$69.25 for 1 st $2,Q00 plus $14.00 for each addn' 1$1,�0 or fraction, to and
including $25,000
$391.25 for lst $25,000 plus $10.10 for each addn'1$1,0� or fraction, to and
including $SO,Ot�
$643.75 for lst $50,000 �lus $7.00 for each addn'1$1,000 or fraction, to and
including $1�,000 �
$993 . 75 for 1 st $100, 000 plus $5 . 60 for each addn' 1$1, 000 or fraction, to and
including $500,000
$500,001 to $1,000,000 $3,233.75 for the lst $500,000 plus $4.75 for each addn'1$1,000 or fraction, to
and including $1,�0,000
$1,000,001 and up
$5,608.75 for the lst $1,000,000 plus $3.15 for each addn'1$1,�0 or fraction
PREPAID PLAN CHECK FEE SCHEDULE
$1 to $2,�0 $29.25
$2,001 to $25,000 $29.25 for lst $2,000 plus $5.85 for each addn'1$1,�0 or fraction, to and
including $25,000
$25,001 to $50,�0 $163.80 for lst $25,000 plus $4.225 for each addn'1$1,000 or fraction, to and
including $50,�
$50,001 to $100,000 $269.43 for lst $50,000 plus $2.925 for each addn'1$1,000 or fraction, to and
$100,001 to $356,000
Over $356,000
including $1(�,000
$415.68 for lst $100,000 plus $2.275 for each addn'1$1,000 or fraction, to and
including $356,000
$1,000 (Balance due with issuance of building pernut)
PERFORMANCE BOND POLICIES
When a building permit is issued for a commercial, industrial or a multiple dwelling residential project which requires
outside improvements, a Performance Bond or a Letter of Credit shall be submitted to the City. The bond will cover
all outside improvements, including but not limited to landscaping, irrigation, curbing, blacktopping, screening fences,
tighting, water & sanitary sewer services, and storm drainage systems.
Calculation of bond amounts will be determined by the building permit values. The bond amount will be 3% of the
building permit value up to a 2 million dollar project or a$60,0� bond. Actual amounts will be rounded to the
nearest $100. The City reserves the right to require greater or lesser bond amounts based on unusual circumstances.
Projects with no outside improvements, generally will not require a bond.
Bonds must remain open until the project is fully completed. Reproducible "as-built" drawings of all exterior
underground utilities must be submitted to the City Engineering Dept before the project is considered complete and the
bond released. All bonds will be held over one winter and through the ne� growing season to insure the survival of all
landscape installations. The City will then inspect these properties in August of the year following the initial planting.
Bonds may then be released in October of that year if all improvements are satisfactorily completed.
sunuc� c ' M11 IVV.
City of Fridley 3 21 � 5
AT THE TOP OF THE TWINS � U I L D I N G P E R M I T
r
! �1 L__�__ COMMUNITY DQVEIOPMENT D1V. �������� R� /�I � /
r � � PFIOTECTIVE INSPECTIQN SEC. �� 6�l L
�
� . ,
l--_. A;����,'� CITY HALL fR10LE`1 SS1�$ NUMBEN REV OATE
t �� 612-571-3450 9tq-Ft5 9/20/O1
10B ADORESS 6501 Channel Road NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION
oescR. 6, 7 1 Erco's Addition
2 PROPERTY OWNER MAIL AOORQS$. ZI
Kozer Kompanies 860 86 Ave NW, Coon Rapids, MN 55433
3 CONTRACTOR MAIL ADDRESS YI
Same
4 AfiCNITECT OR DESIGNER
5
8 USE OF BUILDING
4 Plex
7 CLASS OF WORK
ADDRESS
MAIL ADDRESS '
IIP
PAGE Oi IAVPRpYEO BV
/ �
SEE ATTACMED
SHEET
PNONE
763-783-5068
PNONE LICENSE NO
PMONE LICENSE NO.
