AF - 38009�
�
City of Fridley, Minn.
BUILDING PERMIT
Date: Jan. 16, 1969
�: Emil Bruzek B�� Sane
Adaress 172 53rd Ave . N. E. A� Same
N° 10082
LOCATION OP BUILDING
No. 7429 g�t Concerto Curve p� oP Lot
Lot � __ Block 3 Addil3on or Sub-Division ..� Melody Manor 3rd Addn.
Coraer Lot _ Inside Lot X Setback 35 � ,._ Sideyard 10 � 13 �
Sewer Elevation 878.22 881.22
Top of F�oting
DESCRIPTION OF BUILDIIdG
To be Used as:
Dwelling �nt 40' Dep� 26� 28' xeight 20� Sq. Ft 1078 �, �, 21,560
Garage �t 22 � Depth 34 � I�ei�ht 10 � Sq. Ft 748 � F..� 7480
�pe of Construction Frame ��, �_ 16 000 __ To be Completed
SEWER LOCATION - 94� East of Manhole
WATER LO�ATION - 104' East of Manhole
In cansideration of the iasuance to me of a germft to construct the building descrihed above I agr�e to do
th� proposed work ffi acc�r�de.nce with the description above set forth and in compliance with provisions oP
ordinances oP the dty of Fridley.
m
$100 00 Sewer Con,nection Char�e
In consfderal3on oP the payment oP a fee oP $ 44.00 ��t � hereby granbed to Emil Bruzek
to construct the buflding or addition as descrYbed above. This �ermit is granted upon
the express condition that the person to whom ft fs granted and hia agents, employees and workmen� in all work.
doae fn, around and u�n said building, or any part thereoP, ahall �nform in all respecta to the orrlinancee oP
Fridley� Minaesota reg location� conatruct�on, alteration, ma3atensnce, rePair and. movin8 of bufldinb's
withiu the dty ]ianits and� permit may be revoked at any time upon violation of a�► of the Provisions oP eaid
ordinanc�s.
� Official
�Duildia8' �
Henry F. Muchich
r—.` NOTICE:
71ds psiudt d�s no1 eevsr t6s coeshueHoe, inshQaHon io� wirinp, plum6te8, gn 6eaNng, mv�e er wafsr. B� sun io we
tiro Baildia8 inspeetoe for �sparal� parmtts Por tMss It�m�
��������
�����
_ � ��,
�„ .a
APPLICATION FOR BIIII,DINC P�iMIT
CITY OF F'HIDLEY, MINNF�OTA
OY�i 'S NAME ��� � � /v-Y� �c_, �� .BIIILDSt o4�am,� '
ADDRE�S ��� ' ,S �� ��r � �°� p �a AD�DRESS
LOCATION OF BIIILDITTG
N0. �'S� 2.� STREEl� ��i�C-�'tc L`=����s
LO'P BLOCK � ADDITION 08 SIIBDIVISION��%�t,��, ��.�1'. � e���
, ! ,� �
COR.�'ER LOT INSIDE LOT�_SETBAC� ��� SIDE7�RD 0►� �� .
SEM1IIt ELEYATION �� "�' ,,�- � R> _�� TOP OF FOCTING ,���,, ��--
gppliaes�t attach to thie for� T'r�►►o �ertificatea of SurvQy oi Lot and
proposed building location drs,wn ori thee;; Ce�tifice,tes.
To Be IIsed Ae:�
DESCRIFTION OF BQILDING
i
�`'�"� � — — Dapth �-� � 8 r Height �o I
Square feet � � � � Cubic Fe�t � � ��? � �
a�'
� `� � Height i G' � , _-
;-, ;
� Square teet % � ; Cubic Feet �, � ��
�
Type of Construction�l��+mu� Estimated Coet � �(� 0�2'
To Be Completed .� �,�e ��Y , � � �
The underaigned hereby makes application for a permit for the work
herein apecified, agreeing to do all work in etrict accordance with the
City of Fridley Ordinancee and rulin�a of the Department oi Buildings,
and he�eby declaree that all the facts and z�:�;reee�tations etatEd in
thie applicatiox� are true �nd correcte
/ 9
DATE l �li — c� � SiGN�TURE
(Schedule of Fee Coete can be fourid on -the Reverse Sideo)
� ��g:�, .c�
tZ�.
. �� ��
� � � ��
�---� -• � �
} . , ,� 7Z��
�i' "" �
�
n
r - _ .�
�� -� _,
BIIILDING PII�MIT F'EE SC�UL�
SECTION 2 o The Ine�ctor of Buildinga shall, before iaBUir�g pernits
for the erection of any building or �tructure, or for �.ny addition to any
e$ieting structure or building9 or for any alteration or repaire to sng
esieting buildix�g or etructure, upon applicatioa therefore, require the
payment by the applicant for such permit of fees to the amount heretn
below set forth a,nd i.n the manner herein provided to-wit:
TJniform Buildina Code° Type 1, 2, & 4-�1,75 for each one thoueaad
aubio feet, or fraction thereof, in such cubical contente. Type 3� 5-
�10 50 fo� each one .thousexid cubic feet e
For the purpoae of computing fees for building permite, the cubical
corltenta of any buildin� or a,ddition to a uniform height throughout by
multi�lying the ground area covered from a point eig (6) i.nches below
the �'loor line of the ba�ement or the cellar to the average height of
the upper aurface or to the avera.ge hei�ht of the roof eurface of the
maizi gable of e, pitched roof .
