AF - 42954�* �
* PIONEER
* eng nee
** �*
.
�� PLANNERS • WVOSCAPE ARp117ECT5
2422 EnterpHse Drhre
blandota Helghta, MN 5g120
(612) 681-1914 FAX;881-9488
625 Hlghway 10 N.E.
Blatne. MN 55434
(612) 783-1880 FAX:783-1883
Certifica te of Survey for: THE RO T TL UND COMP,
House Address: �s -6�-sx Chrisie,nson LAn16
�:1
►' i
�.
i
!
i
I
�
�
,
�
,
�
,
,
,
�-
, ,
�
,
�
,
�
,
�
House Model: Gable To�m���pc
K soo.o Denotes Extst�ng Elevotlon
� Denotes Proposed Flewtlon
—�- Denotes Drolnoge Flow Directlon
-- Denotes Drainage dr UtifTty Easement
—o— Denotes Monument
--�— Denotes OfFset Hub BearJngs shown are assumed
LOTS 2- BLOCK �
-
an�orcA covrvn�.
i � .�.,.—�� _ ��
.F / '�
�P_ROPOSED BUII.nING EI.E1�A?IONS
Gorage Slab Ffe�notion: �9•8 (at door)
NO1E: Propoaed buddtng dt� groding la tn ocewdenee �IN ths
grodinq plm�s appro�ed py ihe elty enyineer.
N07E: Cantractw muat vsrity o0 dlmansiaa�a k drlveway desiqn.
CH�ISTE.NSON CROSSING
MINNESOTA
We hereby certtfy that this aurvey. plan or report was prepared by me or under my direct supeMslon and that I a duly Iic�nsed
Land Surveyor under the laws of the State of Minnesota. Dated this _ ZD TJ doy of _ SET�?En�t 8E� q.D. 19 `�6
Q�e� ,$'�S'�l 1 Signed: P10NEER EN ING, P.A.
Scale: 1inch � 30#eet By. �,
Robert B. Sikich� LS. Reg. No. 14 91 or
� 16190059 ,T�rr�nce E. Rothenbacher, LS. Reg. No. 2a595
�
SUBJECT P.EF���k��
City of Fridley ��2 5 41 ��
1 , AT THE TOP OF THE TWINS g � I L D I N G P E R M I T �ppfi O. '
r
� � COMMUNITY OEVELOPMENT DIV. , /
V PROTECTIVE INSPECTION SEC. �/Srn�
� _
� � _�'_
r ; "; ,
' i '
� /'�'1 � CITY HALL FRIDLEV $S4� NUMBER REV DATE PAGE OF AVPROVED BY
�----�' �•� 612-571-3450 910-F15 8/25/97 / /
JOB ADDRESS 6453 Christenson Lane NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 6 2 Christenson Crossing SNEET
2 PROPERTY OWNER MAIL ADDRES$ 21P PMONE
The Rottlund Co 2681 Long Lake Rd, Roseville MN 55113 638-0500
3 CONTRACTOR MAIL ADDRESS 21P PMONE LICENSE NO.
Same
d ARCNITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS Z�P PMONE LICENSE NO.
8 USE OF BUILDING
Townhouse & Garage
7 CLASS OF WORK
� NEW O ADDITION O ALTERATION O REPAIR ❑ MOVE O REMOVE
6 DESCRIBE WORK
Construct a 26.33' x 30.33' Townhouse & a Garage
9 CHAN�E OF USE FROM TO
STIPULATIONS See notations on plan. Paid $375.00 Park Fee.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTR�CAL, PLUMBING. HEATINO,
VENTILATING OF; AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTFiUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OH IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. N0. OWLG. UNITS OFFSTREET PARKING
I NEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPIICATION 1 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 See 6�4c� C'hriSt2IISOII LB.Ae fOr MOII�2S
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LQCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
� PLAN CHECK FEE TOTAL FEE
� �� �
aE oF Co TOFl OR AUTMORIZED AGENT IDATEi � yyHEN PFOPERLV V DATED THIS IS VOUFi PERMIT
/��°"'r�i�
S�GNATUqE OF OWNER�iF OWNER BUILDER� IOATEi 8 G S'� - � OFTE
Prepaid Plan Cherk $
Estimated Cbst $
Receipt #
CIIY OF FIt1DIIL+'Y
' • � I ! �!' �1 • ; I I 1 . ' •
���i �1' �I�.Z��
Effective 3/1/96
• • � � • - fi ►�. A � L-= • .
