AF - 43175MINDER ENGINEE�2ING CO.,INC.
ENGI NEERS AND SURVEYORS
LAND 9URVEYINO 901L3 TE9TIN0
G.IVIL d. MuNiGIDAI ENOINEERINO LANO PLANNINO
6418-56T" AVENUE N.
MINtVEAPO�lS 27, MINN.
KE ?- 3637
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WE HEREOY CERTIFY TNAT TRIS IS A TRUE AND CORREGT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE
�AND ABOYE OESCRILiED AND OFTHE LOGATION OF ALL BUILDINGS, IF FWY, THEREON, AND ALL VISIBLE ENCROACHMENTS,
�F ,�.,,r� FROM oR oN sA�o �Nn. MIN�ER ENGINEERING CO., INC. �
OATED TM�S O►�YOF ����'^ -- A.OJ�S,y EnlG�NEEQ-�S✓ ANp Sui��,vEY 1 �5 P� J.
^ bY --�� ,s���,:�� ; L'��.���-'��T--' '�
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Date:
Owner:
Address
r-,, n
City of Fridley, Mirm..
BUILDING PERMIT ��
— �- � %
43'72
Builder .....�.���?!� � �/d�a-'� � ---_.._.....�__
Address-•-------.......-•-�------- ----..._....----•---•---•-..........._.-------------•--------------------------
LOCATION OF BUILDING
/ �/� � �
No. .-<-.�..�---•---- Street ---.._._------�--•----- -� --..�......�Ll ..�,� ........................._......---�--- Part of Lot ....._......------ -•--•---._......._..._--•--._._._.....
Lot ..........�..._..... .... - . Bl�k .-- �--a........- � _ ................. Addition or Sub-Division ���...-�. _..a+v� . ---�---. ..._.^ .�
..............� -------. ...._---.........
c� � � . �y
Corner Lot .........................._........ Inside Lot .....i�........._................. Setback ...�.�.:.......----........ Sideyard --.C.�..�_�.................._.........-----------
Sewer IIevation
To be Used as:
... . ... --��-- ----------...... e. ..._.....
L���.._° . ......... ..... .....
Type of Cons ction
Foundation IIevation
DESCRIPTION OF BUILDING
,�/ t y f /'% f �i /�j n
Front ..:1_'....� .� Depth ��� Height ��'.�. Sq. Ft. l..._el....� � Cu. F� �.�,� !�
/ ` f � �i
Front �./..-._'._� Depth��..'.� Height /...Ci..-� Sq. F� ��� Cu. F`k ..��T �
.................... .
.------- -............ Est. Cos��-(��..��. .�'�..�... .�.�"�...--- To be Campleted ...__-------•-----.._........_.....---------
In consideration of the issuance to me of a permit to construct the building de above, I ee to do
the proposed work in accordance with the description above set forth com 'an with all ovlsions of
ordinances of the city of Fridley.
%c_ .......... .. ..c...�....._.. - —
In consideration of the a �
P Yment oP a fee of $..�. �.�-•----.--, Permit is hereby granted to....._ .............-----.--------_.......---••----•-.-.---
._._._.._.._..__.._...-•- .............--•---_...._........ to construct the building or addition as described above. This permit is g�ranted upon
the express condition that the peison to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon sa.id building, or any part thereof, sha11 conform in all respects to the ordinances of
FricIIey, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any � e provisions of said
oT(ilII8I1CeS. .. „
B11�C11Ilg IIISjICCtOP
NOTICE:
This permif does not eover the eonstrueNon, installaflon for wiring, plumbing, gas heatin8, sewe� or water. Be sure fo see
the Building Inspeetor for separate permits fo� these items.
4
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1PPLICATION FOR BIIILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners 1Vame Bui].derr ��s'�� C� �/�``l ��i✓�/� C� �s
Addxess Address : `�� [� �Z f,�i__�'��',/%�l✓/��-
�-
"' ' � LOCATION OF BUILDING �
No. �.�� ��,; � Street � ;/�%fi���tf �/s�o Part af Lot . 1 .
. . -; �..' " ��/�,�'�iK/ `�
Lot � Block ��� � Add3tion or Stiik��.Di�v: �'/���r����� ���`�i�
� . . . . �.