For re�ai�s or e,lteratione to an existix� structure, the fee ehall be
at the xate of $3.00 per eaeh iive hundred dollase (i500.00) or
fracti.on thereof in the coat of all proposed worke
Ixi no caee ahall the fee charged for any permit as eet forth in Section
2 be lee� than $5,00�
NSSSD Connection Cha,r�ee based on location - Area 1 or 2.
��
�
�3
!"�
�- . ,.`,,t ` = �
�� � �
^ _ _�-'�
�..=�,.r.�''; <.#r �:f tia+�..�3 w-.+i�r`?';it' - .-r� ....�� .:,a,r 'c=.�;;���' .
' 1.#; .� �, `�
_ . .- � : .. � . . . ` � � ' � . . . �. . - '�A � f�.F`� �c�tr .x;, r�p`�, r`� S � a .k�:'
.. , .. :� .c. . - .
�� . . . ,. � �,.
, . � -r`Nr . . *' � `R.s:4n�°„" 9,4.. . . . . _
.. . . . . K � � �
tkri
. - . " ;�{F'$ �yC. � `�
. � ! �f �. � r .
. . . . . � . .. � ' � -} �id
j'
ta�o►Abnnr►q , ' '�4i�iy�+'"� i� ; �
[adS�.r►r�/;,� . �� ;. � z-
.sw�sTr�� . . .. ��7��'°�.�F���', ��i.i. +1��Ar .` , ��
c�+� b a��► � `��
�►� -�-- Fn �rte�r� � Su�ve�/�s --- : . _ � �
.�
� �
� cjate +�►� �.�r ��...'�. ��.Y� ���l�i�'� ��
� �
� �¢ � t�M�!t ����.
���� � �
� .
- . ����
M1+.
_ . _.- __-__"` .�-_-..i_: ___ �..__�___ - _"_.....-_'-.' _ " _ __ __
. . .. .. � .... . r.
.i .
_^— ___. ..__ _ "-.. _^:..._ -�.�:..:__.- . . - `' rr -- '_�--_"_ .-._._ .-_. .._.:�.: .._ �
�J M
�..�Q ��
x
.
Co�G�'p,'� � ` g �
�
00�1 /� � y a �-�
.�
i V� . . ra ::
- ��:
} �y
ti / ,
`�� � �
t
� 'Q�/ � � �=
��f, 1 �,�
� �:z
- -/£� , '�
LQT � �.; t�, ,�
� °' � .
'.- ,- � ,� { f ;
�
��
_,. .- _ _ _- _ - --- '�
� p��1 �,
� . ;.�
� z�
�
\ �>a
�� #:�
.�� } .
. '; �
� tt�ElIOTEi IRdN�_OtNOTES QRI►tNA6t, A►1iL1 UTi�,tTY E�MENT �
' � ..r
L4T�8LOCK�MELQCY MAl�R �itC �t?O1T10l�i • � ��, �"
/ . �Nri irs s o �r ad a�rrscf r�e�re�rvahehir� �('� �rr+� �'At �w�+r!s �l�i�rr dew+�r� �i►,�r�d . £ x .,�,
� �ars,p. Md� rrsii(r a� ,��y• 1�^� w� aarl � A� .ar�s�t�1� �o�t �..,. �M�t �-� `�:�
�'�Nr !Mc��ri �f'�aV , r -
,�
� � �.ct nu�. SUdURl�W fM614A��Q., �. �• � ��
� �! , s:' �L�� �"?.
�
Scata: �*4� � �" � ��"
�. � `��M
� ,v r z ;
a .� . ee � s...
.. . .. . � � . . . . . .. �. ., «_.... . , . � . . , ,. � -�"'" ����� ��`�:� Q ,� i' ��i
�
a
�
�
:°
'"' O
x
� x
�
N
r���
y x x �
y r � o�
y � �
x x x �
�u � 4� O
A
'���z
����
�
�
�
�
�
y E
� °
�
� �
�
�
c
� �
� �
M w
y � � y z
���,,1 � Cd y�j o 'a�d
"' p � '* ►�pf �
m � � ��� � �
p � �v�i c� o
��y ��p
� � � G
: : � 5
. . �
: : : � :
. . . N .
: : : �,:
: : . �.:
I I I m �
� � � x .
�'��° :
� � �
8� vi °o � �
� � � � �
O
�
r
0
C'
o�
�
'�
�i
c° �
`�° �
w
74 W
m pq
��
�
"1 �
� y
o �
y O
� �
fD y
�
A
A •
�:
� �
�
�
�
�
�n
� o w M �
� � w
w � �
� � �' � x
I � M
a � o
� � �x �
� �
�
` �� '.�
�
� d �
��
0
�
a �
� � �
N � �o �
�
� �
o � � � �
� z
0
� �
!� .a
w a�i
� �
R. R.
w N
o °o
� �
��
��
x�
� �
� �
M '
H
Y
� �
n M
� x
x y
G
R° !*J
� �
P �
� �
o �,
O
�
�
�
�
�
�
W w o 0
� � °o °o
tn t» tn tsa
�
�
�
x
O
'+7
O
�
�
�
0
�
�
�
�
�
S'
C
�
�
�°� b � �
w � �
�� ��
�'.° F.° � � ,��,
����`��
o � ° �+ �
O O �p
� � Q �
� � � o �
�' . hd t+'i
d
w � y �
a � ' G ••
w o : . �
O O . . O
o . . . m
.° : : : �
�
w � � W o
c� � g o °o
�, �, v, �,+
�
a. � �
w o y
Vy
�
b ro � � S
�.��� � �
� � �
�� �
A �
�a�.��
� � �, �
H �
ix `�": � �
O p
�� �
m � � �
p' � • M
a � � �
a �' _ _
e� . .