'�� �� • • �.. / � . /� r. � . `�.
� � • � • ' / � �1 �.i .�� � � � � _i�n �. �� � t..._ ,LL.� � .I - �� � ��
��1 � � �� � �� � ^ I � . . -
�
� ' • � • �
� � L. y � .1� � ■ ��l �� ' • �
�1 • " � � • ' i Y � � -� - • �.
�A i�' �� �_i , � � � �LL_
�
� �
� �� �.� •�• • � ' � �_�M •' "`.. -7.� � y
R : �. '�'S� �� �.� � .�
� � �� � �� �c - \
• � • " • " I i�i / �II �' � �L / �
/ -
HUII,DIl�G DIl�152CS�15
Length /"� Z�_ O�� Width � y� Q" Height���, Sq. Ft .,� # of Stories �
oFC. AREA: Tanc��i-h width xeight Sq.
Ti�SE AREA: L�ength Width Height Sq.
OrlT�R AREA: Length Width Height Sq.
VALi�TTCfl�T
Sq. Ft. � x$ oZ Cost/Sq. Ft. = Valuation $ �"
sq. F't . I, Lp �0 x$ 1 S.`3 2 Cost/sq. Ft .= valuation $ 30�'7'7�. �°l
Sq. Ft. x$ Cost/Sq. Ft. = Valuation $ )
F't .
Ft.
F't .
_ $1��c�, �z�� �
T�OrI'P,L �TAL�IE
��i1 cling Use Eai�, �PtL Oonstruction Type��� OccupancY Group �' J
Air Conditioning �Yes El No Fire Frotection P.tro�vided Ll Yes Q�,No °TDI�1NlHv�'»�S
Perforinance Bond Amrnu�.t $ i`� See RevPxse for Schedule Received. [] Yes [] No
Pezmi.t Fee $
Plan' Check $
F'ire �tiu='char�.Je . $
state Surcharge $ �
SAC �e $
Erosion (�ontrol $
Park Fee $
Spec . Assesstc�nts $ �
Driveway Escrow $
Z'OTAI, $
See Fee Schedule on Reverse Side
In E�ccess of • Prepa.id Amount - See Reverse Side
.001 x Permi.t Valuation (1/lOth o)
$.50/$1,000 Valuation (See Sched. for > $1 Million)
$900 per SAC Unit (Plans to MWCC for detennu�.tion)
$450.00 Cbnsezva.tion Plan Review
Fee Determined By �g:ineering ,
Agreement Necessa�ry [] .Not Necessary []
feet x $13.50/foot
$1 to 500
501 to 2,000
s
2,001 to 25,000
Z5,001 to 50,000
50,001 to 100,U00
100,001 to 500,000
500,001 to 1,000,000
1,000,001 and up
$1 to 2,000
2,001 to 25,000
25,Q01 to 50,000
50,001 to 100,000
100,001 to 356,000
Over $356,000
BUII..DING PERMIT FEE SCHEDULE
$21 (Minimum Fee is $21 plus surcharge)
$21 for lst $500 plus $2.75 for each addn'1 $100 or fraction, to and including
$2,000
$62.25 for lst $2,000 plus $12.50 for each addn'1 $1,000 or fraction, to and
including $25,000
$349.75 for lst $25,000 plus $9.00 for each addn'1 $1,000 or fraction, to and
including $50,000 . �
$574.75 for lst $50,000 plus $6.25 for each addn'1 $1,000 or fraction, to and
including $100,000
$887.25 for lst $100,000 plus $5.00 for each addn'1$1,000 or fraction, to and
including $500,000
$2887.25 for the lst $500,000 plus $4.25 for each addn'1 $1,000 or fraction, to
and including $1,000,000
$5012.25 for the lst $1,000,000 plus $2.75 for each addn'1$1,000 or fraction
PREPAID PLAN CgECi� �, E SCHEDULE
$29.25
$29.25 for lst $2,OOp plus $5.85 for each addn'1$1,000 or fraction, to and
including $25,000 .
