AF - 37090�
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City of Fridley, Nlinn.
BIJILDING PERMIT N° 3 9 0 2
Date: . .. �".°.•: .. . �. ..—... �`� .. .. ......... '
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Owner ....................................... Bttilder ..... .... .. .... ... ........ ..a.�a�
Addre� ...................................... Address ................. ...........................
LOCATION OF BUILDING
No. �. ��!. l. . Street . . ��f�l��,�ii;�-�'J,��'.'�.�.�. . .. .. . . . Part oP t . . . .. .. .. .. .. .. .. .. . . . . . . . .
Lot . . . . ��. . . . Biock . . . . �. . . . . . . . . . . Additfon or Sub-Division . .1 . . . . . . . . . . . . . . . . . . . . . . . . .
,c- s
Corner Lot . . . . . . . . . . . . Inside Lot . .� . . .. .. . Setbaek �. ��V �eyard . .�� : .�. � .. . . . . .. . . . . . .
DESCRIPT[ON O� BUILDIIVG
To Used : � � a ,
. . . . Fro� 7!7.�.� Depth .°2., l. .. �`Height ! .� '� Sq. F't /. .�� � Ctt Fk���� �
� . ... �om .%�.��. ne�cn �./� x��� ./.4.::� sq. �. ���: cu. Fr. �.�.�.�
1�pe of Construction . . . . . . . . . . . . . . . . . . . Fst. C�� . .��. � .��. : .� To be Completed . . . . . . . . . . . . . . . . . . .
In consideration of i�e isauance to me of a permit to congtruct the building de�ribed above, I agree to do
the proposed work in accordanc� with the description above set forth�d in complia�cei��-�}ll provisions of
ordinances `of the dty of Fridley. � 1 �d �
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In consideration of the a nt of a fee of � ��/
P Y� $ .�...... permit is hereby granted to ...................
....... .. ........ ........ to construct the bwllding or addition as described above. This permit 3s granted upon
the express condition that fihe person to whom it is granted and hia agents, employe� and worl�nen, fn all work
done in, around and upon said bu3lding, or any part thereof, shall conform in all respects to the ordinances of
FridleY, Minnesota regarding location, construction, alteration, maintenance, repair and moviug oP buildings with-
o�e�� limits and this permft may be revoked at aay time upon violation of any o�e provisions of said
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NOTICE:
Thla parmit does not cove� the constructlon, Installatlon o� alteration fo� wi�(ng, plumbing, gas heating,
sawer o� water. Be sure to see the Bulldlnp Inapemto� fo� sepa�ate pefmits fo� these ttema �,,
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� APPLICA,TION FOR BUILDING PERARIT
l CYTY OF FftIDLEY,� MINNESOT�
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Dwne�s Name �i�i���� Builder _ - ` _
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�ddress - -� _- ,.:.Add,ress � ���"`' :
, . .. � � ' � ' ��.S..F� .. - .
LOC1�T N 0 BUILDING . . . ` . J � • .
�= ;.� . .. . ... -
No. 3-Greet �� Part. of Lot � `: �
_ - , _ __ . , ,
Lot ..� Block l�dditiori •or Sub. Div. � .
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Corner Lot --,:.. - Inaide �Lot � � �. Set Back � . ` . .,
Appliaant attaEh�td��this:form Certificate of Survey o_f Lot aud proposEd �'� -
; build3�g _ la�c�3,an. . _
DE,SGRIPTION OF BIIILDING , . .� .
To be aed -�:s�; � � . � s '
. � Fron� �� Depth_i�Height � ' .
Sq. Ft. u. Ft. . � �
F'ront _�� � . Depth eight ; � .
- � -�� 7� .