� ° : :
O p . .
pO . .
O : : .
. . � �°
W � � o �
0 0 0 0
� �
H
Hy
t"
��� �
a.a� �
b � ••. � ro
���'� �
p "'� �' �
� d� �
� �,
�by� �
c`�p ~ o (y
Q� �p�� fp
p p� G'C
o E
�roy �
d ���
b �: 5' �
����
����
p� �ft
w
�,a�p
�]'�o
►1
�� � �
���.�
����►
�jyfDM
;����
���
Gc�y
���
�
.7
ri.
���
�
D
�
1'D"
�J
"�
rii
N
_
m
C
m
�
�.
�
'�
x
�
m
O
�
�.
,w
�
�.
�
�
�
O
�
�O
O �
� Q
� 0'
� 'T'
�
�
��
� ��
0 �
0.�
��
�. �,
� q
O.
',
�
�
� __.-
��
�
�
0.
�
.,
��--• ,. r.�,.
,�- e'�
�-' ,.,�
' "� '�"``�,
A
I N
� �
'i�
�
�
�.
ti
�.
�
�.
�
�
�
y�'�o
�. � �
o���b
� O � � �
��o'o�F"°�
�c���
���ys
� �: �•
� � �b �
`°����
�Q ���
�'�,M�•Q ��
� o � °� �
'����A.
0 0 �.a.s'
�, � A �
bd��.�
� � �� ro'
�' °� �
�� ob
A � �
���:o
�, o �
�. �, �: ,
��� �
���'�
�' � �
�• � �
�� � �
o��o -
�
�
��'�o
. ���
o � �•
� � � �'
� A
W � o��.9i. °••
c0 ��r.
S� f�� y `� N
� A ti
,A•�'�
��
� � ��•r�i,
`�pf Q
� � fA �O
��I. � a�
� � �' c0
O�. � aY.
� r'' � �
0
��'��
t;'�� �.
A �,, A �.
b��,�
R. O � C
A���.
�:°���°
Q ����
����
� �, �,, �o
� ���
�
� ���
��'��'
�
�
y
0�
N�n
�
�
�.
�
�
`�
�
O
�
0
�
'rTl, ,� � O
�.. A o
� °� °,
� c � �
� �
m
� �
�
� �
�
�.
�
`� v
� � �
� b A
y � 70
� X y
� �° . S Z
�� � O
a "
�. �
� O
� � �
� y
� O
�
�
n b
� �
� �
� �,
�
�
�
(
O �
a�'�
v O
co b
o �"
�
� �
t3.
J
�
� �
�
��
� � �
tis
. � �
�'
tia
�
�'
�
�
�
�
�
�
�
�
�
�
�
� �
�
� �
� A
� �
�
K �
C
�.
—
�
�
��
�.
� �'p �
• �p
� � �
� A e
� �e �
� � O
�
� O �
� � �
� � �
� � � ��
� � �
Q � �
e� s �
�' � $
y ��
_.
� °
�
n
O
�
• '�
� ��
�
O,
�
0
�
��
�
zv �
w�
�
�
�
�
S�
�
a
N
a
�
<
�
�
�
�
`!
�
�
�
�
�
<0
�
�
�
0
�
�
�
�
�
c�
�
�'
�
� � � � �
� �b`���„
c� r"
� �s
�����
�����
�' Fp �
� � � � �
C O" a" tY Y
�'�'�� �
��� �
� ��
Q ���`' � y
� ^�, �• f0 \
�. �' c� i�+
� � Q � �
� � N.
b y � �
� � A � �
�� � �
� �' _
C�:��o
�' ,� °n �' r
� �
��" F� �.
� Q �' � �,
b �
O � ��
ti�o' °, �• co F�o'
� R
�, � � �
�b�A.�
C =, � � o
� �• � y �
a�" �
��b�'
� O � �'' � �
�
`�i p O is
o � ;���
0
� � �; b � �
� ��� �o�°
�' � A a; e'' t�
� ��w���
0
�
�
�
a4
�
�
z
0
�
�
Op
P
�
�
�
�
K
�
�
�
�'
09
O
K
�
�
� W � � �
� a. a, � �
�
-'
�
�
�
WATER
CLOBET8
URINALS
BATH '�
TU88 F
'�+I\� IBA8IN8
t �J
— x
S1NK8 �
� IWASH K �
TRAYS �
IDRINK � �J
FOUNT. �
��
I ISHOWERB �
�: �
I IFLOOR p �
� �. �
DRAIN9
CATCH �
BASINS �
�
RAINW.
LDR9.
MISC.
FIX.
GAS
APPL..
II aA8
N� i
z
� � x
n �
� o �c ;s� �' O
� �
` � A., A, A
� o � � �'
O t"o � �
�. � � � �
�
1
�
�
�
R:
�
�
i
�
v
�
�
0
.�
�� � �
�. �I °i
p �
��
�O �
�' � o
08 �
� � �
G �
� �
� � �
�
� � �
� � �
�.y � �
A �
ryro �
. ,.
o� �
�O �
�' � � �
an
p � s
� . Z
►� �
M
��
� m
� �,
� o
K
�� �
.� •o
�:
�li �
/�. � ��i
W
r � W
O �� �
W�
�u
�
�
�
d �
� �
� r
��
p �J
: y
: °x
:Y
. m
. ~
: o
: �
.