$163.80 for lst $25,000 p�us $q.,225 for each addn'1$1,000 or fraction, to and
including $50,000 �
$269.43 for lst�$50,(}00 plus $2.925 for each addn'1$1,000 or fraction, to and
including $100, 000
$415.68 for 1st $100, 000 plus $2.275 for each addn'1$1, 000 or fracdon, to a.r�d
including $356,000
$1,000 (Balance due with issuance of building permit)
PERFORMAIVCE 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,
lighting, and storm drainage systems.
Calculation of bond amounts will be determined by the buildin •
building permit value up to a 2 million dollar project or a$60,000 ond Actual amounts will be rounded oe 3% of the
$100. The City reserves the ri ht to re uire � the nearest
b Q greater or lesser bond aznounts based on unusual circumstances, pro jects
with no outside im proveme n t s, g e n e r a lly w il l not require a bond.
Bonds must remain open untii the project is fully campleted, All bonds will be held over one winter and through the
zext growing season to insure the survival of all landscape installa�o�. �e City will then inspect these properties
�n August of the year following the initial planting. gonds may then be released in October of that year if all
mprovements are satisfactorily completed.
� D 17�
� 1� �
o -�
�
rn/�
� 3' \ /
� O �
N � O
-. Z
� � m
o � m
� � �
� O
N
O eaD o
�� �
� n �
a fl.
� _.
co �
� �
O �
r �
= y
; Q
�
�
O
�
.,
��.
0
t�ri -�-� a
Z CD') �
--� � n-
�
� v
m
m �
�
T�. c
< �
rn �
� �
� �
D �
-� �D
�
z
O
L
�
�
d
O
�
cn
w
�
��
�
�
�
�
2[i'►
�
Z
�
8
AZ
-c
�
Z �
0
� c� 4
� � .
-� �
� �
�
�
��
—
�,
�
� n
N �
� 3
o m
A
C =
� a
� •C
� �
� �
m
A
c�
O
0
�
� G)
D �
r �
c
ti i �
�
�
m
0 0
o ?
m
� �
� �
o �
"a �/1
-o s�
�• �
n m
� �
0 0
O �
� �
--!
O
Z
D
c�
�
�tfl .4A ts9
�
so�
0
C �
�
�
1
m
�
�
�
�I
�
rn
O
�
-�+• m -+ z
A C Q �
�p O
� �� �
� �,
� �
� �., �,
� � 2 ��
o � n
m �
c� `D
o �
� m
fD �
� � �
N �
� � �? �
O � � �
a � a =
�-,�
�.'
o�
_
`
,.
�
Q
�
�
�
N
�
y
�
N
tp71
C
Efi
�
c�
N
O
m
-.
m
N
�
m
�
�D
c� a�,�
N p C N
� Q
o.� m �3
� �
r-► � m m
cZo ? 3 a,
� ' ? Q
a ?� � v
��m�
� � m o
� A �
�� m
� �,
� �
�
� � � �
�
O O O O �
o° g °a Qu y
ie
tt� t� �4f, tf�
� � o
1°a �
� �.
rs'�
�-_�-i
�
m
U
�
�
�p`
�)
d
G
�
�
rn
�
�
-i
O
�
�,
��
m
C
�
Z
c
�
m
O
a
�
�
m
�
�
�
>
m
�
n
_
rn
v
C
r
m
y � �
� � A � a
= O � � Q
�. � � N 3'7
� O m � tfl��
� m � ��N
m � � a ,�
�o-��
m3o�—
�� Q e��
� �o��s
� o`_'„ °' 3 6-
a� � o c�u "� -L
a � � m � .�-
n �y� �
� �
1
� � � � �
� � n � �
n �
�C A � O S�
°m m � m
a� � � j'�
�- 3 �
o a: �• � �
m m � o �
_ ? � � -�
m n
� ��� �
��� �
� �. m
t� C t�i� t�D
V � �
a
�C
� � � n—
�WQ��—
I �p^
rn'� � �—
� � � T �
� �
� �
�� �
N 'C �
�' Z �
m m
n
�
Z
O
<
�R1't �
� f
m a
'��
-� o
oz
Z �
Z �
O �
D
� �
o �'0
=� z
o�
z�
za
�
�v
� m
m
�=a
Z
� �
rn p
mZ
CA �
<
Z
-a
�
�
Z
m
��
� U�
� 4
� ��
,c •
��
�
�c
V
, �} ��A , � HOUSE HEAT NG TEST RECORD,ut �� ` �„ ���Y��M��,
� �G .... ., � , yjo "' '' �"� � 'a,
�, ����" l
.�' ' .: 4; `
,^. � t !i
J►ODRESS - }����� -+ E APT� FLOOR CITY — SUBURB
_<:,.�CCtfi�� �;:��_- .'� .,,, , ` OWNER
HEAT L�SS� � � �' ATE�� � TG INST. ` �� �
SOLD BY; -� INSTALLED,BY
�, s ' l,*
El�etr�c� �'Work Bp �� Gas Lin� Br " 4
_ TYPE O�E"' T � GA - FA HiN STEAM "' SPACE HTR. UNIT HTR. OTHER
� p�`' Gi15 C GN ' CONVERSION
MAKE � MAK�"�,,,Qt,IRNER �'
�d•� Model �
S�rioi Max. B''TU Roting.