�.� �. �. � . �
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Type �of Constructiqn — t 7� � Q -�" Esti�iated .Cost ���
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To be completed . ' . � ,
The unde�signed �Sereby makes application for a permit,,for the raork
herein specified, ' a:greeing :.to do a11 work in strict. accordance with"_the �
City ardin�.ncea �rid rr�ling,.of the Department `of Bu�ldings, and .hereby �
declares that all the fac-ts and representations stated in this applic�tion'
are�true and correct� . : , �
Da�e . . _ Signature .,.._. . �
��(1 Schedule of.Fee Costg can be found on the �ev�rse Si�.e) �
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BIIILDIlVG PERMIT F�E SCHEDULE
Section 2. The Inspector of Buildings shall, before issuing an� perm3:t
for the erection of an•y_building or�atructure, or for any addition to
any existing building or strircture, or for an�r alterations or repairs to
an� existing building or structure, upan application therefor� require
the payment by the applicant for such permi.t of fees to the amount
herein below aet forth.and in the manner herein provided to-wit:
2.1 For any such pe�Ait for the erection of any fireproof bui].ding�
other than a garage, wasehouse, factory. or grain elevator, or for the
erection of any fireproof �,ddition, for similar occupanc�, to any
existing building shal� be�at the rate of �1�40 for e�:ch one thousa.nd
cubic feet, or fra c��on thereof, in such cubical contents.
2.2 For any auch permit for the erection of any fireproof garage, ware-
house, factory or grain elevator, or for the ereeti,on of"any fireproof _
addition for similar occupancy; to ar�y existing buildi.r�g sYu�ill be a� the
rate of �1.25 for each one thousand cubic feet, classified �.a "iireproof". _:
by Section 502 of the Minneapolis Building Code. '
HOUSES ��
2.3 For any such pernit for the erection of any non-fireproof building
other�than a garage, warehouse9 factory-or grain elevator, or any
non-fireproof ad'dition, for sinilar occupancy, to any existing building.
Permit �1.00 for each one thousand cubic feet.�
GA.RAGES �
2./� For any^sua� permit-for the erection of any non-fireproof garage,
warehouse, factory or grain elevator, or for thc erection-of any no�..
fireproof addztion9 for,similar occupancy,, to any existing building or �
for each such building or additione Ninety Cents fo� each one� �-
thousand cubic feet or fr�.ction thereof, in the cub�:cal content� thereof ��
with a minimum of �/{.,00� �
For the purpose of computing fees for bu3lding permi.ts the eubical
contents of any bui�ding or addition to.a,uniform hei ht.throughout by
multiplying the ground rarea covered fron a point six �6) inEhes below
the flpor line of the baser�ent or cellar to the average height of the
upper surface'or to the average height of the roof.sur�ace of the��in
gable of a.pitched roof. �
2.5 For repairs�.or €i.lterations to an existing structure,.the fee shall
be at the:rt3.te of �3�D0 for each Five Hundred Dollars (�5ao.00), or
fraction thereof in the cost of all�proposed work, •
2.6 In no case shall the fee charged for any permit•as s�t forth in
Section 2 be lesa than �/�e00�, . �-
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HARVEY A. CARTWRIGHT ��� & O�ON
�NOw► aou�r suRV�rs �
►+cNasr�N courmr �uRVers L A ND S UR V E YO RS
MINN�ArOLIa supv`rs
e110 PALM BTRtET N. W. R[41STtRiD YNOSI! I.A� � lTAT[ OR MINNtSOTA
BUN�[T 4-7a66 L�<�t0 �r ORfi1NANCR OF C�TY QR MINNtA'OLIS
OWNl1�
326 PLYMOUTM BUILDtNGI FEDBRAI. 9-8721
INDYITRIAL — JYDIt1wL NBNNBPIN AT SIXTN • MINNEAPOLtB 'J. MINNB50TA
�us�N�sa - To�oaRwrNicw� ��tTbtpOT'� �tlil�ttBLt
Ct4Y LOTi — rLATTING
Dahtberg I3Ui.lders� Tnc.
