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AF - 43228City of Fridley, Minn. ' _ �P -.�_� - -__ _ _ _:,, B�iI�DING PER�IIT -�� ° 3� 3 4 nate: ...,.�� .�:...:.`"�"��.:.`...:..�? .�..�........ . Owner .................................,..... Builder ..�. . �, ..... ...�.�._`. . Addre�s ...................................... a�ddress ............................................. � LOCATION OF BUILD(NG No. . . . � � � . Street . . . . �. . � . � . ,. . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � ' 'i�� ' t.�%26�! '.:�-"a,�.rr.�ss�,n��+�% • ��a:.r�l �� Lot .....�.:3.... Hloek ........�........ Addition or b-Division Corner Lot ............ Imside Lot ..1�........ Setback ............ Sideyard ........................... DESCRIPTlON OF' BUILDING To be Used as : . . .. ...�"r:".��, . .li�: � Depth . .�� : �'"iHeight . .�,j'�%' ;� Sq. Ft. . ,,�,�„ �. Cu. Ft. Front � � � : � � � . . . . . . . . . . . . . . . ". . . Front . . . . . . . . Depth . . . . . . . . Height . . . . . . . . Sq. Ft. . . . . . . . . (:a. Ft. . . . . . . . . 1�*pe of Construction . .. .. .. .. . . . . . .. ... F�t. Cost. .. ..�:",Q„�.� .. . . . To be Completed .. . .. . . . . . ... . . . . l -�''� . �ry � �� ` � �� In consideration of the i�auance to me of a permit to construet the building desribed above, I agree to do the progosed work in accordance ,,with the descrlptlon above set forth and in compliance with all provisions of oidinances of the dty of Fridley. ..� ............................................... In consideration oP the payment of a fee o! ;. .:�'�. :�. ., permit is hereby granted to . .. .. . . . . . . .. .. . . . . ... .. .... ........ .. ... to construct the building or addition as described above. This permit is granted upott the express condition that the gerson to whom it.1s Qranted and his agents, employees and worlunen, in all work done in, around and upon safd building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota reBarding location, construct[on, alteration, maintenance, repair and moving of buiidings wYth= in the city limits and this permit may be revoked at any time upon violatfon of any of the provisfons of said ordinanc�. ;,f. '�,,s�'��f: � . �.��. .,��„rf • Building Inapector NOTICE: �°° Thia perml# does not cover the construation. inatallatior� o� atte�ation to� wi�ing� plumbin�, pas heatinp, sewe� or waten Be sure to aee the Bu(Idlrt� Inspeoto� for sepa�ata permib fo� these (tems. � •�-�-• t,,,.� � ,--.,: _ - _ _� APPLICATION FOR HUII,DING PERMIT CITY OF FRIDLEY, MINNESOTI � / " i / - •• . � - . •�_ - - : u= �.�� :..� , • _ � ��_ =.. - - � �� .. - - �� 1 �� .� � , . , LOCI�TION OF BUILDING No. � �� Street . ,`� -��--- � Part of Lot _._.�. Lot _._._ Block . � Addition or Sub. Div.-��.�°.,�� Corner Lo� .� •• ,� I+�sfde Lot Set Back gpplicant at�ta.ch to this form Certificate of Survey�of Lot and prnposed bu3ldirig"1voa.tion.� , � � DESCRIPTION OF BIIILDING To be u�ed :�s . �ont � Depth�Height �. Ft. �.��2 Cu. Ft. • ,;::L_. �ont _� Depth HAight _, � � Sq. Ft. �� -�� . Cu. Ft. ____��_..— � � 9� ,� a-� Type of.-•Cans�ruction.�. . Estimated Cost � To be completed The undersign�.d.hereby makes applicat3on for a perm3.t for the work herein specified, a�reeing to do all wqrk in strict accordanee with the City ardinances and ruling of the Depaxtment of Buildings, and hereby declares�.that all the facta and representations stated in this application � are true and correct. ` . �,tg Signature (A Schedule of Fee Costs can be found nn the Reverse Side . � �"'� r``� .� -... - � - � � ` � . .. .. BIIILDING PERMTT � 5CHEDULE . Sec�tion 2� The In: pector of Built�ings $hal,7.;. befo�,e issuing any permit for the erection of a��y building or structure, or for any addition to any existing :buildiug or .structure�, �or f4r an�r alterations or �eg#��rs to . any existing buildi.n� or atru�ture, upon application therefor, require the paymen�: �g the applicFZrtt�:��or., such �ermit � of fees to the amot�nt • herein below set forth and in the manner herein provided to-wit: 2a1 For any suc:h �err,i.t for the erec�ion of any fireproof build'iri�� other than� a��g�rage, •u�arehouse; faetory or g.rain elevator9 or �or the _. erection o� any f�reproof �.d�itior�, for �imilar occupancy� to a.ny existing �uildinu shall be �t the r�.tQ of ��40 for each one�thousand _ cubic feety or fra c vion �herea��; ��in �uch culiical oontents o 2s2 For any suc'� p�riT.�.t for t:ie erection of any fireproof garage� ware- house9 f�;ctary° or grain elev.� ��r, or �'ar the� erection of any fYreproof �. �.ddit�on� for. _s��lar oc��t;� �r.c�r, to :�nF exi:�tin� building sh�.l.l be s't the rate of �1�25 for e�.�ii one '�Izo�:.�;x±�, cubi^ ie�t, �lassified aa "fireproof" b,y 5ection 5J2 oF t.ze I�I°:.��e�.po� �_s �uilu.; n� Co;le�• , _ • _ , . � . HOUSES • • � 2� � For. �.n.ny such pe_Y;�.i, fcr z�.� e.r� c-t� o�n of any non-fireproof builcTing other than� a garag�, �rarehous�,:� f�cto�°� or„grain elevator, or any ,. non�-fireproo� �.ddition, for si-�..a.la.r occupanc�, to �y �.