INPU 9 MAKE OF FURNACE; f
� � Model
� diA� . - _ M'
' :' ����NTi70L5-_ � "�,
THERMOS�A'T He / P � Vsnt Siss " �'"
Yalrs �r ' � KINQ OF LINER -" SIZE � NONE �
�'.�� =��..-
�Limit � Droft Hood �� � � .R"yuleror, � � �.✓ s � �
Limit S�Hi�� Filtsn Siz umbar_. � •'' -'� •
Fan �5etliny ` Chimner Locati r Insida ` Ou�s.ids �� �� `
Ptlot Tr� � � Q,im�er Co�se►�a�en - ' '4 ,
Pilot Maks .
Pilot Model �' � Smake.Bomb Wiring -�^' "
�ilot Timing � � � D►uET ``'' � Test Tap
,L.W. Cut Off Door Pressuro � ,` L�htin st
.. �
Pras'sure � d reent CO2u Date Tested,, ' ��• �' �
Input CFH .�Pe►e�inG""02 �Company Tes��� r,
Stack Tsmp. Perceri� CO Narms of 7sstsr �
�' . , q: ♦ ,,, i,.
Fler�n' 235 �° . f
,
.
, � �y* �.
.i,.4, ,.; , �+..a .,.�t .� ..�.:�.-i....�s .:,�r .. ,..,.°,.b�& , ..c�.�_� „� u_s�:+4..e.:vif�.,., �...,Pi<_.i!�....u�v�v',;�£ u<„n�.,..�,. �2�".Y�'.W �..:t..:f,.r.. .'.a,a'� „�.J..';tr, ,�.�tA�.i,.l,�i.. �,i.Ju.. . u r�e.�,.u.s i..�r...�..... .�..,.Y�c;.
�
rn
rn
�
�
�
c
m
�
c
O
m
>
�
m
W
�
0
Z
0
F=
W
� W
Z Z
Llj ¢ CN
n �N iA
� ; Z
V
u- �� � c�o
O � m ch
� � 'O N
Ci f�0 LL ln
�
U
�
�
�
0
Y1
�
�
�
W
�
0
Q
m
O
7
�
0
w
�
O
z
W
�
W
�
X
LL
�
Z
m
�
J
�
� �
� a�'i �'i
� � �
: o �
� � � '�
� � � �
: m � ',
' Y �
i � .-� ,
.= m �
; '3 m �
. �
� U U '
L C m i
I � � �
i `p .Q �
' U m i
� V i
1 {l�� � i
i C7 � !
! ►_ C �
L � � i
� c c �
� Y O i
� O � +
' 3 '- i
� _ o
: � m �
�
� o � �
� � � j
� � � ,
: rn m �
� c m �
� 'm � '
D � p i
� rn '
N
� m � 1
i °" � ;
� a c i
• � � i
�
rn
rn
�
�
�
�
�
�
�
�
�
'�:yi
I
�
Z �
H �
�
� �
W
�
Q ...
a °D
0
� U
� a
m
� ' c i
C � �
Om' w
�
�
�
z
¢
a
�
O
U
�
z
m
�
�
J
n.