PMONE IICENSE NO
❑ NEW O ADDITION O ALTERATION C� REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Remove two decks and reconstruct teo 8' x 4' Decks on Building
9 CHANOE OF USE FROM
STIPULATIONS
See notations on. plan.
� RQRATE p�R�
EQU jR�D f 11'�
�l��l��� H�� �:
N�A�� ����5
TO
� �
(�efor� digg��g �II fo�
all utility locations
��-000z
�EQUIRED �Y LAIN
SEPARATE PERMITS ARE RE�UIREO FOR ELECTRICAL, PLUMBING, HEATING, "rc vr va,na�.
VENTI�ATING OR AIR CONDI710NING.
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CpNSTRUCTION 20NING
AUTHOR�ZED IS NOT COMMENCED V�IITHIN 80 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOH A PER100 OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OW4G. UNITS
I HEFiEBY CERTIFV THAT I HAVE READ ANO EXAMINEO THIS APPLICATION /{
AND KNOW TME SAME TO BE TFUE AND CORRECT. ALL PqOVISIONS OF LAWS VALUAtION
AND ORDINANCES GOYERNING THIS TYPE OF WORK WILL BE COMP�.IED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �73FT
OOES N07 PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pERMIT FEE
PROVISIONS OF ANY OTHER STA7E OH LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFO MANCE OF CONSTRUCTION $.3Z.C)S
PLAN CHECK FEE
��� �
.�GNA E 0� C 'AACTOp OA 4UTMOp�ZED OGENT IDAtE� HE PR(
///
� �DAT�i
occuPar,Cr
S�.FT
STALLS
r
OCCUPANCYLOAD
CU FT
ET PARKING
IGARAGES
$.50
SAC CHARGE
Fire SC $.74
fOTALFEE
� $33.89
=,7p .p/
Prepaid Plan Check $
Estimated Cost $
Receipt #
Construction Addresa
�in Rl3°JO ay �'1-0/03
Legal IB}(�n �) ����e-S�
Owner & Address �" �
CONTRACTOR & ADDRESS �
Architect
TYPE OF WORK [] New
CITY OF FRIDLEY
R-3, COI�IERCIAL Sc INDIISTRIAL
BUILDING PERMIT APPLICATION
Effective 1/1/2001
(763)572-3604
■�•.���s��������zrlir�iz���<a •
�O � v ��
�
Tel# (�) ���/����
Tel# (%�} ���-�S"
Reg.# Engineer � Reg.#
BIIILDING CONSTRUCTION
[] Addition f/j Alteratio -D scribe
_... n , . C�' G �`� �+C _ .
�
OFC. AREA: Length Width �� Height Sq. Ft.
__`�
WHSE AREA: Length Width Height Sq. Ft.
OTHER AREA: Length Width Height Sq. Ft.