Corner Lot Inside Lot,,,��5et Back �� .S3.de-Yard /�
SEWF,1� ELEVAT20N �'OUiVDATION �ELEiiA�'ION � �� ���'��� ���+�
Applic�:n��attach•to this form Cer�ificate o� Survey of Lot and propased builc��.ng
loca.tion. . . � . .
. DESCRI�'TIOIv OF BUZLDIlVG
To be uSed a.a s �. . . : �. , ' �• ' . .
_ , . � . �i , ' � /
����'C�i/r% Fron-t � � ���� Depth�� . , He3glit �����
�. Ft. Cu. Ft. �
� . � Fror�t Depth Height
, . .. ., .. . .
Sq. Ft. Cue�Ft. .. � .
Type of Construction ��i�i�'� Esti.m�,ted 'Gost ������
To be completed % �_,�/� � � � � ,
The underaigned. hereby. makes application . for a permi.t � for the worlc ,herein specif'ied,
agreei.ng to do e11• work in strict accor.dance. with the Citg Ordiraarices and ruling of
the Depart:mez�t of Buildings, � and herel�y de,clares tha.t all the �acts and representa-
tions etated 3,n this application�are, true and corr t. .
e �/ .
DATE / �.�.��` � � SIGNATURE .���° � ��-`°o� . ��- .
(�. BeY�edvle of Fee cos.ta. can bs found on the Reverae Side.) �
•; , . � . ..
...
,� : _ � . • ,. � . � . � . . . ..
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BUILDING PERMIT FEE SCHIDULE
Section 2.,,.�'he.Inspector of Bi�il�dings shall, before issuing any permit
for the eree`t'ion of any bui:ld3:ng or structure, or for any addition to
any existi:ng builcling or structure, or for any alterations or.-r�pa,i�s
to any existing building or structure, upon ap�li�.tio�•therefor, require
the-payme�t by the a�plica.nt for.-such permi.�� of fees to the amourat-�lr�erein
below _sat .�orti� ancl. in the manner herein provided, to.:.�ai�:�
� 2.1.._, For any-s�eYt permit for the erection of any fire-proof building, other
._-------- •'' �' �'�han a garage, warehouse, factory or grain elevator, or for the erecti.�on of
any fireproof additiori;�-for� similar occupancy, to an�, existing,. b�ildirig
shall be at the rate of �1.40 for each one thousand cubic feet, or fraction
thereof, in such-cubical contents. � _. '�
"' ""' � 2.2. For ang �such permit for the erection of any fir•eproof garage,''�1are-
_.._._house, factory or grain elevator, or for the erection of any fireproqf:.
°°'" �'� addition,., fo�; similar occupancy, to any existing building shall�� b`� at' 'the
_._. .....ra�e of �1.25lfor each one ,thousand cubic feet, cla�sified as "fireprooP"
Y�""��'��� � by�Section �42��.�if the Minrieapolis Building Code. , . =�" ' "' �
_�._�---� --•- �� ��HOUSES . .
r�:, t �,.. . .
� 2.3. For any such.permit for the erection of any non-fireproof builc�ing
other than a ga'r9:ge, warehouse, factory or grain elevator, or any non-
fixeproof addition, for similax occupancy, to any existing building.4
Permit $l .QO for eaeh one thousand cubic feet�.; -�_ ___ ���
GARAGES _ .. , _
rr 2.4. For any such permit for the erection o� any. n�on-firepr�of garage,
warehouse, factory or grain .elevat,a�y or�� �or -Gl�e erection of any non,� �•��
fireproof =a.dditian,-'for similar occupancy, to a,ny�.ex3.s.ting � bui:lding or
._-- --�---•—�"'for each such building or addi��..on.. Ninet� Gents for each one thousand� �"�:
cubic feet or fraction thereof, in the cubical contents`�thereof with a
minimum of �L�.00.., . � . .: . ... .... ._... �
. .__....
. . .4 •�. . . .
_._.--••--°--�'o"r �`the purpose of computing fee.s. f.or-building permits the cubical .��n-tsnts �
of any building o� �-addition to a uniform , height thrn�.ghbti:t by mu7.tiplyi�g•" �
.
_ ., .