,,
�:
r'
�
N
� �
�-i �
pa u M
�� w z p� � ���� n
`° �' �
� p � ri � � � fD �
�� ������
O q � � CL ,�,� , lD - �
�.., . x '�d : O � �
� � � � � � °� o � �
�m� ��a ��:�
CL � �� . P/�
� : � � g : � �° .
. . . O4 . . .
O '
: : : ' W : : :
: : : : � : : : :
0 �
aa aa aa �"�a �e �e �e �e �a �
,u�, '� � � ,!'a ,�i �a r�+ N �
$ � 8 �$ €� g � � g o �
� � � � � � � �
H � 0 y
� � � �
� �
� �
�
�
�
y
�
p
m
0
r
�
�
�
�
m
N
�
2
�
C
r
m
O � p
� �" �
8 a o
� A '�
��
r 1�
� � M
ci. a
� � �
� �
� I
�
0
�
�
�
�
.� . �a. w p �
� p. R,
x�
8
�� h
��
� �
O
a
$ '� t
��
��
8�
� ❑
� �
�n �
a
�
0
�
URINALS
enrH
TU65
SINKS
W�,
� ranrs
DRINK.
FOUNT.
sHw�.
N��R
DRAINS
CATCH
BASINS
�uTo
N/A$1'�ER
GAS
APPL
GAS
RANGE
GAS
OPENINGS
�.
Z.
�
� i
A
m �
n �
� ro
�� a �
y � � � �
�.� �
� m
��,��
�
� � � �
o ce �� o�
,��o�
b
��o�
� � �
. � �' � � �
� �°�°�
��
': w ��'�
; ��'w
�
ro
�� �m
p � m o
� ¢ o p
m �'�,o
M
� a. � P7
� � �
a���.
�o��rt
���y
�����
� �� �
�
~ � M
� . �
A
H+ �'
I ro A
� 3 � �.
�
ro
�
�
�
e
�" d
'� NJ
�
� ro
w�
R�
� �
p �
M �
M �
.b
� �
� �
. �
�
�
� n
� �
{0 �
� �
� � � �
m �
o '* � �G
�
a �
� ;
x �
0
m I�p
� �.
� �
�
�
�
� ��.
`�
,
�
3
�
ti
ti�°p
��:QCCo
o°°��.b
"� O h. i
�0���
�c �� �
�� ��.s
� �•
�����°�0. � b
c�o•�� ry �
�.� ��,�
�o
�~�„�F°'A
� � �•A �
'L7Q'��f3.
oo�R'�
�
�,� A�
����
r. �,
���
� ,b � b
�0 b
Q��
��
� �: o
��
�, o �
� � �:
�
�
���
�� c �
���
y ��p+b
N. �l y
� �, � .
`l� � � �
L�y � y�• � .
� v
f(�0
� .� ny N•
� �
� r ��
N p�
�' `r Y O
Q
O J �'•
� � � �
� o g. �
o ��Q�
A � �
��FA'e�'!
� .� A `�.
GC I
�b��
o`�'�c.
°��`0 to'
��b
����
10 �A �
b���
��
����
� a.° ��•
�b��+��
b ro � t�.
y� Q ��„! J �
°, �:� �, �
�, ��,��
�, ry���
�
� ��o �
� �•�' � �'
�
�
s
0
�
�
�
�
i
�
0
� b �
� o
� �
R.
�
� I (
ti
1
� o
� �
�
� o
O b
y �
� �
1
F'"
Q
�
L�
�
� �
�, o
c�o b
o a'
�
R. r
�
� �
T � e
s
�
��-
� 0
� R
�
�
t3�
J
� �
a �
�.
� ..
�
s�
;�
�
A
�
0
�
0
.��i.
�
�
R
S:.
k7
�
I
A
��
�. � ��p �
O `�' '+� �
�
�
�
�.
, rm
�r
�/:
0
�
Z
�
0
�
�
�.
o � �°
� � �
�� 3
�
O 3 �
;• � �
'i
`° _ .v
� , �
� :� ,
N � �
_. —
���
Q��
° � a.
�' � _
� � �i
T
��
� �
�
O
0 ^
I `
�
�
y+
A �
� ;
N
� �
� �
o: °
� �
C
—
�
�
� ��
�
�
�`5
0
�1 �
�' �
�� �
�� �
STATE OF MINNESOTA
DEPARTMENT OR HUMAN SERVIC68
444 LARAYETT6 ROAD
i/��� ST. PAU1.. MINNESOTA ss101
���
Date
. ,
ing Authori
���/ 7�����%'�,� ��
, treet Address
City State Zip Code
RE: ZONING NOTIFICATION OF APPLICATION FOR LICEIVSURE
DHS-27Z2��)
PZ-02722-02�
��� �"� a��°
�-i���%
Subject: � Type of License:
Name of Day Car ome Applic t Family Day Care i
Street Address Group Family Day Care
• Licensed Capacity /�
City State Zip Code Phone No. ��� 0��.�
This is to in£orm you that we are in receipt
licensure under Minnesota Rules� parts 9502.0300
Rule 2), Family Day Care and Group Family Day Care
this license is subject to compliance with the
Statutes, Sections 245.781 to 245.812 and 252.28,
the Public Welfare Licensing Act and the rules of
Services.
of an application for
to 9502.0445 (formerly
Standards. Issuance of
provisions of Minnesota
subdivision 2, known as
the Department of Human
You should note that under Minnesota Statutes� Section
3, a licensed day care facility serving 12 or fewer
considered a permitted single family residential use o
purposes of zoning. Subdivision 4 of the same section
licensed day care facility serving from 13 through 16
considered a permitted multi-family residential use
purposes of zoning.