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No �'��'S
GOMSINING TMB RtCORD9 OF
J. E. HILLs CIVIL ENGINi[R
NTArIISM[O 1�M
C. F. SAPIOHOFF
CIVIL �NGIN[iR
6sT��t+sweo ��w
JAMSS NELSON
SuRVCroa
i{T4�LIiM[O 11ai
METROPOLITAN LAP1D
SURV[YOR�, ctTw���sM�o �os+
Inv No 206l� �::85-1�6 j
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I hereby certify that this is a true and correct representation of a survey of
the boundaries oF
Isot 11, Broor:viesa I:ddition, �"�noka County, P°:innesot�
and o� the location oi all buildings, ii �y, thereon, a.nd all visible
ancraachments, if any, from or on said l�nd. As surve�*od by me this
9tlz day ol June, 1959 T3.17•
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�I��('�`�.�,6r�„'�``�"'�''�.� Ya � , ���•L " ,.`� tl ,
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City of Fridley, Minn.
BUILDING PERMIT
nate: � . :, ;�. : � : _ �
N° .' 638 .�
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Owaer. � - �� Builder _.� w.� . ; � t ti ,; , } '� � �.:n: � '�...�...__.::'_t.,...._._
Address _._ �: �.:. � . . . .._.. Address � ' ..: ' —'��-•------•---�--•-----
LOCATION OF BUILDING
No. `:_..._ '..:_'` .�._ Street ._._` ° `:; � _: •_ • .....--•_..._...�__._ Part of Lot _._._.._....—.�.—�
Lot �.. --•� __ Block _ �._.__._ Addition or Sub-Divisi� . ' �..�,
Corner Lot — .� Insade Lot —.�. Setback �_ Sideyard —_
Sewer IIe,wattai �____ � Foundatia�n IIevation V... ___
DESCRIPTION OF BUILDING
To be Used as:
Front Depth Height — Sq. Fk Cu. FL _
..._ Front ___._____ Depth � Height _.._______ Sq. Fk Gti1. Fk
Type of Construction _._.._�.._.____ Est, Coat _._..�_..y.�:::::;;.�.�:���.._.._ To be Completed __._
� �.... .. �2:<�: _:C: . ��
In co�ideral3on oi the issuaace to me of a permit to construct the building described above, I agree to do
the proposed work in a�ordance with the d�scription above set forth and in caanpliance with all prov3sions of
amdinancea o! the dty oi FYidley.
In caostderatioai o! the paymeat of a fee o! S' ., Per�►it is herebY 8�'$�� to . .—:�--�=,;;�
�:; a° �.: "� • to c�struct the building or addition as deacrlbed above. This permit is granted upoa
the express coadition that the person to whom it is granted and lus agents, employees and workmen, in all work
darie in, around and upoa said building, or any part thereof, shall oonform in all respects to the ordinancea o�
Fridle3'. Minnesota regarding locatiaq constructiaa�, alteratioq maintenanc�, repair aad moving of baildings
within the dty limits and this permit may be revad�ed at aqy time upon violation of aqy oi the Pr�visians ot said
omdiaaaoes.
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NOTICE:
iWs p�M dea aet eewr fh� eon�feuelioa, tn�all�Nes Mr �ririno. P�+�W Op �Y. aw�r er wN�r. !� wn to s»
IM luiWieo Isp�eler fer apwah P�hs hr fh�a ihea.
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OW1�R' S NAME
ADDRESS
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• APPI.ZZCATION FOB BUS.DING PERMIT
CITY OF FRIDLEY, MINNE50TA
.
� � � LOCATION OF' BUILDTNG
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No. StreeC � Part of Lot
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LOT�,,,�� BLOCR� / ADD,ITION OR SUBIII�RSIOR� - ������' �,�.
Corner Lot�Inside L,aT Setback •Side-Yard �
SEl�ER ELEVATION FOUNDATION ELEVATIdN
Applicant attach to this form Two Certificetes of Survey bf LoC and propoaed
building location d•rawn on tl�ese Certificatea. � �
. • � DESCRiPTION OF BOILDTTTG "
�
To be used as:
Front Dept ` HeighC
• . . . °��Sq. Ft. � ;� Cu.'Ft.
