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BUILDING PERMIT
Village of Fridley, Minn. N° 2 4 0 3
�f....../��... � �.
Date� � .........................
pwner ��.�.�. . . . . `�! .'.�! , ,�,(, ,','�.f . . . Builder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
�[ ���,, 1
Address . �? .f %%�. . . . . �.�; ir'ld�'�'f�'� . . . . . . Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
LOCATION OF BU�ILDING
� $
No. �.!:'� �.. ..... Street .. .... .. .. �.t/?'`"*.^.'v: . . �� .F'.. Part of Lot . ...... .. ..... .. .... ...
V � .
Lot ....��........... Block . ............ Addition or Sub-Division .......................................
Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ����/ ..................
DES�RIPTION OF BUILDING
To be Used as:
�. . . . . . . . . . . . . Front . f. �. . Depth . �:�.�: . Height �i vt �. . . Sq. F't. . !!�� Cu. Ft. . . . . . . . .
�
.................... Front ........ Depth ........ Height ......... Sq. Ft. ........ Cu. Ft. ........
�
Type of Construction .��. .�.� . Est Cost . . .�� �. .��. • • • To be Completed � .� �. . • • • • • • • •
In consideration of the issuance to me of a permit to construct the building described above, i agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of �ridley. ,
.� �'
.`.. �, : �i.?�%t:` ..:.........:. :':�. ���':!'i.�':� ..�.�.
— --
Tn consideration Of the payment of a fee of $. . � . . . , permit is hereby granted to . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . to construct the building or ad dition as described above. This permit i5 granted upon
the express conc3ition that the person to whom it is granted and his agents, employees and worl�nen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, M'�esota. regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon viol on of any of the provisions of said
ordinances. �% f ,, /1/�
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!"Ill�!...... BU1lf�lIIg IYlSp2CtOP
NOTICE:
This permtt does not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these items. �
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Caty of Fridley, Minn..
BUILDING PERMIT N� . ss7�
n ��a��
nat�: �' °" �
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owner: uilaer
Addres$ Address
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LOCATIQN O U ING
N �/ Si�et .�� P f
i
�_ _ Bl� Adciition or Sub-Di on � ,
Corner Lot � 7nside Lot —� �back Sideyard ���
Sewer IIevat4an �— Fo tion IIevation
DESCRIPTION OF BUILDING
To ��
� Front �-- DeP� � Height -�.= S�Y. F'G �� Cu. Ft
_. Depth ITeight ��1. F� Cu. Ft
7.j►pe of Conatruction � Fst� _ _ To be Completed --
In cons4deration of the issuance to me of a permit to construct the building described above, I agi�ee to do
the proposed work ffi accc�r�dance with the description above aet forth and in compliance wlth a11 Prov3sfons of
or8inanc�s oP the dLy of FYldley. / �e�p � �' � , ) P _ _ , __
In cons4derat[an of the payment of a fee of $� � Pe�it is hereby granted to
to cronstruct the buflding or addition as descrlbed above. Thiape rmit is granted nPon
We esPress c�ndition that the P�on to whom it fe granted aad his agents, emPloyees and worl�en, in all work
dane fn, around and upon safd building, or any art thereoE, shall conform in a]1 respects to the ordivances of
Fridley, M9nnesota regardiY, g�t may b�e �o�ked at�an,yn' maintena�ince'tio of any of �visions of�said
withiu the dty Ifmita aad tb9s i�� Y"7� �
ordivancea
F ,��
,� Nonc�
TWs pe�mlt dea net eerar t6s eoastrueHee, Ie�aWllee �er wMeg, plumbiee, ea h�aHag, sswu sr wNsr. B� son to u�
t6� Boildin8 IospKte� hr ap�rds Wrmhs /er fhe� �na.
,;
sue�ecr PERMI "O.
City of Fridley � 13526 �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
; � RE .
� • COMMUNITY DEVELOPMENT DIV. � � ��
� �y-------�
r � � PROTECTIVE INSPECTION SEC.
1 = �
�l /'��/ � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
L'�«� � ,•� 812-580-3450 �� � �
910-F15
JOB ADDRESS 5017 Clearview 5treet N. E.
1 LEGAL �OT NO. BLOCK TRA T OR ADDITION r SEE ATTACHED
DESCR. � � SHEET
2 PROPERTYOWNER MAILADDRESS IP PHONE
Frank Sarazin 5017 Clearview Street N.E.