�
APPLICANT � �C��` `�� 1—l�� Tel # 7�.� - �J %��� Date � Q�
VALUATION
Sq. Ft. x$ Cost/Sq. Ft. = Valuation $ ) � J
Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) _ $ '" ,��i0
Sq. Ft. x$ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE
Building Use Construction Type Occupancy Group
Air Conditioning [] Yes [] No Fire Protection Provided [] Yes [] No
Performance Bond Amount $ See Reverse_for Schedule Received []Yes [7No
Permit Fee $ � � . �7
Plan Check � �
Fire Surcharge ��
State Surcharge� $
SAC Charge $
Erosion Control $
Park Fee $
Spec. Assessments $
Driveway Escrow $
TOTAL $ � _�
PERMIT FEES
See Fee Schedule on Reverse Side
In Excess of Prepaid Amount - See Reverse Side
.001 x Permit Valuation (1/lOth �)
$.50/$1,000 Valuation (See Sched. for > $1 Million)
$1150 per SAC Unit (Plans to MWCC for determination)
$450.00 Conservation Plan Review
Fee Determined By Engineering
Agreement Necessary [] Not Necessary []
feet x $15.50/foot
ATTACH STIPULATIONS
$1 to $500
$501 to $2,0(�
$2,�1 to $25,000
$25,001 to $50,000
$50,001 to $1Q0,0{�
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
BUILDING PERMIT FEE SCHEDULE
$23.50 (Minimum Fee is $23.50 plus surcharge)
$23.50 for lst $500 plus $3.05 for each addn'1 $100 or
fraction, to and including $2,�
$69.25 for lst $2,000 plus $14.00 for each addn'1 $1,000 or
fraction, to and including $25,000
$391.25 for lst $25,000 plus $10.10 for each addn'1 $1,000 or
fraction, to and including $50,000
$643.75 for lst $50,000 plus $7.00 for each addn'1 $1,000 or
fraction, to and including $100,000
$993.75 for lst $100,Ot� plus $5.60 for each addn'1 $1,000 or
fraction, to and including $500,000
$3,233.75 for the lst $500,000 plus $4.75 for each addn'1
$1,000 or fraction, to and including $1,000,000
$5,608.75 for the lst $1,(?00,000 plus $3.15 for each addn'1
$1,000 or fraction
PREPAID PLAN CHECK FEE SCHEDULE
Per Minnesota Building Code - 65 % of building permit fee.
PERFORMANCE BOND POLICIES
When a building permit is issued for a commercial, industrial or a multiple dwelling
residential project which requires outside improvements, a Performance Bond or a Letter of
Credit shall be submitted to the City. The bond will cover all outside improvements, including
but not limited to landscaping, irrigation, curbing, blacktopping, screeni.-�g fenees, lighting,
water & sanitary sewer services, and storm drainage systems.
Calculation of bond amounts will be deternuned by the building permit values. The
bond amount will be 3% of the building permit value up to a 2 million dollar project or a
$60,000 bond. Actual amounts will be rounded to the nearest $1�. The City reserves the right
to require greater or lesser bond amounts based on unusual circumstances. Projects with no
outside improvements, generally will not require a bond.
Bonds must remain open until the project is fully complet�d. Reproducible "as-built"
drawings of a11 exterior underground utilities must be submitted Yo the City Engineering Dept
before the project is considered complete and the bond released. All bonds will be held over
one winter and through the next growing season to insure the survival of all landscape
installations. The Ciry will then inspect these properties in August of the year following the
initial planting. Bonds may then be released in October of that year if all improvements are
satisfactorily completed.
�
�
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Tue Sep 04 14:08:12 2001
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- ' ' � �SUBJECT�. . . , .
c�ty of Fridle� 32612
AT THE TOP OF THE TiNINS s U I L D I N� P E R i�ll I T
;,
,�
COMMUMITY DEVELQRMENT DIV. /'�
r j y � PROTECTIVE INSPECTION SEC. /� L��� �J
1 ; : V �oG�
l-_-- � �����,'� CITY HALL FRIOLEY SS�31 NUMBER REV DAT@ VAGE OF APPROVED 8Y
� �� 612-571-345p s�aFi5 5/20/02 / /
JOB ADDRESS 6501 Channel Road NE
t LEGAL L07 NO. 6LOCK TRACT OF ADDITION SEE ATTACHED
oesca. 6, pt 7 1 Erco's Addition SHEET
2 PfiOPERTY OWNER MAIL ADpR�S$ 21P PHONE
Jack Kozer 860 8$ Avenue NW, Coon Rapids, MN 55432 763-783-9068
3 CONTRACTOR MAIL ADDRESS 21P PHONE UCENSE NO
Kozer Kompanies Same
a ARCHITECT OR OESIGNER MAIL AODRESS ZIP PHONE UCENSE NO.