� � � � Front � D�epEh Height
� Sq. �t. �-:.C�. Ft. �
Tqpe� of Caa�tru�tion- � � � Eatimated� Cos /'� o ro o. �
. . ---T
To b�+ `compleCed_ , - � � ' � � �
. �'
The underaigned hereby makes appl°icatiau for a permit for t�ie work hereia epecified,
agreeing to do all wo�k in strict accordaace;wi.th .the�.City of Fridleq Ordiaauces
and rulings of'the�Department of Buildiags; and hereby declares Chat alZ the facta
and representations stated in this application are:t�ue and correct.
DATE
(Schedule of Fee Coats can be found on the Reverae Side).
G� e.,�t-�� `�
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. BUILDING PERMIT FEE SCHEDULE \
SI:CTION 2. �he Inspector of Buildings shall, befor� �Lssuing anq permit for the �
erection of any b�ilding or atructure, or for any addit�on to anq exiatitig�build- \
ing or stsucture, pr for any alterat�oas or �repaira to any ezi�t3affi bt�ild$ng br
striacture, upon application therefore, require the payin�at by t�e applicant for
aucli permit of-fetls to Che amount herein below set for`Ch and fn Che maaner herein
provided to-wit;
2.1. For any such permiC for the erection of any fire-proof building,
other than a garage, warehouse, factory or �rain elevator, or for the erection
of as�y fire�proof additioa, for aimilar occugancq, to any existing building,
sball be at the rate of $1.40 for each one tbousand cubic feeC, or fraction
thereof, in su�h cubical contents.
2� For any such permit for the erection of any fire•proof g�rage,
Warehouse, factory or grain elevatcr, or for the erectioa of any fire-proof
addition, for aimilar occupancy, to any existing building shall be at the rate
of $1.25 for each one thousand cubic feet, classified as "fireproof" by
Section 502 of the Minneapoli� Building Code.
HOIISES
2.3. For any such permit for the erection of any non•fireproof building,
other than a garage, warehouse, factory or grain elevator, or aay non-fireproof
addition, for �imilar occupancy, to any exiating building - permft $1.00 for each
one thousand cubic feet.
GARAGES
2` For any auch permit for the erection of any aon-fi�eproof garage,
taarehouse, factory or grain elevator, or £or the erection of any non•fireproof
addition, for aimilar occupancy, to auy exietfng building or for each such
building or addition - ninety cents ($0.90) for each one thousand cubic feet
or fraction thereof, in the cubical contents thereof with the minimum of $4.00.
For the.purpose of computing fees for building perm3ts, Che cubical contents
of any building or addition to a uniform height throughout by multiplying the
ground area covered from a point si.x (6) inches below the floor line of the
basemeat or cellar to Che average height of the upper surface or to the average
height of the roof surface of the main gable of a pitched roof.
2.5. For repairs or alterations to an existing structure, the fee sha11
be at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction
thereof fn the cost of all proposed work.
2.6. . In no case.shall the fee charged for any permiC as set forth in
Section 2 be less than $4.00.
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MONTH � -� -� 3 - � ;r
� DATE
DAY
CONTRACTOR CALIr-TIN�; INSPECTION & ADDRESS TII�
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SUBJECT IT NO.
City of Fridley � 10 3 3
AT THE TOP OF THE TWINS g � I L D i N G P E R M I T
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COMMUNITY DEVEIOPMENT DIV.
r � � � PROTECTIVE INSPECTION SEC. ����_�
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� /'�'1 � CITY HALL FRIDLEV 55432 NUMBER qEV- DATE PAGE OF APPROYED BY
!"'"'� � �'� 612-571-3450 910-F15 8/28/91 � �
J08 ADDRESS 6881 Channel Road NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION
DESCR. 11 Brookview Addition
2 PROPERTY OWNER MAIL ADDRES$
Harry Asplund 6881 Channel Road NE
3 CONTRACTOR MAIL ADDRESS
D& D Home Improvement 74Q1 Central Ave NE, k'ridley
d ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAILADDRESS
ZIP
ZIP
3
SEE ATTACHED
SHEET
PHONE
571-5398
PNONE LICENSE NO.
784-7543
PMONE LICENSE NO.
PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof Dwelling (13 Squa,res) Tea.r-o��
9 CHANOE OF USE FROM
TO
STIPULATIONS
Underlaymeait znust comply with State.. Code
TYPE OF CONS7.
SEPARATE PERMITS ARE HEOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR Alfi CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNI
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO $98S
WITN WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqM1T FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $2S.00
STRUC N OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FE
SIGNATURE OF CONTRACTOH OR AUTHORIZED AGENT IDATEI WH �
PANCY GROUP OCCUPANCY LOAD
i. CU. FT.
OFFSTREET PARKINC
STALLS GARAGES
SURTAX
$.50
SAC CHARGE
Fire SC $.�9
TOTALFEE
� 26.49
EiiN9V /f'itii'A AT THIS IS YOUR PEF
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� [ ] Effective 8/16/90
ADI�T [ ] I�l AND R-2
ALTIIt [ J Buildir�g Permit Applicatiaaz
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Legal Description:
owner rrame & �r�s: ��,,��1�1 ��S°,��'Q� �e.t. # ��%� ���
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Attach to this ap�lication, a Certificate of Survey of the
lot, with the proposed oonstructian drawn aa�► it to scale.
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LIVIIJG ARF�i: TPT�h Width Height Sq. Ft.
C�RA�E ARE�i: Iength Width Heic,�t Sq. F't.
DECR AR�i: Length Width Hgt/Gramd Sq. Ft.
O'1'�R:
Corner Iat [] Inside L�t [] Ft. Yd Setback Side Yard SetbacJ�
Z�pe of Construction: ��,� /���� Fstimated (bst: $ � � �
Approx. Ca�npletion Date: �/.� �/ �� ���5
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Proposecl Driveway Width If N�w Is Desired: Ft. $ $
Width + 6' See Back Page
I]A'I'E: �s � �� 9 APPLICAl�I�!': 'Itil . #
Pennit Fee $ o� �. 0 O
Fire surcharge $ � 9�
State Si�hat�ge $ ,�O
SAC Ci�arge $
Driveway F.scraw $
Park Fee $
s�wer Main Criarge $
TOTAI, $ � �v • `� 1
�4!!�_1 s_ � !��_
CI'PY IISE �Y
Fee Schedule on Reverse Sic�e
.001 x Pn.�mit ValuatiCa'1 (1/lOth �)
S.5o/Sl,000 valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee �Ar,n; nprl bY �l�r'�J
Agr�ment Necessaxy [ ] Not Neczssary [ ]
:1� � � � �'"11'i � ' 31" = i�i�71���
Zhe (�ief Buildirig Official shall, before is�,; *+Q �*�++; ts for the erection of ariy
�, i 1 ding or structure, or for any ac�dition to ariy existing b�uildirig or structure, or
for ariy alteration or repair to any existirig building or structure, upan application
therefore, require the gayment by the applicant for such permit of fees to the amcunt
herein belvw set forth and in the manner herein pravided to-wit:
� �AL VP�IIJE
$1 t.o $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
i a�a.
$15 (Mininarm Fee i.s $15 plus suzrharge)
$15 for first $500 plus $2 for each additional $100 or
fraction ther�of, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to and including $50,000
$414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to arid including $100,000
$639.50 for fiYSt $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to arid iricluding $500,000
$500,001 to $1,000,000 $2039.50 for the fizst $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and ir�cluding $1,000,000
$1,000,001 arid � $3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction thereof
DRIVE'fi�iY DEPRESSI�iT F5i'�W
(C�ncrete Curb Streets On1Y)
Alternate ��p,�� : Remaval and replacem�nt of curb arid gutter only - Dtiveway width plus
6 feet time.s $13.50.
Alte,rnate "B": R,�noval and replacemerit of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
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Pexmits for construction will be issued 8 m�*»�� of 24 haa�rs fraan the time of
a�lication to allaw for praper review of the proposed structure and of the
oo�struction site. �
A Certificate of Suxvey of the lot, shcxaing the location of the fawzdation anc� it has
it has been constructed will be required before proceeding with the framing.
sue�ecr PERMI . -
City of Fridley 19 3�
' , AT THE TOP OF THE TWINS g � I L D I N G P E R M I T O
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� � COMMUNITY DEVELOPMENT DIV.