,�, �i
�
0 0 0 0 0 0 0 0 0 0 o a o
0 0 0 0 0 0 0 0 0 0 0 0 0
��� �� � ti o� o 0 0 �
� � � � � � � � � � � � �
�I. I I� I( I I I`I I I? I
O1
�
i
�
m
3
m
7 V V m
�C Y � � # � �
lL � a �'j m m
3 m F- a m p c
Z � � a W � �
m
L
N a7 C Ol C J'Z �� �N # # d
7 C Q� �� m m m m� m 3
� aopm� a`2= � Z'i° N
0 � p ��- a
`- � �� m r� ao m o�
3
Z O m m U a`�C c3n � 3 � O C3 m
�
�
' �1
�
�
0
Z
J
W
H
d
m
0
W
Z
C3
�
� �
�
�
a�
�
0
�
c
�
�
z
0
�-
�
w
J
Q m
� C
Z �
a •-
� Q'
� Q
Q
= W O
O � 3
�
m � O
m Z m
� a �
� W �
U = �
�. � o
�n O �
C
� Q �
�
�
0
c
I
t
�
�
0
�
m
v
a�
O
a
a
Q
O
��
� �a
�
� �
m
�
l�
L
U
7
�
�
�
�
w
w
�
�
�
0
_
CIZYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNNERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287
March 17, 1998
Rottlund Homes
2681 Long Lake Rd
Roseville, MN 55113
Re: Final Inspection at 6453 Christenson Lane NE, Fridley, MN
Dear Sirs:
A final inspection was conducted on March 16, 1998 for the above noted townhouse. We found
that the construction of the building complies, to the best of our knowledge and belief, with all
the requirements of the building codes of the City and the State of Minnesota relating thereto,
and permission is hereby given for the occupancy of said building.
If you have any questions on this matter, please feel free to contact me at 572-3603.
Sincerely,
�( _
BARR RIESCH
Building Inspector
:7 �
sue�ecT PE
� City of Fridley
AT TME TOP OF TNE TWINS g � I L D I N G P E R M I T 2 8 9 8 3
I
� �• COMMUNITY DEVELOPMENT pIV. n,�/O
v PROTECTIVE INSPECTION SEC. �O
� • ; '.•'•,
:� .j .�: .
� , /"'1 � CITY MALL FRIOLEV �}5132 NUMBEt1 NEV OATE pAGE, O� APPROYEO B�
����� � �'' 612-57�-3a60 9�aF�s 3/5/99 / /
70B ADDRESS �
6445, 6447, b449 6451 6453 6455 Christenson Lane NE
� �E�� LOT NO. BLOCK TRACT OR AODITION SEE ATTACNED
OESCR. 2 to 7 2' Christenson Crossin SNEET
2. PtiOPEqTY OWNER MAIL ADORES$ 21P PMONE
Rottlund Homes
3 CONTRACTOR INAIL AODRE33 Z�P PMONE LICENSE NO
Town & Countr Roofin 7910 12 Ave S Bloomin ton 542 545-4233
1 ARCMITECTORDESIONER MAILAODRESS IIP PMONE LICENSENO.
545-4233
S ENGINEER MAII AODRESS IIP PFIONE LICENSE NO
8 USE OF BUILOINd
� Townhomes
7 ,CUBS OF WORK
'� ❑ NEW D AODITION O ALTERATION �! REPAIR O MOVE O REMOVE
8 OESCRIBE WORK
Reroof Building (90 Sq ) Tear-off .
9 CHANGE OF USE RROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
`.:r';
SEPARATE PERMITS ARE RECUIREO FOF ELECTqICAL, PLUMBING, MEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY �OAD
VENTIIATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK Oq CONSTRUCTION 20NING SO. FT CU iT.