3 CONTRACTOH MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE IICENSENO.
5 ENGINEER MAIL ADDRESS Z�P PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
C}� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a storage shed 12' x 12'
9 CHANGE qF USE FROM TO
STIPULATIONS Shed must be on a permanent foundation or attached to the ground by
pilings.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. Fr�e
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. 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 OFFS7REET PARKING
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION �. STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,065 .53
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR IOCAL LAW REGULATING CON- ��� $S.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
$5. 53
SIGNATUREOFCO I'�RACTORORAUTHOR2EDAGENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
� �,, _ � � -� ,�� �' �' °',� ;� �� 2.l .� ���lt'ut�� �' ��°'%6
.
:6= ' ia.�-,�� r � .�+�/? a -
SIGNATURE OF O ER IIF OWNER BUILDERI IDATEI BLDG INSP �ATE
�
, �+� �'L14A1 1UN 1�UIt ItL511�LNTil1L, ALTERATION, •
OR AllllITION �3UILllING PL•RA4IT
0
• CITY OF FRIUJ.LY, biINN�SOTA
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ADDR�SS :i�.L.�: G°/���/� [/,� .� �ST. /ii£-ADDRESS :
Na : . �5 0 [� s TRE�T : ,, /�r- tiRVr �r� ' �S T' iS/�E ..
. .�
LOT : � $LOCK : � ADDITION : ��/'�/�'a �t/ ,�'vi/1? / / /l7f1A/O�
CORIV�R LOT: INSIDF LOT: � SETEACK: SIDEYARD:
Appli.cant attach to this form Ztao Certificatcs of SuxveY of LQ� and proposed
building location dra�,m on these Cextificates. +
a
0
To Be Used As :
UESCRIPTION OP BUILDING
��%d�ll�'_;,�' Fxont: ��Depth: �� Reight: /�
Square Feet :�N Cuhic Feet : � �`�� �
� Fxont: Depth: Height:
. �. Square Feet; Cubic Feet•
Type of Constructian: �,�� .����� Estimated Cost: ����,����
, To Be CompleCed: ��� � .
The undersigned hexeby makes applicatinn for a permiC fox the work herein��
speciiied, agreeing to do all work in stxict accoxdance with the City of
Fri.dley Ordinances and xulings of the Department of Buildings, and hereby
declaxes that all the facts and xepresentations stated in this application
ttxe true and corxect. � �
. , . �
� ��
� D�ATE : ��,�,�,!��_ SIGiQATUr.E : ` .
(See Revexse Side For Additional Information.) �
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�BUILllING PERI�TIT r�E SCI1L'llUL�
SECTION 2. The Tnspector of Luildings shall, beiore issuing pei-mits for the
exection of any buildin� or structure, ox for any addition to any exisL•in�
bu3.iain� or structure, or for any altcra�ion or repairs to any existing
building ox struc�uxe, upon application thexefore, xequire the payment by the
applicant for such permit of tees to the amounC herein below set forth and in
the manner herein provided to-wit: .
UNIFOItM EUILDING COD�: Z�pe I, 2& 4-$2.15 for each one thousand cubic
feet, �ox fraction thereof, in such cubical contents. Type 3& 5-$1.85 for
each one thousand cubic feet.
�
� � ADDITIONAL INFORI�IATION
Tor the purpose .:f computing fees for building permits, the cubi�cal contents
of any building or addition, is determined by multiplying the gxound area
covered fxom a point six (6) inclies 'ueloca the floor line of the basement
ox the cellar to the avexage lieights of the upper surface or to the average..-
heighL ot the roof surface of the main gable of a pitehed roof.
Fox xepairs or alterations to an existing structure, the fee shall be at the
rate oi $3.00 per each five hundxed dollars ($500.00) or f�:action thereof in
the cost of all proposed worlc. '.
In no case shall the fee charged for any germit as set foxth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOT�: Permits for construction �vill be issued a ininimum of 24 hours from the
ti.me of application, to allo�a for proper review of the pxoposed stxucture and
of the constxuction site.
A Certitied Survey oi the lot, showing the location of the foundation, once it
has been constructed, will be xequired bcfore proceedinfi with the framing.
CERTIrIC/�TE OF OCCUPANCY
Application for a Certifi.cate of Occupancy shall be made ten (10) days prior
to the use or occupancy of miy structure tor tahich a building pexmit has been
issued; and said structure shall noC be used or occupied until a Certificate
. of Occupancy has been issued. � .
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Fi�Ia
CI'lY OF FRIIi�
1�IE!lORAHDDM
NASIM QURF�HI� CITY MANAGIIt
JOHIJ FLORA, PUBLIC WORRS DIIiDC1�R
�11. � �" • 1 • ' y� � •� 1 'MI . �. �,
. DATEs NDVIIKBIIt 15, 1982
Councilman Fitzpatrick requested we investigate the flooding problem
indentified by Mr. Sarazin at 50�17 Clearview. We investigated the property
and found there is only a 1 ft. drop in elevation from the rear of Mr.