5 ENGINEER MAIL AODRE$S , 21P PFIONE UCENSE NO
8 USE OF BUILDING
4 Plex
7 CIASS OF WORK ' ,
� NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE - O REMOVE
8 DESCRIBE WOfiK
Replace basement windows
9 CHANCiE OF USE FpOM TO
STIPULA710NS '
SEPARATE PERMITS ARE REOUIREO FOR ELECTFi1CAL, PLUMBING, HEATING. TYP� OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL ANO VOID IF WQRK OR CONSTRUCTION 20NING SQ. fT CU FT.
AUTHORIZED IS NOT COMMENCED V�IITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDEO OR ABAN40NED FOR A PERIOO OF 120 DAYS A7 '`
ANY TIME AFTER WORK IS COMMENCED. ' NO, DWLG. UNITS OFFSTREET PAqKING
I HEFEBY CERTIFV TMAT I HAVE READ ANO EXAIy�IN�O THIS APPUCATION 4 STALLS GARAGES
AND KNOW THE SAME TO BE Ti�UE AND CORRECT. ALL PROVISION$ Of LAW$ VALUATION SURTAX
AND OiiDINANCES GOVERNING THIS TVPE OF WpHK WILL QE CfJMPUEO @
WITH WNETHER SPECIFIED MEREIN OR NOT. TME GRANTING OF A PERMIT `Y2sOOO �I.00
DOES N07 PRESUME TO GIVE AUTHOFiITY TO VIOIATE OFi CAMCEL TNE pERMl7 FEE SAC CNARGE
PROVISIONS OF ANY OTHER TATE Ofi LOCAL LAW REGULA7ING CON-
STRUCTION OR THE P OR ANCE OF CONSTRUCTION �E)9.ZS Fire SC �Z.00
PLAN CNECK FEE TOTAL FEE
� � a� , $72.25
S NATU O�CON'p Oa RAUTMOAQEDOGENT ID Ei ►.� pq� VAU TEO THIS IS VOUR PERMIT
— - ' ,`.,,�•�''d �
S�GNATU�7EO�OWNEA��fOWNEp8U�L0EA� IOAiE� . ' DG �NSp' � pp}E
NEW [j
ADDN [ ]
At,.�R Il
Construdion Address:
Legal Description:
CITY OF FRIDLEY Effective 1/1/2002
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R 2
BUILDING PERMITAPPLICAT10N
Owner Name & Address:
Contractor. �%l� E
LMNG AREA:
GARAGE AREA:
� Tel. # ���" 7�'J�-���
MN LICENSE # o`�� 3OI S�f
Tel. #�✓�/o'� � �����^ ��v
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width Height Sq. Ft
DECK AREA: Length
OTHER:
Width HgUGround Sq. Ft
Construction Type: �, � rZ ��� ]3i1Y1,('�Yl_ ��_ Estimated Cost: $_���C�C�
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DATE: S o?U �j APPLICANT: %C� Tel. 7�,.3 ^ '��
� �
Call (763) 572-3604 for Permit Fees if mailing i applicati n or Fax to 763-5T1-1287 if using c�edit card a�d 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
� �����
$ < ���
$ � , l`� G�
$
$
$
$
$
$
$ �. «���
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1 �ODO 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 [ ]
�
STIPULATIONS:
BUII.DING PERNIIT FEE SCHEDULE
The Chief Building OfFcial shall, before issuing permits for the erection of any building or structure, or for any
addition to any existing building or structure, or for a.ny 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
helow set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $5�
$501 to $2,�0
$2,001 to $25,000
$25,�1 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,Q00,000
FEE5
$23.50
$23.50 for first $500 plus $3.05 for each additional$1� or
fraction thereof, to and including $2,000
$69.25 for first $2,0� plus $14.� 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,�0
$643.75 for first $50,0(� plus $7.� for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,0� plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $SQ0,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,OOQ or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb 5treets Only)
Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00.
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site. .