If we do not hear
will consider the
your local zoning
Sincerely,
from you within
above-mentioned
code.
�
.�.:��_1� ���� �� . �//�L
- - • • - ��
Street Address
245.812, Subvision
persons shall be
f property for the
indicates that a
persons shall be
of property for
30 days after receipt of this letter, we
day care home to be in compliance with
COA�AMUAIITy MgALTFf 8� �r�IwL
�6RVlCES DEPARTME1Yy'
' �+OdNTY OR ANOICA
�OYH6. FOYRTN RLOOR
' ��W MtNNB�OTA �ase�
Name of. Agency/Organization
City State Zip Code
/� ' �'�
� ��v� �r��
AN EQUAL OPPORTUNITY EMPLOYER
� r � c� c� �e E u, . x z n m o0 0� z C
10 , tn o W R�C m m r m N G m
a o y x m m rr n 8 a w rr a m w n 8 �
�, x .� ..
' � i" M W W ry o G�� O G'0 � r �
� < � � �Q �e � rr ►7 M r m m rn ►+� �D %
a rn fD m m� N w M o� �n m o� n
° a b h m m � co z � m m �o w w a ,,'`�,,
a � Z � m�+ o C M a w 5 w rr � x
-•, d � m r �o m r m m. c� 'a
� M � a 5 r r m w m M �
M N �� � �`° w� a �" m m e:�
tn w � � �0 W M � �
° o q '� r~- a e"�1 [�rl
�D 7D M {b � rf �
y � � x K
o � . � m �
M
b ° • ri
rN► N �+ � Cn
W w � m C7
K w ?
� ° " a
I y � � � I v � �
r � N O
K9 l0 y� N f/! N f/1 N iA N f/l fA �/l N N Ll
t� � r r �
t f M`� o o Nt �I U7 U� tn Uf N as I-+ w y� y
'� . . . . . . • • . • . . �
� O O O O O O O O O O U1 � O
0 0 0 0 0 0 0 0 0 0 0 o c
� N � N fR f/► N i/1 N N N N tA i/l f/! N N y
0
r
o p�
� �
ro�
��
��
�
��
o "+]
H�
�
C+7 ►C
Sti .1"'y
n�
M
[�l �
ro
C9
�
M
H
N
N
�
tr�
0
0
�d � �
� � � _
o ro ro
z
3
y � �
i
� W q
r � a
� � �
� � I
A W N 1-� � SLOZ�@S
� � �r' a a n
n n a r
z � Closets
� K
� � Urinals
}7 � BatYs 11ibs
�
m
� Basins
r �
c� a 3inks
� '� Wash Trays
a 7 Drinking
�q Fountains
Showe;s
� Floor Drai
y� Catch
� Basins
� Aut�atic
Q' Washer
F£+�
� Gas Appl.
Misc. Fixt
E y Gas Range
w m
M
�° � Other
m � cxo w
A �t �
0
� � � g o �
�n Fn �
O � �1
��� �.
d
C �
ro °r� �
�
H �
0
�
�— �6 �
0
ro
� %
H
O
� �
W �
n Q�
��
� w � � rfD-,� ro °�
M lt W fD M �
O!�-� W G l�J� M�
� W a fD �I M t7'h O�0
5 `°w � �ao �
�M� a OfD �
O `C p0
` '0 � 'JW CL M�
f�D � � �' 0~+
� �O � � W
. � M�} O � �
F�+� 9 � 9
� � r �
mod�
W � M>''R7
�� �. w � w
:� ram a �
� �`�m o � �
N� � M
W � Q M �
� 7 O W C
� ��
o��� �
�� � S ►O1 \
M � � � �
�O �� � W � �
c� `C 7i'
�a �a�
��� o
K
a
�
�
r
�
�
0
Z .
'n
0
�
�
E �'
3 � bd
GZ'1 O
a T
z
e �
�
D C7
cn r
m.
T �
�
z
Gf
-v
m
�
m
fi
�
� �
e
(D
m
a3+
�
�O
OD
�
�
� �
f
�
-�-
� �
= D
� ~
� O
�y o
y, �D
o �,
7
o �
3 0
a '"
o �
�, �
� m
m
� a
0
� y
S �
� �
�ta
C
O
�
�
m
Z
c/i
v
�J
�'7
Z
TI
m
m
w
0
0
0
�
�� I°o
� ����
� �
z �
�� �
C�
� �
�r
O
nc
�
Zn
� �
T�
�v
�m
D �
n �
m
�
n
�
�
m
�
n
�
z
Z
a
�
v
<
c�
a
�m
.
�� �:
/ ;
'e
�
0
c
�
�
!
�
v
�
�
�
m
v
�
m
�
� �
��
�
� �
�
��L
�n =
�
a �
0o Z
.� c�
n
0
�
�
m
O
t
O �
"'� "m'►
m
r �
C
m �
�
�
�
R� �
o ,,� o
�
�
�c
C �
m
�
�
_ /� m
S
�
�
m
z
0
m
v
�
�
J �
o m
� �.
c �
m '
�, �
� �
�
0
�
o�
�
�O
o, ?
m
,
sn L
m �
o, m
D ri
v �°
p� D
� m
�' �
0 0
o �
� r
�
Z
D
n
3
� �
�-�i�o
m c a •
� �,
m m
3 m
� �
to
� y
�
2
-� � C�
m n
(7
m
� �
m
m �
a �n �
� m � 3
a�o^
� • _
�
�
m
�
�
a�
�
v
N
n
�
�
2
O
C
�
�
�
m
�
v
�
m
c
�
z
�
•
�
n
0
�
a
0
�
�
m
D
�
m
�
�
y
v
m
1
�
N
�
a�
m
m
� � �
...► J J
0 d �
0 � 0
O O O
� � �
m
�
a
m
�
n
�
`�
�
�
m
�
�
z
O
a
�
�,�
�
�
C �
r Z
�
�
s
m
�
m
a
a
�
�
�
�
c
3
�
v
�
�
0
G
�
D c �
� � �
���
� �
� � �
; � ?