�t�g bu�ia��. Permit ��:700 for eacti o�e tho'�s;�nd cubic f'sete . � _, _. _... .. _ . , GARAG£S - -- � . . . 2-L� For any su�h permit for the erection of any non-fireproof gerage� � w�.rehouse, �`�-�'torar �or grain�•ele.�ator, or for the .erec�ioa of._any non- i� repy oaf �.dczi �ion9 �'ar simila-r occupancy, to any existing building or � ' f �� ea�h '�uc�° 'bu�laing� or •aci�.it'ian, N3nety Cents for _ each one . ,-.. thous�r_d cubir: faet or f`ract3on thereof3 in the cubical contents thereof ur� ��z a m�:�iira.rs �f � f,00- _ :'�r�`�Y�� pur�os'o of` �ca�,i;s�.t�n� .foes for bti31d3:ng. permits the cubical ; - contenta oi" :.��* 'puilds?�g or �:r3dit�oil to a uniform height throughout by multip� ��-+n� r.,��:� �c�ana �:r. e�.� c•�ac�� eci �ro�a �. -point s3x �6) inEhes b81�4w �.. the fl�or 1:rc; r-� tl.�: un3�� :v or ca?_lr�r. to the �verage height of the u�p�r 511+.'"�'Ic`1.Cr'• �i .' ��.� -::,L:� ZiFF?"1�-�°,3 ��i�nt� � o�' 'che roof surface of the ;ma3.� gable of a pi�tdiiEd � �c'' � 2�5 For xupa�.-rs or� �1�:e��,t.+.o�s to a�z exis�ti.ng structure, the fee shall be at the rat� ef �?.,00 Lo� �:wcl1 Fiva �?un�s�d Dollars (�500s00)., or ,. fr�c-tio� the,.reol° in ��^ cav�c c.f �?.1 �� o�osed wark., 206 Tn no case shall the °E: �Y:^s�� i�r an�� pernit as set forth in Sactio:� 2 be less '.h�.� t�.�-.00, � �� "� � � . - _. .c . ? 0 �^� City of Fridley, Minn. BUILDING PERNIIT nate: . . . .�`. . �.� ..��..�. � . . .. .. .. .. . �iY1�11{71- • �� • Addr� ...................................... r�� Nm 3850 % s - ' J . r i � .' .. S . � , :- y • . � '' i, _� _ , � � - - �.� LO�CATIQN OF BUILD[NG No. . ,%!.� . . . . Street . . �.'��.�. . ��'�:°:� . . . . . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lot . . ��. . . . . . BYock . . . . .� . . . . . . . . . . Addition or Sub-Division . . . . a.a . . . . . . . . . . . .�.�.�i . �e Corner Lot ............ Lnaide I.ot ............ Setback ............ Sideyard ........................... DESCRIPTION O�' BUILDING To be Used es• �� fl� ( � � .,�� .. . . . Frout Sb� : �. Depth � .�.�. Height ��°L� �`J� ° r . •':�• • . . . . . . . . Sq. Ft. . .. ..'?� (,il. F� ��.� . .. . . .. .. . . . . . . .. . . . Front . . . . . . . . Depth . .. . . . . . Height . . . . . . . . Sq. � . . . . . (.ii. E't. . . . . . . . . �- ' 1�►pe oP Construchion . .. ........ ........ Est Cost. . ��.� .. .��. .�. .. . To be leted :.................. In cronsideration oE ffie �tssuance to me oP a permit to construct the building desribed above, I agree to do the proposed work in accordanc� witk� the descripticn above set orth and in cromp ce with all prov3sions of arrlinances of the dty of Fridley. ��A �� . . . . . . .��. �. �` . . . . . . . . . . . . . . � In consideration of the payment of a fee of $..� ... ..., permit is hereby granted to . . . .. . . .. .. .. . . . . . . . . . . . . to construct the building or addition as described above. This permit ia granted upon the eJCpress crondition .that the person to whom it is granted and hia agents� employees and worlflnen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordfnances of Fridley, Minnesota. regarding location, con$truction, alteration, maintenance, repair and moving of buildings with- o�� limits and this permit may be revoked at sziy time up� violation of any of the�ovisions of se3d / ��J�:�� • � � : . - .. NOTICE: This permit doas not covar tha aonstrua�tlon, inetallatlon or alte�ation fo� wiring, plumbing, gae heaUng� sewer o� wate�. Be sure to see the Bulldln� Inspector fo� eepa�ata permlt� for these iteme. � ._ t. Owner� - Ne3ae: � Addrese �� APPLICATION FOR HUILDING PERMIT CITY OF FRIDLEY, MINNESOTA . . � �� Builaer �i.� � _ r � t� Address �� z�� ra-Q .�� z�� LOCI�TION OF HUILDING No. Street _ Port of Lat _ Lot ._._�.� r$lock �ddition or Sub. : Div. Corner Lot I�aide Lot Set Hack gpplica.�•e��fi,ach to this form Cert3ficate of Survey of Lot �aaid propoaed buil�;i�g.,. �ae�tion. ' � � ....-,- ,�.t• .. .. DESCRII'TI�Id OF BIIILDIlJG � s To 'be used as / l �; Front �� Dapth !� Height .- �i,.,. • . . �� • � Sq. Ft. Cu. Ft. . F�ont ._..__. Depth HAight Sq. Ft. ` Cu. F`t. _..._.�_ Type cf Construction Estimated Cost ....__.. To be completed . The undersigned�hereby �es ap�lication for a permit for the work here3.n specified, agreeing to do all work in.atrict accordance wfth the City Ordi.nances e.nd ruling of the Department of Buildings, and herebg declares that all the facts and repreaentations statad in th3s appli�ation � � ��.�� are true and correct. � • � ��j' F �% Da'te �� ' ��°'/ Si.gI18.'tUT6 �° ' �� ---_. ,r (1 Schedule of Fee Gosts can be found on the Reverse Side) �''ti ;---, � � __,_w, �'/I�—_F\ C�c��-`�`�� f � ��'l� � � � pl'° ��.�� ,�. � � �� r�°-� . , _._ ;-° � APPL�CA2'ION FOR �tJIY.DING PERMIT ° � . � ' _ � CITF' OF .F1tIDLEY, M'.aVNLSO,TA � r _ . �WNLR�S , Nl�; �.B��i�]� e,.�: ' .. BUII:DER� A1` �'d:' Ra��,��r�i�� Po�9t- �'•- . . ..�_. .._.._._ , - �_ . . . ,; . . , _ -� ADDRESS,�,. ,. ].12 ��rnr� �ia�. ' � " ADD�ESS ��9� �'r��'�'� � A� � 9t. P�1 1'� � � _.. � . . . :y.i � .. . ' � � � , . -.