_...._.---�-• °tlie ��ground area cover.ed..fr•am. a point � six � 6.,inches ; belo�a the floor<;l•�ne of
. the.basement or'cellar to the'average height.of t�he upper�surface or�to the
- `�=' � ` �" .avera,g,e .kte�.:ght � of .-�i�e roo� sta.xface of the � main �g,a.bl� af a pitched roof .
• `•.s�'4 °..._. . . . .._ ' • . . . - - . �
. . . • , :,i! , . . .
,.
"� r� `� 2.5. For repairs or alterations to an existing struct�are,�-t�he-�f�e �shall be
- at the rate of �3.00 for each Five H�indred Dollar-s (�500.00), or;fr.&ction �
thereof in_ the cos�--�o�f -all 'proposed work. �
._ ,
2.b. In no case shall��tYie fee charged for any permit as set forth in
Section 2 be less than �4.00.
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SUBJECT
c�ty of Fridley � 2 0 5� O
' , AT THE TOP OF THE TWINS g � I L D I N G P E R M I T REC NO.
r
� � COMMUNITY DEVELOPMENT DIV.
� •
� Ly ����•��
r � � PROTECTIVE INSPECTION SEC. 3 7% �
1 = �
� /"'1 � CITY HALL FRIDLEv 55432 NUMBER REV. OATE PAGE OF APPROVED BV
�"""� � �'� 612-571-3450 910-F15 9/19/90. � �
JOB ADDRESS 132 Craig Way N.E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. � 2 Pears:on � s Craic�,tay Estates SHEET
2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE
Rich Beisbois 132 Craig TnTay N.E, 571-4322
3 CONTRACTOR MAIL ADDRESS ZIP PHONE UCENSE NO.
D& D Honie Itnproveirlent 7401 Central Avenue N,E. 784-7543
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO-
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reside DFtelling (Vinyl)
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONIN(i 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. OWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO $3 �375 a QQ Sl . GS
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqM1T FEE SAC CHARGE
PROVISIO S OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- $63.OQ
TRUCTI OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
, Fire SC $3.37 $68.05
SiGN UREOFCONiRACTORORAUTMORIZEDAGENT iDATEi WHEN PROPERLY ALIDATE� THIS IS VOUR PERMIT
' � � l !
SiGNATUREOFOWNER�IFOWNERBUILDER� �DATEI BLOG INSP rl!•TE
� []
� [ ]
1°�'� L )
•. ti . � .;. -
R-1 AND R-2
Building P�ermit Application
�
EffeCtiVe 1/1/90
Il�'dl D2SCY.'lptlOri:
OWnex' Name & � ''''• �: _�'� ,f _�/� 'l�el. � ��/ �L
cor,tm�:
z�e.t. # ���=�.5��
�: ��% � ,
- ���'��,�� a ���
m
Attach to this application, a Certificate of SuYVey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTI�T aF Il�VII���
LIVIIJG ARE�i: L�etigth Width Height Sq. Ft.
G�R�E ARE�ia Lealgth Width Height Sq. Ft.
D�3cR �,: 7�ength Width Hgt/Graund sq. Ft.
�:
Corner L�t [] Inside Lp [ Ft. Yd Setbac�k Side Yard SetbacJss
� $ ��e..� %c�°�
Zjipe of Construction: � ��� �;
Approx. Caam�letion Date: , � —� — �',Q
Proposed Driv�way Width If New Is Desired: Ft. $ $
Width + 6' See Bacac Page
L1A'I'E: � � APPLICAIVT: ��(,i �, #
�exmit Fee $ ��' . C, G
state surcharge $ f, �c°�
°e�P r,,�,�.7e $ �• � r�
�
Driv�way Escrow $
Park Fee $
Se�aer Main Ct�arge $
. �.
���:
$ (��. o�'
CI'I'Y IISE ONLY
Fee Schedule on Revexse Side
$.50/$1,000 Valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Detexmined bY �9��
Agreen�ent Neczssazy [ ] Not Nec�saYy [ ]
.