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r � � PROTECTIVE INSPECTION SEC. �' � �
I = �
� /'�'1 � CITY HALL FRIDLEY 55432 NUMBER REY OATE PAGE OF AVPROVEO BY
�'""'�"� �'� 612-571-3450 910-F15 6/29/93 � �
JOB ADDRESS 6881 Channel Road NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ]_]_ Sxookview Addi,tion SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Ha�ry Asplund 6881 Channel Road NE
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO.
Wes.tern Remodelexs 252Q W L enteur St aul 551 3 �45�1411 3847
4 ARCHITECT OR DESIGNEH MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
� NEW � ADDITION O ALTERATION I� REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Aluminum so��i:t & �asc�a
9 CHANOEOFUSEFROM TO
STIPULATIONS
Tnstall smake detectors as per UBC 121Q ^ adjacent to all sleeping
areas and in basement.
TYPE OF CONST. OCCUPANCY 6ROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATINO,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED 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 �- STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORREC7. 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 $2 � 7QQ $�., 35
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISION ANY OTHER STATE OR LOCAL LAW REGULATING CON- $S4.00 Fire SC �2.%O
S RUCTIO TN E ORMANCE OF CO TRUCTION.
PLAN CHECK FEE TOTAL FEE
License SC $5,0� $63,05
SIGN TUREOFCONTRACTORORAtl ORI2EDAGENT IDA � WHEN LY DATED THIS IS VOUR PERMIT
. ` 0 ��
SiGNATURE OP OWNERiIF OWNER BUILDERI IDATEI BLDG iNSP r1ATE
NEW [ l
ADDN ( j
AL1'ER [ J
Conshuction Ac�recs:
a
Legal l�scription:
Owner Name &
�� � � � ��_ �
�
LIVII�IG ARBA: Le�tgth
QrARAGE AREAt Length
DECK AREA: T.ength
� .�. ,
CITY OF FRIDLEY
SINGLE FAMII.Y AND �DUPLEXES R-1 AND R-2
Bailding Permit A�lication
c
%,
�
Effe�ctive 5126/93
��07�
.� Tel. �
MN LICENSE # �/�'
Tel. # � �P � =-/ �/ i�
At�ach to this application, a CerlificatL�of Survey of the
lot, with the propc�sed �n�ruction drawn on it to s�ale.
DESCRIPTII'?N OF IMPROVEMENT
Witith
��
Width
_ ,.. �' . � � �
Height
Heig6t
�igtlGramd
�� c. �� ; ) �,- �� ,I
Sq. F�
�. Ft.
�- �fi.
Corner I.ot [ j Inside Lot {] Ft. Yd Seiback Side Y�rd Setbacks
Type of Conshvction• ,ti, '����, E�mated Cost: $ 2. 7� 1�
r-�--
Approx. Complerion Date: `� � c3 � � `�
(Cosi on Back)
nr�e�ay c� c� vv�am rr�: F�. +�c = gc x$ _$
,
DATE: �`� Z- 7' 3 c, APPLICANT: s Tel. ��� �'' `�i � I
Per�mit F�
F'u�e Surcharge
Siate Surcharge
SAC Charge
License Surcharge
Drivew►�ay Escrow
w
Erosion Control
Park Fee
Sewer Main C6arge
TQTAL
$ .��-��C�
$ �-''�
� /- �'�s�°
S
$ � �� �
$
$
$
$
� ��. �-�
�. _�. ' � .�l _ .
Fce Schedule on Reverse Side
.�1 of Pe,mdt Valuati� (1/lOth�)
$,501$i,000 Valuation
$750 �x SAC Unit
$5.00 (State Licensed Residential Contractors)
Al�. "A" or Alt. "B" A►bove
Con.servation Plan Review $450.00
Fee D�mined by Engiaee�ing
AgreemEnt N�+ [ 1 Not NPCessary [ J
STIPULATIONS:
�. � -
. _ ,.�;,.