- - z� -' . . . . .. •- . .. . . . � . . � ' o.'. . . � , . ... :. . . , . . . ' . . ... . , � " - � . - � " ` LOCATIOP OF BUI�DIN� ' _ . _ � �• . :_ . . , .. ._ _ ,, .,: _ . No. , , � / � " • � �� ' ` Street' ��,r� .�� , Part �of ,LoC . ..•: ,-... ■. , .. � "�-_ �, "'�� ' . � . EAT��'' '• ''` � �" . .. . . BL�IC - � � ' . ADDITION OR, SUBDIVISION ��.,_ :,�,_�.,�,,,.��,��L��l- ?�/L�'l, . , :, :. . _ .. . . . . ; �.r , �. ' .� �:Co�iei �'Lo� ` Inside LdT' ' Se�ba�k , � - .. .` Side-'�ard' � � r � �� SEWER LLEVAT.TUN . . . � , . � FOUNDAT�ON�� ELEVAiiOid' , .. :*�^ ��{ .. . . , - . , . . . �. �•-A�p�1i��nt �ttach �eo � this ':�ort� Tuid Certificat�s 'o£ Surveq• o£ Lot and proposed _ . , . buiidirig 'focat�.rnd� drawty oe thege Ceitifi�ates�. - - :. - , , . ` ° ° DESCRYI*tION bF Bt�'tLDrNG ` . . .. _ . . . •�: To be i�seA �s y . , , ... . � . _ . . . -. : . Front � Dept � eight - - . :. � � 5q. Ft. Cu. FC. . , , ., FY'ont = : ' . Dep� � eig�it � , � . �� 5q:. Ft. � .Ca, .��, . ._ . ; � :Ty�ie :of' Cos�truc,tion= . I�'�.i�.��` `�$teP�: D�e • 'EstimaCed Cost' ��,�t� ...—._ .. ?' � . . . . , . . , � , � . . . To �6e �ompleted� , . :. • � _ :. . _ � , ,; , .---, , ..._, . � _ . �---- ^ . .. . '" _. _. , . ' � , , . �. , . . ,.. , , Tha� �deisigned "hereby' �kes� app�.ication : ior � a:p�rmi.t for. th8 �ork herein sp�ecified, ; agreeing•to do'all work id e��rict �ccordance�with the Cit,q of Fridley Ordinances �,and�;ruliag� of the; Departme�ti of Build3ngs, arid tierebp declares that all-the facta and repi��ent�t�.ons stated in this �applicatidn are �rue �and 'correct. �=' "� , . , � .- `DATE `��` � � � SIGNATURE ��/� �% �,jy � , a� s �r►+.... �� 1:L�-L(�.....�� . . - (Schedule of Fee Costs can be found on �he Reve�se Side). � � ., _ r A . � BUILDING PERMLT FEL. SCtIEDL1LE � . .- .. SECT_ ION 2. �� The Inspector of Buildings shall. before.issuiag any permit for the erection of any building or structure, �r for any addition to aay existing build- ing or structure, or for any alteratioas or repairs to any eaiet3a$ buildin� or structurp, upon applfcation therefore, raquire the ��pment 6� the applicant for ' ' such permit of�fe�s to the amaunt herei� belcw set �orth and°in the manner here3n. pro�ided ��o�Wi,t; 2.1. For any auch permit for the erection of any fire-proof building, other than a garage, warehouae, factory or grain elevator� or for the erection of any fire-proof additioa, for aimilar occupancy, to any existing building, sha11 be at the rate of $1.40 for each one thousaud cubic feet, or fraction °�- thereof, in eu�h �ubicat contents. °- 2.2. � For auy euch permit for the erection of any fire-groof ��a��ge, Warehou�e, factory or grain elevator, or.for the erection of any fise-pr�of addition, for�similar occupancy, ta any existing building shail be at th� rate of $1.25 for each one thousaad cubic feet, class3fied as "firep�oo#" by � Section 502 of the Minneapolis Building Code. flOIISES 2.3. For aay auch permit £or tYue erection of any noa•fireproof buildin�, oCher than a garage, warehouse, factory or grain elevator, or any aon-fireproof addition, for similar occupancy, to any exiatiag building - permit�$1,DO for each one thoueand cubic feet. � GARAGES ° _._.__ 2� 4. For anq suc& germit for the erection of anq non-fireproof gara�e, warehouse, factory or grain elevator, or for the erectioa of any non�fireproof addition, for`similar occupanoq, to any euieting building or for eacti such buildiag or additioa - ninety cents {$0.90) for each one thousand cubic feet os fraction theaeof, in�the cubical cont�nts thereof with the minimum of $4.00. Far the purpose of computing fees for buildtng peranits, the cubical contenCs of any building or addiCion to a uniform height throughout bq multiplyiag the ground area covered from a point six (6) inchea below the floor line of the basemene or cellar to the average height of the upper surfaae or to the average height.of the roof aurface of tbe ma�.�i gable.of a pitched roof. 2.5. For regaire or altera�ions to an esistiag structure, th� fee shali be at the rate of $3.00 per each Five Huadred Dollars ($SOO.QOj os fractioa thereof in the cost of all proposed work, 2� In no case ahall the fee cl3arged for aay permit aa set forth in Sect�tan 2 be less than $4.00. �� n � .� � _,� .. � � a,� $p :,��<�z,:; . . �.� ,� ,� -� -,, . `�� '�,�r _ ?K£ y: �� {^�� F '�E}-. .. . . �4��.,�.��' . . �� .'�', ... .. �:` ' " - _ t ..- �' _ , I I �I � � 1�� ..� �:� �� V��A�� i �? ✓1� � i j � A. . I " _ �t� fi �!^ #' - �y . , < m7- . .. . , . _ - _ . . K .. . . . . . �'.�" �-Kl v _ , . . .. . . . . . . . s . . - t .. :�� . � - . �'-� _ c . � � � � , . x � .,.. - _ ._- : . .. ' z . . . .- - �.. _ .. . .. 1 . 3 y _ � �y _ k _ "4. , _ � . ' .. - t . � - - � - v'D?.d ' �a' �F KJi . .r'._. . ' . , . . ` ' .' . ', y'- ,, ',-. - ..x _ �: ,: ;.'. . . " � _ . , . : . �� , : � ,�� _: T . t „ - w , �: � �� - _ !i - � Z ` � . ': ^'_�,'s �Y ; ��.. .:/ � $ . ido. ;W� #s ' _ �� a�.:; �`, �, � _... � , t:_'.. � . .