m
m�
� a
�v
m �
� o
�
00
c
�
1
�
�
0 �
� �
0
D
` � r
�
�?� �-�
� �� m �
� � � > >
a»�ya
� � y � �
�
a Qi � �; cc
co � a cc �
'��' � c � a
a���
m °, �D• a
m � `° `�
� m o 3
� c°am
_. o
� Q m �
v. �O o �°—
�,v��-• c ,r
�^ �' o
a � � 3
��
Sm �o
y � A �
� � o �
a
�
��� � o
.» a � �
� � s
� � m
m N � o
� �
:r
�o
�
�
�
m
n
_
�
�
�
�
V � Js A
Nac.��
� �
rn� c O
�Zm�
N �
��v
`� r
N � �
zz
m�
�
n
-�1
z
�o > °
<
^� ^r
Y/ "
a
D O
-� Z
� �
� l.J
7i
vo
a�
��
n �
O �
z
vZ
��
oD
z
�v
N =
�
m Z
��
D �
Z
v r
vz
� <
nm
mZ
N �
�
z �
�
�
�
O
7
�
�
c
�
�
�
�
�
-t
K
PROHER Chief
Date: 04-18-1995 (CI*I03)
Fridley Fire Department
Complete inaident Report
Page #: 1-A
Depart�nt Name : Fridley Fire Depertment ID #: 02308 lncident Year : 94 Iruident �: 47 Eup #: 0
Yncident Date : 01-25-1994 Dey of Week : 3 Tuesday Alarm Time : 1654 Arrival Ti� : 1700 Back In Service : 1729
Situation Fotu�d : 11 Structure fire
Action Taken : 4 Rertwve hazard
Mutual Aid .
Fixed Property Use :411 One-femily dwelling: yr round use
Ignition Factor acto o Fire
Correct Addres :7429 NE CONCERTO CURV FRIDLET, MN 55432 Census Tract .
Occupant Name Phone :785 785 8 Roan/Apartment :
Owner Na� :BUDNICKI Address :7429 NE CONCERTO CURV Phone :785 785 8
Owner City :FRIDLEIf State :MN 2ip Code :55432
Method of Alarm : 4 Radio Inspection District : GEN Shift : G No Alarms .
No. Fire Serv Persnl: 15 No. Engines Resporded : 3 No. Aerial Apparatus Responded : No. Other Vehicles Responded :
No. Injuries - FS : 0 No. Ynjuries-Civilian : 0 No. Fatalities - FS : 0 No. Fetalities - Civilian : 0
Complex : 41 Dwelling complex (one 8 two family) Mobile Property Type : 0 Mobile Property Type undet/not rept
Area of Fire Origin : 0 Area of Origin undet/not reported Equipment Invotved in Ignition: 0 Equip Invtd in Ignitn undet/not rep
Form/Heat Ignition : 0 Form of Heat of Ign undet/not rept Type of Material Ignited . 0 Type of Material �mdet/not reported
Form/Material Ignitd: 0 Form of Material undet/not reported Method of Extinguishment : 0 Method of Extinguishment �mdetermin
Level of Fire O�igin: 0 Level of Origin undetermined Esti�ted Total Dollar Loss .
N�nber of Stories : 0 N�anber of Stories undetermined Construction Type : 0 Undetermi�red or Not Reported
Extent/Damage Flame : 0 Extent Flame Damage ur�determined Extent/Damage Smoke : 0 Extent Smoke Demage undetermined
Detector Performace : 0 Detector Perfor�nce �mdeterminEd Sprinkler Perfor�nce : 0 Perfora�ance undetennined
7ype/Mat Gen Smoke : 0 Type of Material undet/not reported Avenue of Smoke Trevel : 0 Most Signi Av of Smoke undetermined
Form/Mat Gen Smoke : 0 Form of Material undet/not reported
Mobile Property: Tear: Make: Model: Serial #: Lic #:
Equip Involved : Year: Make: Model: Serial #:
Mem�er Making Report: 18 Chief CHARLES J MCKUSICK Date : 01-25-1994
Officer In Charge : 18 Chief CHARLES J MCKUSICK Date : 01-25-1994
Party Celling : Phorte: Assigned Incident: Y Stations Responding:
2nd Alarm Time: 3rd Alarm Time: 4th Alarm 7ime: 5th Alarm Time: Members Attending : 15
E�rgency Contact 7: Time/Contact: E�rgency Contact 2: Tia�/Contact:
Contact Ti�s-Police: EMS: Elec: Gas: Water: Fuel :
Portion/Struc Inv .
Flame Spread e
Smoke Co�ition .
Value Structure:
Value Contents :
Value Mobile .
Temperature e
Precipitation e
loss Structure:
Loss Contents :
Loss Mobile .
Yind Direction .:
Fla� Color
S�ke Color
Ins Structure:
Ins Contents :
lns Mobile .