:?1 � � ■ "�i'J � ' :rl' :��.:1}I�'1
The Chief Building Official shall, before � s�+» *+� �+�*�; ts for the erection of any
�; � dirig or stnicture, or for ar�y addition to any existing building or structur+e, or
for a� alteration or repair to any existinq �;�dinq or structure, upan application
therefor+e, require the payment by the applicant for such �r++;t of fee.s to the amount
herein belvw set forth and in the mannex herein pravided to�ait:
�►I'AL V�1LUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 tfl $100,000
$100,001 to $500,000
���
$15 (N1�ninnrm Fee is $15 plus surdzaYge)
$15 for first $500 plus $2 for each a�itional $100 or
fraction thereof, to ar�d including $2,000
$45 for fiYSt $2,000 plus $9 for earh additi.onal $1,000
or fraction thereof, to and includuig $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 eac� additional
$1,000 or fraction thereof, to and iricluding $100,000
$639.50 for first $100,000 plus $3.50 for each aclditional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and includirig $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction thereof
DRIVEf�,Y DEPRESSION ESCROW
(Concrete Curb Str�ets On1Yi
Alternate ��p,��; Remaval ar�d replac�nt of curb arid gutter only - Driveway width plus
6 feet times $13.50.
Alternate "8": Remaval ar�d replacement of curb arid gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
►'/�+; ■a+ v: Y •)� • � �� ��.i�._ M •;.
P+exm.its for co�nstruction will be issued a min?�+n++ of 24 hours frcan the time of
ap�lication to allaw for proper revi�w of the pr+oposed structure and of the
oon�struction site.
A Certificate of S��rvey of the lot, shcxaing the location of the foundation onc� it has
it has been constructed will be required before proceeding with the framing.
sueeeer PERMIT NO.
c�ty of Fridley 2� s o 0
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
� � RECEIPT NO.
� � COMMUNITY DEVELOPMENT DIV.
: �L - -- �� � � �
f � � PROTECTIVE INSPECTION SEC.
1 . �
� � /��'1 � CITY HALL FRIDLE� SS4$2 NUMBER REV. DATE PAGE OF APPROVEO BY
�'""� � �'� 612-571-3450 910-F15 9/26/90 / /
JOB ADDRESS 132 Craig Way N.E.
t LEGAL ��T NO. BLOCK TRACT OFi ADDITION SEE ATTACHED
DESCR. 9 2 P'C.'3ICSOIl��S Craigway ES't3'�S SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Richard/Karen B.risbois 132 Craig Way N.E. 571�-4322
3 CONTRACTOR MAIL ADDRESS Z�P PFIONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII AODRESS Z�P PHONE LICENSE NO.
8 USE OF BUILDING
Residenti.al
7 CLASS OF WORK
❑ NEW C� ADDITION ❑ ALTERATION O REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Construct a 26� x 15'10" Deck. Addi.tion
9 CHANOE pF USE FROM TO
STIPULATIONS See nota,tions on plan.
�AR�oNG
SEPAFtA�'� PERMITS REQUIRED FOR' Before digging cail for
W!Rl;��, 6-LEI��'l[�1C1, PLUMBIN��. �.p g����� a�� utility locations
REQUIRED �BY
LAW
TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATIN(3,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONINO SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAVS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE FiEAD AND EXAMINEO THIS APPLICATION 1. STALLS GAFiAGES
AND KNOW THE SAME TO BE TRUE AND COfiRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3 � O.QO $1. � SO
WITH WHETHER SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OF; CANCEL THE pEpMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- $54 e O.O
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
Fire SC.$3.00 $58,5Q
S TUREOF N' ACTOFO 'AUTHORIZEDAGENT ID EI HEN PROPE L �A THIS IS YOUR PERMIT
v
,�, �-p . � � y.
Si NATU E OF O NER i1F OWNER UIIDERI EI BLDG �NSP npTE
� []
� [ ]
�� I 7
�. .
_._ ��«
� - . ��- �
•. twt= �_•
• .,. - �� �r
Effective 8/16/90
R-1 AND 1�2
Bui].a.inq P�rmit Applicatioa�
LIV�.JG AREA:
(�iR1siGE AREA:
.�y«- �• �..
• Y'151'
Attach to this application, a Certificate of SuYVey of the
lat, with the prog�osed o�tn�c�t.ioaz drawn aai it to scale.
n�T�mr�T OF II�'t�f7VH�iP
Leizgth Width Heic,�t Sq. Ft.
LPazgth Width Heic�t Sq. Ft.
Length Width �� iiyt/Granu�d �� Sq �
`��I X i��i����1 ��...,�'p . Ft.