>....,s .._. . .. -.. ... . . . . ...� . ........�d .�. ,� Date: Owner: City of Fridley, Mirm.. � �� '�� 0 93i� BUILDING PERMIT JULY 25, 1967 LEO J. REPOLLO B�� STRAND CONSTRIICTION COMPANY �,d� 112 CROWN ROAD N. E. �,d� 9240 �YNDA�E AVENU.� SOUTH FRIDLEY, MINN1sSOTA 55421 MCNNEAPOVIS, MCNI�SOTA LOCATION OF BUILDING No. 112 Stseet � CROWN ROAD N. E. � p� of Lot �� 10 __ Block 2 - Addition or Sub-Divisian . ��SON'S SiTNIl�?IT MANOR, NORTH ADDN'. Corner Lot — Inside Lot _.._.. � Setback —_ Sideyard � Sewer IIevatian Fotmdatton IIevation DESCRIPTION OF BUILDING To be Used as: ADDN. TO GARAG�t _._. Depth Height Sq. Ft. Ca�. Ft -- Front Depth H'eight ._.._.. Sq. Ft � Cu. Ft 1�pe of Construction � �, �^$1, 5 00 , To be Completed ADD 4' to 20 x 20 aad some cement work �—.� ._ 6/22 slab by service door 4/20 garage slab for addition some driveway repair �� Ea consideral3on of the issuance to me of a permit to construct the bwllding described above, I agr+ee to do the proposed work in acc�rdance with the description above aet forth and in compliance with all provisions of ordinances of the dty oP Frldley. _�/J � a„ In conafderat[on of the payment of a Pee oP $ 5.00 ��t ��by �� ,� STRAND CONSTRUCTION C0. to conatruct the buflding or addition as described above. Tt� permit is granted upon the express c�ndition that the person to whom it is granted and his agents, employees and workmen� in all work done in, around and u�n said building, or anypart thereof, shall conform in all respects to the orciinancee of Fridley, Minneaota regarding location, construction, alteration, ma3ntenance, repair and moving of buil�tnga within the dty ]imits aad thia permit may be revoked at any time upon violation of any of the provis�lons of se�d or3inan�. CLARENCE BELISLE B�� NOTIC� Thb pa�ti does aot eevsr t6e eoes�ueHoe, 1�1a1lafloe fe� wirta6� P��+�B. 6�s haNeg, sswu er w�r. B� wn lo a� t6a Buildieg lesp�eter for separal� pormiis M� t6as thms. I � - OWNER'S NAME � ADDRESS A.�?��.xc��=�.��:a �uz �T�p:�n�r�c :�� iT C;.';;`� OF i�..�c"�.'J:��i� r��;y�SCTA ��'`-�C.-l� A��t•�3ER `L�-�/�� 9�% � �� AD�P.ESS�2 � G 2� - . �e �-'. � � ��— /�°"" . - LflCA�'ZON OF BUIT�DIPrG . ,�� r10. � � ,�, STREET ��.�v-� I� � � � PART 0'� LOT ��a�X.,i�.�-i� � LOT ' I(I BLOCK �— AD�IT'tON OR SUBD�VISION �� 8� � `� � o� � COP.1{IER LOT INSIDE I,OT SET3ACK SIDE-YARD SEWER ELEVATION FOUNDA�iO�f ELEVATION ApplicanC attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. 0 DESCRIPTIO:Y OF BUILIDIRTG- " ' ; t - -� . � To Be Used As : F �.�, ; j� . � - �;" . . - � . __ -�+� � .:i . - . . � tirt.- Front � � Depth � � Aeighe � � � �'�'/�i° �"u � °Z"� � Sq. Ft. Cu. Ft. . �./J��?�.t_CQ.,-�-�Ov�.'�-�e-N�, . : rnt • Depth Height � �C �-Q �..e �,�j.��-t� ; = Sq. Ft. . - Cu. Ft. Type of Construction �t.Q l��-�_ Estimated Coat J�`�(.�' To Be Compieted_ �cs.-Q�-'�1, �-- / .p �,�� . � v The undersigaed hereby makes appiication foa a permit for the work herein specified, agreeing to do all work in strict ac�ordance with the City of Frid?ey Ordinar►ces and rulings of the Degartment of Bui�dings, and hexeby declares that all the facts and representations st2ted in this app:.ication a=e true and correct. . - e��'� � = _ DATE � Q �� ^ SIGI�ATURE L� � -� (Schedule of Fee Cosi�s can be found an the Reverse Side}� 0 ��a� - a , �.� -�� . y:�" �: � ; � � . _�� .� � m ,� � � � �� = a � -� .• � � , BUILDING PE£�MIT FEE SCHEDULE 0 SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building of structure, or for any addition to any existing building;or structure, or for any alteration or repairs 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: Ur.iform Building Code: Type 1,2, & 4- $1.75 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3& 5-$1.50 for each one thousand cubic feet. - � � - � For the purpose of computing fees��for building permits, the cubical contents of any building or addition to a uniform height throughout by multipluing the ground area covered from a point six (6) inches belo�J the floor line of the basement or cellar to the average height of the upper surface or to the average height o€ the :oof surface of the main gable of a pitched roof. _ For repairs or alterations to an existing structure, the fee shall be at the , rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction thereof in the cost of all progosed work. In no case shall the fee charged for any�permit as set forth in Section 2 be less than $5.00. � . NSSSD Connection Charges based on location- Area 1 or 2. n . 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DATE PAGE OF APPqOVED BY i �� 612-571-3450 910-F15 9/15/87 / / JOB ADDRESS 112 C�0V�71 Road N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ].Q 2 ��.SOII� S Sunmtit Manor North SHEET 2 PROPERTYOWNER MAILADDRESS 21P PHONE Michael E� Hei,ntz 112 Cxown Rc�ad N. E. 574-1554 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Satne 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDIN(3 Residential 7 CLASS OF WORK ❑ NEW �1 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a, 16' x 16' Additian to Dwelling 9 CHANOEQFUSEFROM TO STI PU LATION S See stipulations on plan. Use 2'� x6" wall stucls with R-l� insulation. WARI�ING SEP�4RATE PERIViITS RE U1RED Before digging cs11 1QCa{ ut+lit�es y�eRO��, ��,�TI�;G, PLU BlNG AND SIG TELEPI�IONE - EL�� GAS Ete. NSe � '`'�' i ,; }'' ... i.,� '� `�� , t.