AUTMORIZEO IS NOT COMMENCEO WITMIN 80 DAYS. OR IF CONSTRUCTION
ON WOFK IS SUSPENOED OR ABANOONED FOR A PERI00 OF 120 DAYS AT
ANY TIME AfTER WOqK IS COMMENCEO. NO DWLG. UNITS OFfSTqEET PAAKING
I HEREBY CERTIFY TNA? I NAVE READ ANO EXAMINED TMIS APPLICATION STA�LS GARAGES
AND KNOW TME SAMH TO BE TRUE ANO CORRECT. ALl PROVISIONS OF LAW$ yALUATION SUR7AX
ANO ORpINANGES GOVERNING TMIS TVPE OF WORK WI�� BE COMPLIEG @
WITM WMETFIEi1 SPECIfIEO MEREIN OR NOT. TNE GRANTING OF A PERMIT W7 f 713 �3.86
OOES NOT PRESUME TO GIVE AUTMORITV TO VIOIATE OR CANCEL TME pEpy��T fEE SAC CMARGE
PROVISIONS OF ANY OTMEp STATE OR LOGAL LAW REGULATING CON• $137.25 �7.71
STRUCTION OR TME PERFORMANCE OF CONSTFiUCTION
PLAN GNECK FEE TOTAI FEE
�w- � �,�,D �.5� Li ense SC $5.00 $153.82
S�GN�TUpEO�CON•p�CfOpOp��lTMOp�2ED�GENf i0 rE� WMEN PROPEAL ALID ED TMIS IS YOUR PERMIT
vv ' �
S�GN��Upf O� OWNEp��� ON�NEpBURDEp� �D�TE� gP q6T(
Building
[nspections
763-572-3604
763-502-4977 F.�X
DATE o�����L
5IT'E ADDRESS � �
TH1S APPLICANTIS-
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
DESCRBE WORK BEING D
ROOFING
NUMBER OF SQUARES _
GARAGES
PROPOSED SiZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 1-1-OS ,.,
YOUR E-MAIL ADDRESS
/�'(.tl �.L2Ld c�vL. �s� s"-��.
❑ OWNER �ONTRACTOR
NAMF• -P/IO� !
�j..@���C�1�4� ���
vl %i �� � 07 �i �'.�'e�?�'� �
�� ��3� ��e"C�i�
� - � . 1���%r / � �
�� -
� - - -� :
�- � �-��.. j1i
�.'-��,� .
ADDRESS: � � CITY STATE ZIP,
PHONE
FAX
STATE LICENSE #�� �Z (� � 4� EXP DATE
�SINGLE FAMILYMEW CONSTRUCTION
❑ TWO FAMILY/NEW CONSTRUCTION
❑ BASEMENT FINISH ❑ ROOF
❑ DECK ❑ SIDING
O SWIMN
❑ NEW HOIv� CONSTRUCTION ❑ ADDTTION
C�A�vIAiNTENANCFJREPAIR ❑ REMODELING
WINDOWS
RJ EXISTING OPENiNGS ❑Yes ❑No
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE IAiSTALLED
c'�vi2 c �� �
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
❑ WMDOWS
❑ DRAM TILE
O OTHER
HEIGHT
�
BASEMENT REMODELING SUBMIT:
1. Existing Fl�r Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCT[ON INCLUDING DECKS,
OSoffit ADDITIONS & PORCHES SiJSMIT•
❑ Trim 1• Site Plan/Survey showing the existing strucU�res
❑ Fascia and proposed project
2. Two sets of construction plans
3. Energy Calculations
LOCATION OF WMDOWS
OF
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
� �iJSING THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $ �� C� '—' OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surchazge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ o? � j U See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ � .001 times the total job valuation
$ � .0005 x Permit Valuation Minimum $.50
$ $5.00 (State Licensed Residential Contractors)
$ $1825 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$Zl =$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ v Make c6ecks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; thaz the work will be in conformance with the ordinances and codes
of the City of Fridley and with the Min onswcti n es; that I understand this is not a pertnit but only an application for a permit and work is not to start without a
permit on site; that the work will be i accordanc�e with th appro plan in the case of all work which requir r iew and approval of plans.
SIGNATURE OF APPLICA �c' PRINT NAME ���–�G��� `�-���,'L DATE���� �l�
�� c�.�
APPROVED BY _ DATE
Page 2- Building Residential Application
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official sha11, before issuing permits for the erection of any building or
structure, or for any addition to any existing building or structu.re, or for any alteration or repair
to�.n3� existing bt,il in or .�cture, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below set forth and in the manner herein
provided to-wit:
VERIFICATION OF FOUNDATION
Pemuts for construction will be issued a minimum of 24 hours from the time of application to
allow for proper review of proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required. before proceeding with the framing. New Houses Onlv
City of Fridley
Bnilding Inspections Department
6431 University Avenue NE
Fridley, MN 55432 '
763-572-3604
Faz: 763-502-4977