� BUII,DING PERMIT FEE SCHEDULE
The Chief Buildiag Official shall, before issuing permit� for the erection of any building or slructure,
or for arry addition to aay existing building or structure, or for aity alterdtion or repair to any existing
building or structure, u�n application therefore, require the pay�mem by the applicant for such permit
of fees to the amouat herein below set forth and in the maaner herein provided to-wit
TOTAL VALUE
$1 to $500 �
$501 to $Z,OIXI
��
$15 (Minimum Fee is $15 plus surcharge)
$15 for first $500 plus $2 for each additi.onal $100 or
fraction thereof, to and including $2,000
$2,001 to $25,0� .$45 for first $2,000 plus $9 for each add.itional $1;OQ0
. or fraction thereof, to and including $25,000
$25;001 to $50,000 '
$50,001 to $100,�0
$100,001 to $500,000
$500,001 to $1,000,�
$1,(100,001 and up
$252 �for first� $25,�0 pl�s $6.50 for each additional $1,000
or fiaction thereof, to. and iacluding $50,000 -
$414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fi�ction thereof, to and including $100,000
$639.50 for fiist $100,000 plus $3.50 for each additional
$1,000 or fiaction th�eof, to and including $500,000
$2039.50 for the first $�00,000 pins $3 for each additional
$1,000 or fiactioa thereof, t,o and including $l,(J00,000
$3S39.SU for the first $1,0�,000 plus $2 for each additional
$1,OU0 or fraction �thereof �
DRIVER/AY DEPR�SSION ESCROW
(Concrete Gtirb Sire�ts Only)
Alternate "A" : Removal an.d replaceme� of �urb and gutter only - Driveway width plus 6 feet times
$13.50.
Alternate °B" : Removal and replacement of curb and gutter and install a 3 foot wide .
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for cons�ruction will 1� issued a minimum of 24 hours from the time of application to allow
for pro�r review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the l�on of the foundation once it has it has been
constructed will be required before pr�.ing w+ith the framing.
JAN—li-200T 03:50
rsu�ialn,g
Inspections
763-572-3C04
PM STANDARD WATER CdNTROL 763 5�7
I �U�,DING
�tJESIDEI"�''1"'x,AL AP�'LICATI+C�
�CI'1". Y"Y 1�� FRID�,EY
' � �S� �' � %i� %%��J +�' 1 ! ' �
��.i. • ■ �
. 1.Cri\lfl, 4
9U8M1'r A CpPY Ol�
YpUR STATS LIGE�TSB
WITH AI+PLICATtON
�
'PRdP�RTX'I�PE
OF
BTATE L[C8NS8
.. �:� �� �,•„
�■.•«
DBSCRIB� WOItK B�AV4
sQua� �
SrABA�'rF�
�RaPasEn s�:--- .
pROP(?SED ft�i7': ,_„�,
�[
a rr�
0 Al�aum
❑ Gt�� �,
�
1N BJQS'iZ�T� OP�AiO3 01tea �l�io
OR PC1R N6VY OPErID�G9-D�iCRiBE Si2B OR
OPEN�tG CHN�(QES �
TYPB bF WII+IDOW TO 88 �19TALLm •
at.L �s � s�is�n ox v
Pemrit Fee
Plen Iie�viow
Fire Suxcha�
Surcharge
Lic,�m9e Surcharge
SAC Charge
Gurb GS�t Fsctow
Broeian Control
Perk �ee
S�aer Main ChargG
��.�n�s
���
h3 SID�iG
o xou� �c*aanc�
� A7 l'��7H� GAnaGE
o n,�r� a�►anc�
C�soffit
G Trim
C7 Peoaia
Lt�CATYdN C�"�WS
EJLP DATS
1i01�,, Ii1iCLUDIIITC� Tl� CUST OF
T�E .� U.&C FEE S��EDX]LEl
.. �
■ � �s�'
1882 P.01
P�nn�it Na.: �, � �
N R����a �:
D�te Re,c'd: � � -�� �
!. Exi�tic8 Yioor Plee
2• Propoee�i floer plm,
s_ Ltat of s�ucaaat member� w be ueed
FL
Y+�R NEW GOh18TRUCPION II�.UDBVG ri�CKS�
1. Slte Pled$�avey �Itorvmg tbe ealstiug eti1lCAmes
� E�P� PmJaet
2. ltivo ee� o4consagc�iaa �s
3. Faser� C�1cu�a�a
S C�l� J�(: b See 8ack Pega fdr Fe,� SchaduIe