��.� �': Lsk , ; , SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHOFiIZED IS NOT COMMENCED WITHIN 80 DAYS, OH IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. • NO. DWLG. UNITS OFFSTREET PARKING `I HEREBY CERTIFY THAT I 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 $3, 550 _$1. %S DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEAM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERPORMANCE OF CONSTRUCTION. 544. SO � PLAN CHECKFEE TOTALFEE $11.13 $57.41 TU OF� HO iZ AGENT iDATE� WHEN PROPERLY VA 0 TED THIS IS VOUR PERMIT `��7 / � IGNATU EO OWNERiIFOWNERBUILD IDATEi BLOG INSP n TE NEW [] City of Fridley Effective �/1/86 ADDN. GC] R-1 AND R-2 pLTER. [ ] Building Permi� Application Construction Address: %/Z CP-UI.aJ p- �� Legal Description: /�� `snhg Sc�rri�-� i�/.�-n,�t� N Owner Name & Address : �� '�/ E �c'T,� � Tel . � ��L/ / ��'� Contraetor: Tel. � Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construetion drawn on it to scale. DESCRIPTIOA OF IMPROYEMENT LIVING AREA: Length � Width �G � Height �_ Sq. Ft. ZS �1 GARAGE AREA: DECB AREA: OTHER• Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. � 2� �t /3 .� : 3S st� . �-�. Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setbaek Type of Construction: __j �-� o �� Estimated Cost: $ �� Approx. Completion Date: o �`� Alt. A Alt B Proposed DriveWay Width If New Opening Is Desired: $ $ See Baek Page for Explanation DATE: �� Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAI. APPLICANT: ��-Z�i�.�� h'��aZ Tel. � ��L� ��S-LO � y�� $ t e.03 $ �•`�� $ � $ $ - � �'�.y�� CITY IISE ONLY STIPULATIONS: (,�� l 6 Gu r�- �' � .� t.J�� R-19 �Su�'�r Fee Schedule on Reverse Side 25� of Building Permit Fee $.50/$1,000 Valuation � 525 per SAC Unit Fee Determined by Engineering Agreement Neeessary ( ] Not Necessary [ ] 3�� 3a.s� a.00v a� � '.�- ��.�Z � . � ��,�a - �� 1'�. �� BUII.DING PERMIT FEE SCHEDIILE i 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 strueture, upon applicatio n 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 Valuation $1.00 to $500.00 Feea $10.00 (N[inimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraetion thereof, to and. ineluding $2,000. $2,001.00 to $25,000.00 $32•50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and ineluding $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each - additional $1,000 or fraction thereof, to and including $50,000. $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraetion thereof, to and � including $100,000. $100,001.00 and up �u33.00 for the first $100,000 plus $2.50 for each additional $1,000 or Praetion thereof. DRIYEWAY DEPRESSION ESCROiiT (Concrete Curb Streets Only) Alternate "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 approaeh 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 construetion site. 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N° 90686 - Building Job Report ---- ADURESS �/� � �� A) n OWNER J� ( �� 1.)i Z_ BUILDEfi DATE � � � PERMIT NO. � �� DESCRIPTION 5 1 �' � IAISPECTIOM AECOAO DATE qEPORT �� C nr�..�cn. I�S � 9�. E. i..� �.' 1�Wavt, _ C ILAC� W� '�f'i � rc.S � W� U O�.J Gr' � C� � a�, o�, '�,z i 5C A� � � i s i�-�. sc. � c;�- OWNER - REP INSPECTOR � � O � > M � W a a < 2 0 � � c� a'c � � z 0 � 5 �' W V � O } � Q W J z a G ,� J y �� ,�� o^ z ; �� `s`� o �~ r a o 2 N O F� �.� 2 � � Q � W � � OC � Z O � < � J 4 °d _ W= N � � m m m 4 � � � � kl � 5 � v � Yp C � M � + Y Y M � N iu�Jg � ��.� :• � V � � � � � V � � M � � �� z w8�. �° • � �' � Y � e � a � .". i aa"� � Y � > a�� § '° `' o ° � .. : � � � � ^ .. . � �3 � �� 8 � ��.o ��:y '�+ .0y�1 r M O 4 �+9i w�i 4 q m M e�n � � �� Q i W 'J ro �. . � u 9 .� $uH �q� � 0 � N fA N N 4► O O O O O O O O • • . N � .��i � N N V� M ♦ ^ x 3� � a+ .+ � �� 8 0 • � $ � �" 9.. m a v�i ., e � • r� ti+�a� a� � e a 3 a� a O M Ir m OJ � � y a� � c� c°� � �� 0 �� d\ � � i a'� v � � �� I u� � � I � � � � 1`�°' �� ,� � � �� ' o � � � a a � � m � � $ � � � Y� o � � � a o � � . � N y ff1 N tl1 O O O .�1 M 10 M C O � 3 y a �m � � C � r � .r O � �! a � b � o \� +� M � �a0 o .� .r � � . � w � m � ."�i a� � � �� N 7 .�1 �! > � o � r .r u � O� J°. M �t�A • a� m � o • o vi .• � .. m O� � y � e .r • � � �� 3 � � � '� ai I, � � I � � � � � � � � a�c� � e x � • y a ci. � � o� � �� a°N �� a M u N� � � � � � 4 � s �� a g � � � � ` � � � m o � « � S � � � u � +r � � u a+ °� a 4 � � r, ; ., o � a a �e c � � � m � � g w 3 � � c� '� m ` � H � � m �\ � q V `1. ~ $ � � �� o �� o� � � �� K � � � � � 0 �� L � � � ; at ... Q�� o � $ � �� : � �{ � � V O �O �n i M � M y � ►�► 01 M E 9 �~ m � M •Q� c �g� ' � �� s '$ $ Y ' 4� e d � oN � o a � � -� OY �O � � '� �L �� e �� s s z L .r 7C � s y �j �, I�l�l � Y�� . � ' .