Sarazin's property to the cat�ch basin which is located approximately 280 ft.
away to the east. Mr. Sarazin has oo�m�ented in the spring before all the snaw
has melted in order to prevent flooding in his yard, he has to shovel the snaw
along the rear of the adjoining properties to the catch basin in order to
allav the water to drain. Our irrvestigation supports his claim in that the 1
ft. difference in elevation c3oes not provide for a very rapid flaw of water
plus the fences and hedges along the property lines have a tendency of
hindering the flaw of water, particularly when there is snaw on the ground.
The area along the back yards of the properties facing Clearview and Panarama
Drive have the front portions of the yards draining to the streets and the
rear portions of the yards draining to the rear where it was prograa�aed that a
drainage swale would take the water and direct it into catch basins which run
north and south in the storm system from essentially 2 1/2 St. to Horizon
Drive.
Mr. Sarazin has requestec7 the City oonsider installing a ca tch basin at the
rear corner of his property and putting in a pipe system from there to the
existing storm s�wer line in order to alleviate the flooding problem that he
experiences in that he has a lav point in the entire syst�n of back yards and
has a tendency of water building uip on his property. I advised Mr. Sarazin
that the Gity has no easement along the rear property lines but if he would
obtain the petition from the affected properties with the understanding that
they would acoept the assessment for the improvenentr the CitY wuld go in and
install an unc7erground systsa fran the rear of his yarcl and connect it to our
existing storm system for water clrainage. This would not only include a
considerable oost but an adclitional easement dedication to the City for acaess
on to the property and maintenance of the system installed. An alternate
suggestion was that the r�ighborhoa7 or r�eighbors oould get together and slvpe
their rear sections of the yards in orcler to provide drainage into the
existing cat�h b�asin.� �lie Pa��es to the south of the drainage system,
namely, 5001 Clearview and 175 and 187 Panaraana aould install a clrainage clitch
along their rear lines o�nn�ecting to the catch basin which would alleviate
sane of the water that has a tenc3ency o�f building up at 5017 Clearview. In
all the above alternatives, the City does not have any plans for improvement
nor does it have the proper authority to enter this area and do any
construction.
I have advisecl Mr. Sarazin that he
to establish concurrence to reques
they can work togeifier to solve th
JF/bd
4/0/30/6
attenpt to work with his neighbors in a way
t a,n impravement or initiate action where
e problen.
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. ;
CHIMNEY AND BTACR VSRIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes (�. No ()
2. Is free from ni�t or deterioration Yes (�Cj, No ()
3. Has no fore
4. Is securely
5. Meets all
size and
6. Has total
All other BTU
TOTAL BTU's
D etn a rL �
ects lodged within
Code requirements for
's connected
_ . , , <�i� I�
' . � � �.
„
i 1/
Yes � No ( )
Yes � No ( )
Yes �- No ( )
�
List Alterations Beinc Done:
BLAINE HTO, A/C 8� ELECT. INC. -__
13562 CENTRAL AVE N.E.
HEATING COMPANY ANOKA. MN 65304
Signed By �
Date / � " / 3 � � �
`�
e
������ "E''n"� HOUSE HEATING TEST �iECORD
AIR CONDITIONIN6
AND EI.ECTRIC. INC.
ADDRESS � ��I / L ��t /� IO� �PLU �
OCCUPANT .� Ml�I �
HEAT LOSS ATE HTC. INST. /07•1 s'�L/
SOLD BY
Eieetrieal Work By �
TYPE OF HEAT GA FA HW 3TEAM_ SPACE HTR._
GAS DESICiN
MAKE
Model � �
Serial
INPUT �
/� � CONTROLS
THERMOSTAT 7V � D' % Heat Plug
Valve
Limft ' hC�^�
Ltmlt Seriing _
Fan Setting _
Pflot Type _
Pilot Make _
Pilot Model _
PUot Tlming % .l �..
L W. Cut Oft
Pressure Peroent CO�
Input CFH E3� Percent Ot �
Stack Temp. '� � Percent CO
Form 235
APT. � OOR�/ CITY f/ � 0 SUBURB
OWNEH I �iPC� "� )v!n i'1S d �
INSTALLED BY
Oea Line By
UNIT HTR. OTHER
CONVERSION
MAKE OF BURNER
INodal
Max. BTU Rating
MAKE OF FURNACE
AAodel
11
Vard Size
KIND OF UNER gIZE NONE
Dreft Hood G Regulator
FlMara Siza 2- 'r d Number
Chlmney Location Inslde � Outeide
Ghlmney Construetion
Smoke Bomb Wiring �
Dralt Te� Tag 1� i
Door Pressure LlghUng Inst.