�
Canpany/Agent :
Ca�any/Agent :
Company/Agent :
Wind Velocity : Sky Conditions :
H�anidity : Dew Point :
HAZMAT Reports: N
Susp:
-�
PROgER Chief
Date: 04-78-1995 (CI*I03)
Department Nar� :
Fridley Fire Department
Complete Incident Report
Fridley Fire Department ID #: 02308 Incident Year : 94 Incident #:
Pege #: 1-B
47 Exp � : 0
Comnents/Remarks :FIRE IN FILTER AND DUST IN FURNACE. rEMOVED FILTER, SHUT OFF ELECTRICITT AT BREAKER AND SHUT OFF GAS. CHECK
ALL REGISTERS AND PLENUM. VENTILATED BLDG. ASKED OWNER TO CALL FURNACE REPAIR, AND INSTALL SMOKE DETECTORS
Impede Response .
Impede Firegrd Oper :
Y�ede Extinguishmnte
Other Arrival Cond's:
0
�
N
� C
�
�. �
�
rn
D �
��m
�o�
-�
oz
���
�o�
� ~ �
� � N
� � 4
m�
� D �
� �
7 �
� � .
�
�
�
z
N
�
�
1d c�
�
�
a
m
�
�y
�Q �
s t
�
'
m
.. 1
m �
il
!I
�
� ;
� ���,
c� .
t
W
U�.
�
-i�i���N��mP��10�n�
� ����i� �.� ��� o�-�
�
��� ��`�� �m �� �,�
� * ;��, �-������ A
�m'��� '��
� �d; �
� �' � �
� '�` � � � c
� � �
Q
�
V1 . -
v
� O � � � � � � � � ' � � � �
� ����������w�
(J/ O O O V p V V V V N p V
g gg$8$8$88888
� �
� �
� �
� m
� ��
O
�
�
1
> �
�
s
�
�
�
�
�
�
�
�
.
_,
'- ,
�
�
C
�
.�a
� �' � � �
C
�' �2��.
��� �.
� � � �
� o � �' �
� � � ° �
� T � �
a g` °�° �
� �o '�
� � p �. N
� � �' �
!� � �
� ����
3 g
� � O �
� �
V ����
�
� .�
W �, a��a
��--�
� . a .. �
al� � A
-�c �' ° �
� . ���
� �
r
�
�
�
�
�
�
�
�
t/l .
2
0
�
�
�
0
a
�-
�
�
�
������
sosa�
QaQ�m
Pwn�-.� w.
�
' � �
'.. � "•
. ,. --. ._, � .
3
�.
��.� �
- , in . �i
� �
a
� �
�
- �,:. W
" o
, ���
_ ��
o - �,
_ �� o
c'��*+ rn
�' �i �
�i
. .:� w �
,�. �. �., �
2
Y�s �
� O =
1 19
� ..,
� ,,, ,
� - ��+":
� �
��
.��
��
Na��
�'
�
��
��� ,�
Z��
���
N � {
��
'�
rn
b
�
�_
.0
�
m
�
�
�
�
�
�
ZOiZO'd 800'�N 8��bI S6`6Z �aS l8Zt-ZZS-ZT9 :�31 A3lr�I�� �0 AlI�
4� - : _
sue�eer pf .
City of Fridley 2 8 0 6 6
AT THE TOP OF TNE TWINS g � I L D I N G P E R M I T
�
� � REC O.
� `V __��_ COMMUNITY DEVELOPMENT DIV. ����
r � � PqOTECTIVE INSPECTION SEC.
�
i = �
' �"'1 � CITY NALL FRIOLEr SSIJZ NUMBEF NEV DATE VAGE OF APPRpVEO BY
�---•�' �•' 612-571-34b0 s�aF�S 10/1/98 � /
lOB ADDRESS
7429 Concerto Cu e
t LEGAL �OT NO. BLOCK TRACT OR ADOITION SEE ATTACNED
DESCR. � 3 Melod r SNEET
2 PROPERTY OWNER MAIL AOORES$ 21P PNONE
Kath Cram _
3 CONTRACTOR MAIL ADORESS ZIP PHONE IICENSE NO
Nutzmann Bros. Const
4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO
8 USE OF BUILDING
R sidential
7 CLASS OF WORK
❑ NEW � ADDITION O ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and ara e 20 S T ar-off
9 CHAN(iE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS AqE REOUIREO FOR ELECTRICAL. PLUMBING. HEATIN(3, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAO
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU fT
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR If CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED FOii A PERIOD OF 1p0 DAYS AT
ANY TIME AF7ER WORK IS COMMENCED. NO DWLG. UNITS OFFSTpEET PARKING
I NEREBY CERTIFV THAT I HAVE REAO AND EXAMINEO THIS APPLICA710N STA�LS GARAGES
ANO KNOW TNE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX
AND OFIDINANCES GOVERNING THIS TVPE Of WORK WILL BE COMP�IEO
WITH WME7MER SPECIFIEO HEREIN OR NOT. TNE GRANTING OF A PERMIT 1714 .8G
DOES NOT PRESUME TO GIVE AUTNORITY TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CNARGE
PROVISIONS Of ANY OTMER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERfOqMANCE OF CONSTRUC710N 56.75 Fir C 1.%1
�, /� J� LAN CMECK FEE TOT L EE
S�GNATUA Of ON'AACTOAOpAUTMOp4EDOGENT IOATE� Lice S•Q �'#.3G
EN ROP VALIDA TNIS IS �+ERyll
l
S�GN4TUAE O� OWNEp��� OWNEp BU40Ep� �O�iE� BL �NSp ��iTE
t - _ s
NEW [ ]
ADDN [ l
ALTER [ ]
ConstructionAddress: �'
Legal Description:
Owner Name & Address:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�� ����
Effective 1/1/98
��� �
� ��
� �
Tel. # y�'�- S `��f J
Contractor: /� �-��w-.�„� f �xU� �,,� � MN LICENSE # �c,��r � �
Address: `7 76 � S�' � c.e uv � Tel. #� g�-U�� �_
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIP'TION OF IMPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: ��.� �c-c- !�P Estimated Cost: $ Os
(Fee Schedule on ck)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: /� � ci APPLICANT: , Tel. # 6,� -O/oz �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
� /
$ . 75 Fee Schedule on Reverse Side
$ .001 of Permit Valuation (1/lOth%)
$ . � $.50/$1,000 Valuation
$ $1000 per SAC Unit
$ � O�% $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 [ ]
$ �� z
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,Q01 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additiona.l
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1, 000 or fraction thereof, to and including $1, 000, 000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1, 000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Altemate "A": Removal and replacement of curb 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 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.