VERIFICATION OF FOUNDATION
A Certifica.te of Survey of the lot, showing the location of the elcisting foundation will be required before
proceeding with the framing. New Houses Onlv
�
. .�
sue�ecT IT NO.
City of Fridley 3 3 4 6 7
, , AT THE TOP OF THE TWINS g U I L D I N G P E R M I T R E O
r ��� �` _��_ COMMUNITY DEVELOPMENT DIV. r
� v � PROTECTIVE INSPECTION SEC.
r � ,
, _ ,
� ��"1 � CITY NALL FRIOLE� SS132 NUMBEA REV D�TE v�GE Oi �vvqOVED 8r
�""'� � �'' 763-571-3450 9t0-Ft5 4/24/03 / /
JOB ADORESS 6501 Channel Road NE
t LEGAL �OT NO. BLOCK TRACT Ofi ADDITION SEE ATTACFIEO
oESCR. 6 Pt 7 1 Erco ° s Addition SHEET
2 PROPERTY OWNER MAIL AODRESS 21P PHONE
Jack Koz�r
3 CONTRACTOR MAIL ADDRESS 2IP PHONE IICENSE NO
Koz:�r Companies 860 86 Avenue NW, Coon Ra ids, MN 55433 763-783-9068
4 ARCNITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
5 ENGINEER MA1L ADDRESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
4 Plex
7 CLASS OF WORK
� NEW ❑ ADDITION 0 ALTERATION f� REPAIR p MOVE O REMOVE
8 DESCRIBE WORK
Install new window in existing openings in upper units
9 CHAN(iE OF USE FROM TO
STIPULATIONS
Insta�.l per manufacturer's specifications.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAO
SEPARATE PERMITS ARE REOUIqED FOH ELECTRICAL, PIUMBING, HEATING,
VENTILATING OR AIFi CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SQ. FT CU fT.
AUTMORIZED IS NOT COMMENCED WITHIN 80 DAYS, Op If CONSTRUCTION
OR WORK IS SUSPENpED OR ABANDONEO fOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED NO DWLG. UNITS OfFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 4 STALLS GAFAGES
AND KNOW TME SAME TO BE TRUE AND CORAECT. ALL PROVISIONS OF LAWS VALUATION SURTAI(
AND OHDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO
WITH WNE7MER SPECIFIED HEREIN OR NOT. TNE GRANTING OF A PERMIT �l�8OO �.90
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEI THE pEqMIT FEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE L AL LAW REGULATING coN• �63.LS Fire SC �Z.SO
UCT�ON OR THE PE FORMA NSTRUCTION
PLAN CHECKFEE TOTA�FEE
� � � (; $65 . 85
SiGN aE OF C CT p 0 /0 T OA�ZEO sGENi iDATE� N PROPERLV VALIDATED THIS IS VOU PERM T
� V'c
S�GNarU OwaEA��FO�NNEABU4DEN� iDAiEi Bt ��h5� ��titE
CITY OF FRIDLEY
6431 University Ave NE R-3, COMMERCIAL & INDUSTRIAL
Fridley, MN 55432 BUILDING PERMIT APPLICATION
(763) 572-3604 FAX (763) 571-1287
Effective 1/1/2003
� � � � i � • .� �� ,/ _// _�.�%I�lt�� ��/ � • • � -
- . . �. 1� - �' /'
f � , � . � '!j 1"�' - t, �/, :
� � . . . I i � � � It _�- �
ii �
� ' i • �' . ` 11' ii�_` • _ i � ��I / � � -/ � � L �, t
Architect
TYPE OF WORK [] New
Reg.# Engineer.
BUILDING CONSTRUCTION
[] Addition [] Alteration -Describ
. � .
�
OFC. AREA: Length Width Height Sq. Ft.
WHSE AREA: Length Width Height Sq. Ft.
OTHER AREA: Length Width Height Sq. Ft.
Reg.#.