Date Tasted — y
Company Testing ci �
Name of Tester —
City of Fridley
AT THE TOP OF THE 7WINS
� �
� �
� �y __��_. COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTIQN SEC.
1 = �
� �"'1 � CITY NALI FRIOLE� SS�32
�""'� � �'� 612-571-34b0
JOB ADORESS 5017 Clearview St NE
t LEGAL ��T NO. BLOCK TRAC'
�U ILDING PERMIT
� (�`' �m����
iB�p REV OATE PAGE OF
910-F15 9/24/O1 � �
DESCR. � 5 Carlson's Summit Manor South Addn
2 PiiOPERTY OWNER MAIL AqDqE3$ Z�P
Weber Norbert 5017 Clearview Street NE
32�
RECEIPT NO.
ar
SEE ATTACFIEO
SNEET
3 CONTRACTOR MAIL ADORESS ZlP PHONE LICENSE NO
Jim Berthiaume Const �9��—E�e���e�a-6�—AiF 763-263-3698 20035341
a ARCMITECT OR DESIGNER MAI AODRESS ZIP PMONE LICENSE NO.
165 NORWOOD DR, BIG 7�AKE, MN 55309
5 ENGtNEER MAII ADORESS 21P PHONE IICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION � REPAIR p MOVE D REMOVE
8 DESCRIBE WORK
Reroof House (13 Sq) Tear-off
9 CHANGE Of USE FROM
TO
STIPULATIONS
Underlayment must comply w�th the State Building Code.
SEPARA7E PERMITS ApE RE�UIREO FOH ELECTRICAL, PLUMBING, MEATING, ��� � � �
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTFUCTION 20NING SO. FT
AUTHORI2E� IS NOT COMMENCED V�!ITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNI7S
I HEREBY CERTIFV TMAT I MAVE READ AND EXAMINEO THIS APPLICATION 1 STALIS
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AW$ yp�UATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHE7HER SPECIF�ED HEREIN OR NOT. TME GRANTING OF A PERMIT �1,393
DOES NOT PRESUME TO GIVE AUTMORI7Y TO VIOLATE OR CANCEL TME pERMIT FEE
PROVISIONS OF ANY OTHER STA7E OR LOCAL LAW REGULATING CON• �SQ.95
TR TION OR HE PERFOFMANCE OF CONSTRUCTION
� PLAN CNEGK FEE
� �0 Cit ense
S�GNATUiiE OF CON'AACTOA Oii 4UTMOAiZED eGENT IOATEi uC Done i vw
Na
� �o•re�
� � 5 y � '
�Y GROUP OCCUPANCV �OAO
CU FT
OFFSTREET PARKING
GARAGES
SURTAX
� �.70
SAC CMARGE
' Fir SC $1.39
TOT L FEE
53.04
1 T 7N15 I$�LQUR E M O
/�
y- • �
N� � � Effective 1/1/2001
ADDN I l �� CITY OF FRIDLEY
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �63) 572-3604 Bldg Insp
BUILDING PERMITAPPLICATION
Construction Address ,�C� Z � �' (,� , � � • «� �—,�,
Legal Description:
Owner Name & Address: (�.�!'„� Z � / �y 2� � ,, � Tel. #
e .
Contractor: i`� �� c o�x/,�� MN UCENSE #�O 6��'��l /
,
Address: /�S"' �� � ,. o o �� �� �. � G� � � Tei. #,��3 � C 3 3 C y �
LNING 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 Height Sq. Ft
Length Width Height Sq. Ft.
Lengtl� Widt HgUGround Sq. Ft.
`� D � ����' � . / 3 � i� �:�-i��
Construction Type�D� G', " o� Estimated Cost: $� /��'�
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DATE: APPLICANT: � Tel. # % � � � � as^
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$ �� 5� Fee Schedule on Reverse Side
$ ,,/ 3 9 .001 of Permit Valuation (1/10th%)
$_ . `%D $.50/$1,000 Valuation
$ $1150 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 [ ]
$ �� °6�
�_ • .
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 stcucture, 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,(�0
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,OOO,Q00
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,�0
$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.i5 for first $50,000 plus $7.00 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 $500,� 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 times $23.25.
VERIFICATION OF FOUNDATION
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.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before proceeding with the framing. New Houses Onlv
. _ , _.