Building BUILDING PermitNo.��� ��
Inspections RESIDENTIAL APPLICATION Received By:
763-s�2-3604 CITY OF FRIDLEY �A'� � ���a
763-502-4977 FAX �cTTVE i-i-ao�o
DATE ,1 ` � ' � � YOUR E-MAIL ADDRESS
STTEADDRESS 7��g �ovlC�s��z i�ti/uL �1°1^�. ����/�c� l�/1� S.jjl3Z
THIS APPLICANT IS: ❑ OWNER '�NTRACTOR
PROPERTYOWNER/ NAME: Sec.r� `� Jc,�,�c C�rct.��"
TENANT ,,�D�s: -� cr � 9 C c�c e- k C e.�uc �� ��cr�rr �i� rJlc v STATEGVIW ZIP SS' �-I 3 Z
PHONE: P� %!o� p'��- $44Q
CONTRACTOR Nq�: lrfuwK.- ivw�n 12e112NC��l,�r
SUBMIT A COPY OF STATE LICENSE # 02�%� 3o S-3 y EXP DATE 3' 3�' o2Qi 2
YOUR STATE LICENSE
AND CERTIFICATE OF ADDRESS: �O(o4� UG Kiv� 3C.v� U•9. W CITY UJ d.^'L� STATEdkIJ ZIP SS�U 1 Z,
INSURANCE PHONE % (� � ' LI ��/ " `t� `i S FAX C� ' �/ '�l - � �
PROPERTY TYPE �'SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE O ADDITION ❑ GARAGE/SHED o wnvnows
❑ BASEMENT FIIVISH �OOF ❑ DRAIN TTLE
O DECK O SIDIIVG ❑ OTf�R
❑ SWIMIvIING POOL
TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION
� MAINTENANCElREPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: j'e — Y'd�
STZE OF IMPROVEMENT ' LENGTH WIDTH HEIGHT S Ff
ROOFING ❑ HOUSE ONLY
NUMBER OF SQUARES �� S� ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT:
1. Existing Floar Plan
GARAGES ❑ ATTACHED GARAGE 2. , Proposed floor plan
PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used
PROPOSED HEIGHT:
SIDING FOR NEW CONSTRUCTTON INCLUDING DECKS,
❑ Virtyl ❑Soffit ADDITIONS. & PORCHES SUBMIT:
O Aluminum ❑ Trim 1• Site Plan/Survey showing the existing structures
and proposed project.
❑ Other ❑ Fascia 2. Two sets of construction plens
WINDOWS 3. Energy (;alculations
IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U-VALUE AND
OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WRVDOW.
OPENING CHANGES 8c
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
Eu.L r �:�� Alcr; 1s.�11;li Vlv vALUA llulv, livc:LUllllv(= "1'H�; (:U5�1' Ur' LABUK ANll MA'1'�K1A1.5:
/I (LISING THE 1997 U.B.0 FEE SCHEDULE)
JOB VALUATION $�`I ZI OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surchazge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Dne
$ ��''J, ��_ See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ ,�% .001 times the total job valuation
$ .0005 x Permit Valuation Minimum $.50
$ F;,� $5.00 (State Licensed Residential Contractors)
$ $2100 per SAC Unit (Plans to N1WCC for determination)
$ ft+6ft= ftx$24=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ �'a �� Make checks payable to: City of Fridlev Attach
THIS IS AN APPLICATION FOR A PERNIIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Consrtruction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case o ork ' i equir s review and approval of plans.
SIGNATURE OF APPLICA PRINT NAME �1 ��t i h+�s I"'n DATE :J ' o� I JO
Page 2- Building Residential Application
BUILDING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or
structure, or for any addition to any existing building or structure, or for any alteration or repair
to any existing building or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below set forth and in the manner herein
provided to-wit:
TOTAL VALUE FEES
$l to $500 - $23.50 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $l00 or fraction, to and
includin $2,000
$2,001 to $25,000 $69.25 for 1�$2,000 plus $14 for each additional $1,000 or fraction, to and
includin $$25,000
$25,001 to $50,000 $391.25 for 1�` $25,000 plus $10. ] 0 for each additional $1,000 or fraction,
to and includin $50,000
$50,001 to $100,000 $643.75 for 1� $50,000 plus $7 for each additional $1,000 or fraction to and
includin $100 000
$100,001 to $500,000 $993.75 for 1� $100,000 plus $5.60 for each additional $1,000 or fraction to
and includin $500,000
$500,001 to $1,000,000 $3,233.75 for the 1� $500,000 plus $4.75 for each additional $1,000 or
fraction w and includin $1,000,000
$1,000,001 and up $5,608.75 for the 1� $1,000,000 plus $3.15 for each additional $1,000 or
fraction
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 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
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977