APPLICANT U C K 'E`LOZL'C Tel # i./� • Gyy'i��� Date � �^' �
VALUATION
Sq. Ft. x$ Cost/Sq. Ft. = Valuation S ) � �
Sq. Ft. x$ Cflst/Sq. Ft. = Valuation S )_$ •�
Sq. F t. x$ Cost/S q. Ft. = Valuation $ ) TOTAL VALUE
Building Use Construction Type � flccupancy Group
Air Conditioning CJYes []No Fire Protection Provided []Yes []No
Performance Bond Amount $ See Reverse for Schedule Received [7Yes []No
Permi t Fee $ �' �S
Plan Check $ � go
Fire Surcharge $ ` �
State Surcharge $
SAC Charge $
Erosion Control $
Park Fee �
Spec. Assessments $
Curb Cut Escrow $
TOTAL $ ��" ��
P'�RM�T FFES
See Fee Schedule on Reverse Side
In Excess of Prepaid Amount - See Reverse Side
.001 x Permit Valuation (1/lOth �)
$.50/$1,000 Valuation (See Sched. for > $1 Million)
$1275 per SAC Unit (Plans to MWCC for determination)
$450.00 Conservation P1an Review
Fee Determined By Engineering
Agreement Necessary [] Not Necessary C]
feet x $17.00/foot
ATTACH STIPULATIONS
�, � , M
$1 to $500
$501 to $2,000
$2,((��1 to $25,(}00 .
$25,001. to . $50,000
$SO;OOI `ta �100jU00
$1�,(�l to $500,000
', 11 11 • '� 111 111
$1,000,�1 and up
BUILDING PERMIT FEE SCHEDULE
$23.50 (Minimum Fee is $23.50 plus surcharge)
$23.50 for lst $500 plus $3.05 for each addn'1$100 or fraction,
to and inclu�ling $2,(�0
,•$69.25� �or 1°st $2,000 p1us. $14.00 �for eaEh addn'1 $1,000 or
fractioi�, to and including $25,000 � e
$391.25 for lst $25,000 plus $10.10 for each addn`l $l;� or
'''fractidri, ta anc� incluz�iing�$50,000 _. ° _
$643:75 fo�.15t $50,000 plus $7.(�,for each addn'1 $1,Q00 or
fraction, to and including $100,000
$993.75 for lst $100,000 plus $5.60 for each addn'1 $1,000 or
fraction, to and including $500,000
$3,233.75 for the lst $500,000 plus $4.75 for each addn'1
$1,000 or fraction, to and including $1,000,000
$5,608.75 for the lst $1,(�O,fl{NJ plus $3.15 f�r ea.ch addn"1
$1,000 or fraetion
PREPAID PLAN CHECK FEE SCHEDULE
Per Minnesota. Building Code - 65 % of building permit fee.
PERFORMANCE BOND POLICIES
` Vt�ien:.�, building permi� is ; i�°sued for �a commercial, industrial or a multiple dQVelling
residential project which requires outside improvements, a Performance Bond or a Letter of
Credit shall be submitted to the City. The bond will cover all outside improvements, including
but not limited to landscaping, irrigation, curbing, blacktopping, screening fences, lighting, water
& sanitary �sewer services, and storm drainage systems.
Calculation of bond amounts will be determined by the building permit values. The
bond amount will be 3% of the building permit value up to a 2 million dollar project or a$60,000
bond. Actual amounts will he rounded to the nearest $100. The City reserves the right to require
greater or lesser bond amounts based on unusual circumstances. Projects with no outside
improvements, generally will not require a bond.
Bonds must rema.in open until the project is fully completed. Reproducble "as-built"
drawings of all exterior underground utilities must be submitted to the City Engineering Dept
before the project is considered complete and the bond released. All bonds will be held over one
winter and through the next growing season to insure the survival of all landscape installations.
The City will then inspect these properties in August of the year following the initial planting.
Bonds may then be released in October of that year if all improvements are satisfactorily
completed.
T � . •/