� _ GS"/o of Euilding Pan�it Fe�
$ .001 timas tha tatal jab �valluataoa
$ .�OS x Permit VaYuatiion 111�1inimua� 5.50
� - - S�, �LL � �5.00 (Stau Lice�ed Rmsid�tial C�n'tt�acto�)
$ $1550 per SAC Uuit (Plans tD MWCC for dete�minatian)
$ ft+6ft=�ftX$21=$
$ $430 Coneervation P�an l�ewiv�v
� �� Determiacd by AQBiaeeripg
$ � A$reement �,eceseary' i ) Non Necessary+ ( )
� � _ . _ � � . Muke c�ecl� �reyable ta: C� of �'rldlev ae�
T�5 i� AN APPLICA,1'�Cf�1 � A PER1�T NOT VALB1 LR�'�IL PROCSSS�
t hei+�by apply for s building permit end I�ka�wl�ige thet the �fo:metian above i� cc►mplete aad sccueate; that the wosk wvill be in
c�anfornmnae vvh6 thc ordinsa�os �d ca#es of tha Gity �€ Fridicy e�d veith the Miane.sota Coustructioa Codes; tbat I unde�staad d�ie is aat a
pttmit but oaly an appiication for a pmmit ead wark �.. nc+s ta �tart wi�ut a permi� thst the work vv�71 be in sccordm4ce with the �mved
plan ia the cese af all wark w�ui� re'vi�vr ep� a�pprm'�'al of piane. !, ,, ,. .
BIGNATURF. OF AFPLIC�WT
Buildir�g BUILDING Permit No�� ���
Inspections RESIDENTIAL APPLICATION Received By: `�
763-572-3604 CITY OF FRIDLEY nate Rec'd: a� o�
SITE ADDRESS J
1'HIS APPLICANT IS
PROPERTY OWNER/
TENANT
CONTRACTOR
❑ OWNER
�c i i�
E-MAIL ADDRESS
C�
SUBMIT A COPY OF $TATE LICENSE # � S � EXP DATE � ^ � � � ,
YOUR STATE LICENSE ADDRESS: �D ��dt I CTfY�,
WITH APPLICATION PHO � � S AX 7 °
PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCITON SIZE
❑ O FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE � �DITION ❑ GE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ROOF ❑ DRAIN TILE
❑ DECK SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK: o ��'�'
❑ MAINTENANCE/REPAIIt
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
NUMBER OF SQUARES �
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
LENGTH
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
WIDTH HEIGHT
STATE��IP ���
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
Ft.
SIDING FOR NEW CONSTRUCTION INCLUDWG DECKS,
❑ Vinyl OSoffit ADDITIONS. & PORCHES SUBNIIT:
❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing slructures
❑ Other ❑ Fascia and proposed project.
WINDOWS • 2. Two sets of construction plans
IN EXISTING OPENINGS OYes ❑No LOCATION OF WINDOWS 3. Energy Calculations
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
��� � TOTAL JOB VALUATION $�-, _ d OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Chazge
Curb Cut Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
Total Due
$ �., a�
$
$ a
$ r < <-I
� � �C!
$
$
$
$
See Back Page for Fee Schedule
65°/a of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1675 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21 =$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary (
Make checks aavable to: Citv of Fridlev
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID IJNTIL PROCESSED
Attach
I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of e City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a pe ' ork not start without a permit; that the work will be in accordance with the approved
plan in the case of all work which uire e e of plans.
SIGNATURE OF APPLICANT PRINT NAME !/� /G{� �P �!�'�DATE �� ' � � � /