Corr�er Iot [] Inside 7nt [�] . Yd Side Yard Setbacks
w� of Construction: _ (ev�t` ���� Estimated C�ost: °� ' a
3m $ ���
�pprox. Caanpletion Date: �OOCI
Proposed Driveway Width If N�w Is Desired: Ft. $ $
e .dth + 6' See BaCk Page
DA��: � D APPISCANr: Tel. # �',°f /- 1/,�,�
CITY USE �Y �� % � �� � / �/� ,
'�� b o `�
P�ennit Fee $ d- Fee Sd�edule on Reverse Side
r'ir+e suYrx�arge $ �� 3, @� . ool x Permit valuation (1/lotn �)
State S�u�r,harge $ I�. /. ��$.50/$1, 000 Valuation
SAC C�arge $ $600 per SAC Unit
Driveway Fscrr�w $ Alt. ��A�� or Alt. °g�� AUove
Park Fee $ Fee Det�etmiried by F�ngineerir�g
Sewer Main CliaYge $ Agreement Nece.ssaty [] Not Neoe.ssaYy []
�.���
sri�,TTOxs:
$ ��� �g ���
._ ,
`� o� d
s
• ��vc� - �P�
I� 5' �s.
��
I:���� � �,_ ��+;;Y��+ �+�- = �:ia��_�� ;�
The �ief Buildir�g Official shall, before issuing p�xmits for the erection of any
,; � dirig or stnicture, or for ar�y addition to ariy existing building or stnicturn, or
for ariy alteration or repair to any existing building or structure, upon a�lication
therefore, require the payment by the applicant for such ��;t of fees to the amount
herein below set forth ar�d in the manner herein provided to-wit:
�►I'AL �TALLJE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
� �.
$15 (Miniimm� Fee is $15 plus surchaYge)
$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 ar�d including $25,000
$252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to ar�d includ�rig $50, 000
$414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and includirig $100,000
$639.50 for fisst $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and iricluding $1,000,000
$1,00O,OOl and up $3539.50 for the firs� $1,000,000 plus $2 for each additional
$1,000 or fraction ther�of
DRIVE�iY DEPRFSSI�T FSCImW
(Concrets Ctirb Streets OnlY)
Alternate "A": Remaval and replacement of curb and gutter only - Driveway width plus
6 feet tit�es $13.50.
Alternate "B" : Rentaval arid replac�nent of curb and gutter and ir�.stall a 3 foot wide
approach with 6 inr.h depth - Driveway width plus 6 feet times $15.75.
� �,- ■ �� . . � . �� �. • .;
P�ermi.ts for construction will be issued a min?m►m+ of 24 hours frcan the time of
application to allow for prapex� review of the proposed structur+e and of the
aonstruction site.
A Certificate of S�xvey of the lot, showing the location of the fo0.uidation onca it has
it has been constructed will be required before proceedirig with the �m;m.
�
MIlOiI)E �.� � �t�e��1�T�.
ENGI NEERS AR�D SURV�YOR�
LANO �VR`lEYINO 9OiL� TE9TIN0
GIVIL 8�. MUNIGtDA� ENOINEERINO LANO PLAtdhtlNe
6418-56T" AVENVE N.
MINAIEAPOLlS 2Z, MINN.
KE 7- 3637
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sue�etT PERMIT
City of Fridley 2 8 22�
� , �,��o��THETWINS g�JILDING PERMIT
; � RECEIPT NO
� `y __��� COMMUNITY OEVELOPMENT DIV. � ��r/
f � � PROTECTIVE INSPECTION SEC. Q
� . �
� j �'�'1 � CITY HALL ffiIDLE� SSI�2 NUwBER NEV O�Tfi PAGE Oi APVROVEO Bv
�""'�" �'' 612-571-3460 910-F15 10/13/98 � �
JOB ADORESS 132 Craig Way NE
t LEGAL LOT NO. BLOCK TRACT OR ADOITION SEE ATTACMED
oesca. 9 2 Pearson's Crai a Estates SNEET
Q PROPERTY OWNER MAIL ADDRES$ ZIP PNONE
Richard Brisbois 571-4322
J CONTRACTOR MAIL ADORESS ZIP PMONE IICENSE NO
Giertsen Co. 860 Decatur Ave N Golden V1 MN 55427 546-1300 1796
a ARCMITECT OR DESIGNER MAIL AODRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAII AODflESS 21P PHONE LICENSE NO
8 USE OF BUIIDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION � REPAIR O MOVE O REMOVE
8 OESCRIBE WORK
Reroof house and garage (25 S) Tear-off
9 CHAN(3E OF USE FROM TO
STIPULATIONS
must
Underlayment � comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAI, PLUMBING, MEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAO
VENTILATING Op AIR CONDITIONING.