� .� (��. l �,�,�.�,�,�,�,- � �� ; �� - i i � �.��. �d ��, � � P � � � , �� .� �� . � ` :��,.�. �'-��''�� „��, ,�, �►� � � UJY�-� �- �Yl-c- �„ . ,� � � � G�� n�, � �� . -��' � ' �� r�-� � , .�� . � �� ,� � �� , �,�� , �� r� .� 4 � . � ,,� �� -� , .� � ,� �G �� -- ��I �CI �'� NS 1( ,� �r�t,�>n �! �� i Fr�dl , m� a�� ,�. �� he,� ►�e. ('�-+r la�!- own Rd N� Fvidl�, M� ��4�1 SUBJECT City of Fridley 2 0 8 4 0 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � RECEIP . � • COMMUNITY DEVELOPMENT DIV. � � 7� ' j L �"��', / r i � PROTECTIVE INSPECTION SEC. 1 i � � /'�'1 � CITY HALI FRIOLE� $S4$2 NUbiBER REV. DATE PAGE OF APPROVED BV �""""� � ,'� 612-571-34b0 910-F15 5/23/91 / / JOB ADDRESS 112 Crown Road NE t �EGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oesca. 10 2 Carlson � s Summit Manor North Addn SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Earl Edmunds 112 Crown Road NE � 633-4591 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Jeffrey James Construction 2249 Sur�rise Dr, Maplewood, MN 55117 776-3946 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAII ADDRESS Z�P PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW �] ADDITION � ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 6. 5'• x 20 � Gaxage Addi:tion to Detached Ga.rage 8 CHANGE QF USE FROM TO STIPULATIONS proyide a hard sux�ace clxiyeway, WARHING Before di�ging ca{I for all utility locations 454-0002 REQUIRED BY LAW TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REOUIRED POR ELECTRICAL, PLUMBING, HEATIN(3, VENTILATING OF AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. FT. CU. FT. AUTMORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I 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 WI�L BE COMPLIED WITH WHETHER SPECIFIED HEi;EIN OR NOT. THE GHANTING OF A PERMIT $2pOOQ $ZsOQ DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- $45..QO �].Y`E SC $2.00 TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 48.00 Si T OF oN�R CTO ORAUTHORIZEDAGENT E� � WH N PROPE LY ID TE NIS IS VOUR PERMIT � � c SiGNATURE OF OWNER tIF OWNER BUILDERI IDATE� DG INSP r1t•TE �I [ ] EffeCtive 1,/1/91 ADLN [�'] R-1 AND I�2 ALZ�t [ ] Building P�mit Applicatian oonstn�cticri Adar+�.s: I I� C ��% �� . ' Ieyal De�'��- Lo�'�� l�c�. Ca��sa�s S�rnnn��f' �I�i��a� �errtZ. ��d�.. Owi�er N�oe & =�'�'-•w�: �ar� ��.w+�n�5 'rel. � G�tYactor: �cJ� re, �e.5b�r�.Q./ Z�P1. s.a,a.�: �� y I S�w��`S� � r'�� . �•��L ; ,��; (� 7�i: � �i: �S � b�3��1�+ 1 � >> �-3� y� Attach to this applicatian, a Dertificate of Sluvey of #he lot, with the p�tipoe,ed aot�ructiaai drawn an it to scale. Ie�th Iength � 01 Tar� h � \ . .. ,-. .�- Width Heic�t Width ��,°5 Heic�t Width Hgt/Grotuxi . , �. s � . Sq. Ft. Sq. F't. Sq. Ft. G. S �c't� � o a ��•,� .� �� , � = a o �a , �� Oorner Iat [] Inside Ict ()(] Ft. Yd Setback Side Y� S,�etbacJ�s Z�pe of �tiori: �ew�,Za � Estimated Qost: $.��°`—' o�.� � Approx. Cam�letiaaz Date: �-�-91 Pra�oe,ed DriveGray Width If New Openir�g Is Desired: Ft. $ $ Width + 6' See ffick Page n�: �� G � ��c�r: ` rne�. #�?� 3�4� C,L'1'Y � C�1I,Y P�etmit Fee $ � � (� Fire �arge $ � ,. i�G State S�1t�aYge $ j�rl [ � sp,c azarge $ Driveway Escrow $ Park Fee $ Sewer Main �arge $ Z+o►r�w S s� L�� ,_oc� s�pv�ta�rs: � �y� � � Fee Sciledule an Reverse Side .001 x Permit Valuatiaaz (1/lOth $) $.50/$1,000 Valuatian $650 per' SAC Unit Al't. pAn Or' Alt. pB° AbOVe Fee L)etprtni �i �ri r�ri r� ��lY I l � N�-�Y I l �:_i�� t�i=��Y�4 �:�: ;�:is��I : The Chief Buildir�q Official shall, befc�+e is�uit�g penaits for ti�e erectioai of any building os �tn�Cbure, a� fc� any add,itian to any �cist3ng build,in,� os �, or for any alteratian a� �air to anY ��J ��n9 �'�, � aPPlication thex�efore, require the payment by the applicant far eu�di permit of fees to the aano�uit 2�ere3n below Eet forth anci 3n the �ar�rwr herean pYW3c3eci to-wit: Z10►!'AL VAIIJE $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 $5Q0,000 � a. $15 (Minitann Fee is $�.5 plus a�d�a�+e) $15 for fixst $500 plus $2 for each �dditicnal $loo or fractian tir.reof, to azrl i=rluair�g $2, 000 $45 far� first $2,000 plus $9 for each additiaasal $1,000 o,t frdC'tiGai ther+eof, to ai�d inCludi�g $25, 000 $252 for first $25,000 plus $6.50 for eacii additioa�al S1,000 as frdCtion t2lei�eof, to BTid inCluditx� $50, 000 $414.50 for first $500000 plus $4.50 for eadi additica�al $1, 000 or fYaction t2�reof, to and includir�g $100, 000 $639.50 for first $100,000 plus $3.50 for each additional $1, 000 or fractian tiyereof, to ar�d iricluding $500, 000 $500,001 to $1,000,000 $2039.50 for the fixst $500,0a0 plus $3 for each additional $1, �0 ar frdctiorl th�x�eof, to and inCludit�q $l, 000, 000 $1, 000, 001 ar�d up $3539. 50 for the first $l, 000, 000 plus $2 for each adciitional $1, 000 or fractian ther�eof D[tIVL�Y �BIC�T EBt3�W (Ctax�rets curb S�i�e�t� �lY) Alternate °A�� ; Relroval and re�lao�t of airb arid gutter aa�ly - DriveWay width plus 6 feet times $13.50. Alt.ernate "B" : R�oval ani repla�nt of curb a� guttet at�d ins�tall a 3 foo�t wide eppxo�3di with 6 ir�di de�t'h -�3vewdy width plus 6 feet times $15.75. .