TNIS PERMIT BECOMES NULL AND VOID IF WORK Oq CONSTRUCTION 20NING SC. FT CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO fOR A PERIOD OF 120 OAYS A7 '
ANV TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING
I NEREBY CERTIFV THAT I NAVE READ ANO E%AMINED THIS APPLICATION S7ALlS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALl PqOVISIONS OF LAWS yp�VATtON SURTAX
AND OROINANCES GOVERNING TMIS TVPE Of WORK WI�L �E COMPLIEO �
WITM WHETMER SPECIFIEO MEpE1N OR NOT. TME GRANTING OF A PERMIT 21G.2 ],.O]
DOES NOT PRESUME TO GIVE AUTMOFITY TO VIOLATE OR CANCEI TME pEqMiT FEE SAC CMARGE
PROVISIONS Of A O STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR ORMANCE OF CONSTRUCTION ]4.. ]5 Fire �', 2. L�F
P�AN CMECK FEE TOTA FEE
� � �� Licen C 5. 2.96
SIGNATUpEO�CON'RACTOAOp�UTMOp�ZEOOGENT iD�iE� N P OP 10 T TMIS IS �OUR PEA IT
- / �
S�GNATUAE 0� OWNEp��� OWNEp BWLDEp� iD�tE� BLD �NSo � �i` f
NEW [ ] � Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 /1
BUILDING PERMIT APPLICATION �
� ��� ��
� �
ConstructionAddress: ,�'� 3 Z �y����C C�i�y �-�� �
Legal Description:
Owner Name & Address: _ ��z,�� ��$' � u� Tel. # ��� — �� �Z '
���/�i�$ q! a�f �
Contractor: MN LICENSE # ��! �
Address: � 0 � �/�✓t� �ri` .�j �� � Tel. �# �t/'G �l� � J
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Ixngth Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Construction Type: �?�"�U e� ���� Estimated Cost: $ �/ �o�
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: /�I� �� APPLICAN'T: Tel. # �� �� `�"
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ � S
� �_ ��
$ i,v�
$
$ � DO
$
$
$
$
� �
,
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1000 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 [ J
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any additio� 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
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEBS
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to �nd 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 additional
$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.
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a' �� HOIJSE HEATINf; TESi FiECORD
Minnegasco
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ADDRESS G1��^`, O� � APT. FLOOR CITY ��� I'e
OCCUPANT PiSboo-� OWNER o '
NEAT LOSS Yes DATE HTG. INST. �-0°�
SOLD BY CenterPoint Enerqy Minnegasco INSTALLED BY CenterPoint Enerqy Minnegasco
Electrical Work By `` Gas Line By ► e
TYPE OF HEAT FA V SPACE HTR. UNIT HTR. OTHER
GAS DESIGN
MAKE C�-¢�Pf� °e'�
Model __,�'� ° ED �0 'Y 1 �
Serial �4�e� �,�-j�"��
NPUT (��A 0 0
CONTROLS
THERM STAT a� W@�6 Heat Plug
Value d./ ` �
Limit 6—� iic
Limit Setting � 0 �
Fan Settinq "r � �`
Pilo3 Type' !� ��c1� �
Pilot Make e.�� �� �
Pilot Model '%t`'�
Pilot Timing �! S�iP4'
Pressure � Percent CO2 W ^
nput CFH Percent 02 �e l
Stack Temp. �Ob Percent CO � PP�
CONVERSION
Vent Size .� � 1 � � �°
KIND OF LINER �il�+'� eJ �� SIZE
NONE—�-
Draft Hood J� I1 � Regulator
Filters Size
Number
Chimney Location Inside � Outside
Chimney Construction � � � �
Wiring �
Tes4 Tag
Lighting Inst.
Date Tested � ° � � �
Company Testing CenterPoint Energy Minnegasco
Name of Tester �,