�� •:�i,�. ; V ��.I Piermits for oor�ctiaal will be is��ed a miinimnn of 24 i�ours fi� the time of applicatiaa� to allcw far prapex review of the proposed str�cture and of th+e ooa�tn�cticai site. A Qertificate of S�vey of the lot, showirg the locatiaaz of the fan�datiaal once it has it has be�n coaLStxvcted will be zequiYed before prooaedirg with the fra�ing. J W LL aD y ;a> � UQ °b N W a J � 0 � mw � v► O � w� Zw FW- Z _ � p� a � Jy� Q NS N LL y Of J !- W N Q Q W 0 m 4 � J � J� �� O NQ Q � 2 C 3� d oa g ZJ \ �� x °C UD Z � Q Q ` , � � / 1 i � i� � / \�� a p�'� o `'� � � Q W m Q ~ � W V. "' 0� W �? U O 6=- � ~��` QW Qm O HV1 �W Q Q� m �� W O�/ lt w F Q V �/ [C O ? U N c�c 4 � m N N � � F- 1 � � J J Q � � x N w U Q � � m y 0 j W y w W J J m � d Q � � v N Z 2 � � �2 Q LL Q OZ � o° i y o a � y W- � 4 ..i .� _ � H Q � Q + � 3 0 N x I �D X � t7 2 S � Q J LL � J Q � J b V � c� 2 N Q U y � W W W Q J Q n' d W � _ O� N �- J J m mm � DOQ �� W � F � J O m N � w O Q Q 2 U � W � a sm 2 � J� � O O � �� O� a � �p N n � �N ~ u> > N � � 2 H � � U � �-� .� �� w N /� �m wQ U J � N OW LL F' z W WU � Z v� Z O i� a Q _ V Q O � a Q N 0 H J Q ON N Z W J =a �> �} z � J Q N m � Q � � O O O O Q W T � W � O O � N � w Z � O U w a � i�- } J Z � Oa a� Qa Qw 0 F' Q _� �o � _ m� JO N 1- i � ? (��t� � C CARD , : : : YEAR BUILT :CTIVE AGE ATTACHED "ORIES � FOUNDATIC BY EXTERIOR Z` 3 ROOF INTERIOR O.H. DOOR: ELKTRICITY YEAR BUILT fOUNDATIC EXTERIOR ROOF X X X X X X X X "l�il�■ GS �r��l�� DEf CLASS BASM'T FLOOR CL455 FLOOR T.3 �rr� �;' . . ; YEAR BUILT � FRONT OPEN FOUNDATION EXTERIOR ROOF INTERIOR SIDE SCREENED � ' �i� CLASS BACK GLAZED / � "�� c`�,'.,i�j' i; � � i �%y � /, I � d �� . r' C�� t ' ,:l '� �' �,,�.e�.��:. 8 �'�, . , . � . �—_ -- --- ,_ _ = DIMENS.ION$ gp '��/ ,��.-a—:�i� ' l�� X � � _ �3�o x - � � ,�� 3�p. , _ X = ��,,,�;? X — •. . X = � • X a _ S �_---.� .�. X _ �°I��i I � � 1 O = X = _:^-�°'°� 0 � X a= 2-�a X = s�►,...� X X �,, � x" ,. . _ �.. �. f T. ...,.._ .. . r ,.. ."; . � ..._ � _ _ , , ,, � ' ' � �__ r �. � , � ' , _ � s,� � , f , 1 � - � �...,.�, g ..;._.,_ �._ .��w.�.. .... _, ..�. .. ., . 6 , �_ ,. " _ � ., $�c" �� , ; � PCH _ ,.. _ � ' � F ._. Q 1 F 2 .,. . A, , �.. . J � .-,�_ � - ` �L.�.. � ' � - - w � F { . . , . � . � , ; 3 � I 1 ., _ , � ;... , , �. . , . �f �' .., , '. �... � . �� . . . . f7 C v 5 cv, . . . , y� ,¢ : , � _ _, ._., . .. � _:. _� _._ . .. _�.._ . _ _ .., i , t } _: , , ; � � � , ,' , r � ;_. a , . ,. _. .. . �.. , ?" � � _.., , ..r „ . .__ �, �, _ ;.. i_. . ..', ,_ . ,. i t : . � � .z__ _... , . . . . . � _.. _. _ � ._.. .., E , y ,. ' � � ' • A�9�E�.�IEN�' I, � ,� / ��D�! ��c � , owner of the property iocated at /�� lOwo� �eA• /U-� , have no objection to the City allowing the construction of(�/an a. to be iocated at //v? �BWO� .�. L' , wi thout the required certificate of survey that the City ordinarily requires for all new construction. 1 � .[_ r � �i,f'./1�l �11.1� ! � ��. �`� � � � � .�, �� ; � r SUBJECT c�ty of Fridley 2�. 0 2 5 ' , AT THE TOP OF THE TWINS g � I L D I N G P E R M I T REC . r � � � • COMMUNITY DEVELOPMENT DIV. r � L � PROTECTIVE INSPECTION SEC. j ��`� 1 i i f � � /'�'1 � CITY HALL FRIDLEr 55432 NUMBER REV DATE PAGE OF APPROVED BV �""'�"� ,'� 612-571-3450 910-F15 8/26/91 � � J08 ADORESS 112 C�own Road NE t LEGAL LOT NO. BLOCK TFiACT OR AODITION SEE ATTACHED oesca. 10 2 Carlson's Summit Manar North Addn . SHEET 2 PROPERTYOWNER MAIIADDRESS ZIP PHONE Earl Edmonds 112 Cx�own Road NE 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Jeffrey James Construction PO Box 17991, Little Canada 55117 486-0.525 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW � ADDITION ❑ ALTERATION [� REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Rexoof Dwelli.ng (16 Squax'es) Tear-of� 9 CHANGE OF USE FROM TO STIPULATIONS Undex'layment must cont�lX with. State Code, TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATIN(i, VENTILATING OF; AIH CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONE� POR A PERIOD OF 120 OAYS AT ANY TIME AFTER WORK IS COMMENCED. N0. OWLG. UNITS OFfSTREET PARKING I HEREBY CERTIFY THAT I 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 GOVEHNING THIS TYPE OF WORK WII.L BE COMPLIEO WITH WHETHEF: SPECIfIED HEREIN OR NOT. THE GRANTING OF A PERMIT +�832 $.SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATiNG CON- T UCTION OR THE PERFORMANCE OF CONSTRUCTION. S23eOO k'ire SC yti`,S3 � PLAN CHECK FEE TOTAL FEE ��0�� $24.33 OFCON7RA T ORAUTHORIZEDAGENT IDA7E� yyH PROPE Y AT THIS IS YOUR PERMIT �� -�- SiGNATUHEOPOWNERiiFOWNERBUILDERI IDATEI g� INSP � ��aTt � � [] � � � �� [ ] .. �'�."�_ . � . .,,� I = . : �_ _« � •� • � �l � �Z 8iildirq Petmit AppliCBatiQ1 �,� �� . /4 - �?, �,��-�50�)' S Effectiv+e 1,/1,/91 � i �, 0 �o , owr,er rra�e � Aaaress: _ �a�l �dw��s Z+el. # �33'4�1 �xT� 13�, �,�.��+s � •� � Ad�31�R.RI � �-�IC �7°l�'!) �..: }1�'�; 'C�,wtr�� ,�v� J' S 1)� I.iYa1G 1�: � 1�►: �3C1C 11RF.�: �t: Zlel. # Attaci� to th3s a�plicatian, a Oeitificate of �r+ey of tt�e lat, t�ith the p�vpo�ed oaristnx.fiian � an it to scale. ��I� � II�� Ien�th Width Se,ic,�t Sq. Ft. I�9th Widrh Heic�t Sq. Ft. Length �, Width Hqt/Gro�tmd Sq. F't. i°�-S'�� f/lc S�,r �%�� - v�,� Cbrner Iot [] Irr�ia� Iot [] Ft. Yd Setback Side Yatti Setbacks '�e of �tnic.'tiari: J obf'S v.rz Estim3ted OoE,t: c• o" c= �02 .�pprcx. O�pletiaai Date: °i- f - °� ) PY�q�osed D�ive�ray Width If New Opening Is Desired: Ft. S S Width + 6' See Back Page flATE: �"o°i6 9 l , APPLICANI': CQ-� �tccr 'l�e1. � 4�6 �So`�� lt FE� $ .a7�- �% �� '�+e stin�arge $ � �',3 �te S�rci�ary� $_ ,� O � �e S Drive�aay E�u�r $ Fark Fee $ SEWEr M33I'l Q]32LJ2 $ • v• �TIPU7�TIQZS: i $ � - , «� ' �''' ' y'- F1ee Sci�ule an Revetse Side .001 x Petmit Valuatirn (1/lOth $) $.50/$1,000 Valuat3ari $650 per SAC Unit Alt. MAn G� Alt. MBn AbOVE F�ee L�'t�*�^; *� � �ri ru�ri �r A�7� r�S3Yj1 � � NOt N802SSd� � � � �: � �•�. c Y�:��i 1,�� ; �:i_ � �i - Tt�e Chief Huildinq Official ehall, bafa�+e 3ssuir�q peimits for the eractian of any bu; � ding a� ettvc4ae, a� fa� any ac�diti,on to �1' �.stin3 buildin9 a� �n�c4u�e, or for any altexat3an c� repair to anY e�istincJ iuildin3 a� et�uc�e. t�o�l ePPlicatica� ther�efo�e, iequ.ite the payment bs► �e aa�plicant r� e�rh pe�it of fees to tth�e a400�t herein belaw set fa�rtii and 3n the �•41P*- Lere,in p�vvided tro-wit: '1�II�iL VALIJE $1 to $500 s5oi to sa,000 $2,001 tC $25,000 $25,Q01 to $50,000 $50,001 to $100,000 $100,001 to $500,000 - � �. s� c� r� � $�` P�-� �''��i 57.5 far first $500 pltffi $2 fcr ea� additianal S100 or fract�icn there+of, to arrl i:�cludirg S2, 000 $45 fa� fiist $2, 000 plus $9 for eac3i additia�r�al $1, 000 o�' fraCt�iCn thereof, t� aTid including $25, 000 S252 fC� liret $25, 000 plus $6. so faar eac� ac�ait3aa�,a� Sl, o00 cor fractian ti�ereof, tm and includinq $50, 000 $414.50 fa� first $50,000 plus $4.50 for each additianal. $1, 000 oar fraCtian theieof, to and it�cludi.r�g $100, 000 $639.50 for first $100,000 plus $3.50 far each additioa3al $l, Oa0 or fraction thet,eof, to et�d ir�cltriit�g 5500, 000 $500,001 to $1,000,000 $2039.50 foar tiye fi=st S500,000 plus $3 for each additianal $1, 000 C�' fractiCr► t2�er+eof, to er�d it�cludirg $l, 000, 000 $1,000,001 ar�d up $3539.50 fer the first $1,000,000 pl� $2 for each additional $l, 000 or fractian tbereef ntlVE�IY �BI,Q�T �8C'li0� (Corrcrete Qirb St=eets Q�lY) Alternate "A" : Re�o�dl end ��eplao�t Of c�lz'b e� gutter' C[�ly - Dr3vew�y widt2'� plus 6 f�et tim�s $13.50. Alternate "8": I�o�ral ani z�plac�tt Of a�rb ar�d gutter and fr�tall a 3 foat wide approadi with 6 i� depth -�riveway utidth plus 6 fee�t times 515.75. '/-i; ��!': � � = �i {�_�i,'�': M � � Permits for aor�vctian will be issue�d a minim�mm of 24 hwYS fram the time of applic�tian to allow fear p�vper ieview of the parvpo� etnicture ard of the �ian site. A Oertificate of �vey of the lot, et�owin� ti�e locatian of the faaY3atian arioe it has it bas been will be reg�i�ad be%se p��ooeedin3 with tiie fra�ir�g. ' -' � SUBJBCT . ' � � 11 IVV. �' City of Fridley 3 2 5 9 6 � AT THE TOP OF THE TWINS g� � L D I N� P E R M I T ; � RECEIPT NO. � ; y __��_� COMMUNITY DEVEIOP�ENT DIV. r � � PROTECTIVE INSPECTION SEC. i .1 � ' 1 �'��: � CITY NALL FRIOLE� SS�3Z NUMB@R pEV OATE PAGE Of ACPROVED BV ��'� � �'' 612-5.71-3a50 s�aF�s 5/15/02 / / �oe aooaess 112 Crown Road NE t LEGAL ��T NO. 9LOCK TRACT OR ADDITION SEE ATTACFIED DESCR. jO 2 Carlson's Summit Manor North Addition SNEET 2 PFiOPERTY OWNER MAIL ADORES$ ZIP PMONE Angelito Dela Cruz 112 Crown Road NE 763-502-9428 3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO Same 4 AFCHITECT OR OESIGNEF MAIL ADDRESS ZIP PMONE LICENSE NO. 5 ENGINEER ZIP PMONE LICENSE NO 8 USE Of BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADOITION ❑ ALTERATIpN � REPAIR � MOVE O REMOVE 8 DESCRIBE WOqK Reroof House & Garage (26 Sq) Tear-off 9 CHANdE OF USE FROM STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED FOR ELECTiiICAL, PLUMBING. HEATIN(i, '"�� .•�. VENTI�ATING OR AIR CONDITIONING THIS PERMIT BECOMES NUIL ANQ VOID IF WORK OR CONSTRUCTION 20NING AUTHORIZED IS NOT COMMENCEO VtIITMIN 80 DAYS. OR IF CONSTRUCTION � OR WORK IS SUSPENOED Oii ABANQONED POR A PER100 OF /20 DAYS A7 ANY TIME AFTER WORK IS COMMENCED. ' NO- DWLG. UNITS I HEREBY CEFTIFY THAT I MAVE REAO AND EXAMIN�D TNIS APPLICA710N 1 ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAW$ ypLUATION ANp ORDINANCES GOVERNING THIS TYPE OF WpAK WILI �E CpMP41E0 WITH WHETMER SPECIFIEO MEREIN OR NOT. TME GRANTING OF A PERMIT �2f 787 OOES N07 PRESUME TO GIVE AUTHORI7V TO VIOLATE OR CAMCEL TNE pEqMl7 FEE PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON• @ SiRUCTION OR THE PERFOfiMANCE OF CONSTRUCTION y�S3.25 S�G`NATUpp 0�(CON : FACTOA OQ 4U � � J � D 4GENT IOATE� � �^ �� iO�fE� •_ � S�. S7ALLS OCCUPANCVLOAO CU FT. OfFSTREET PARKIN( IGARAGES $1.39 SAC CHARGE Fire SC $2.79 fOTALFEE �8y.43 ) NIS IS VOUii PERMIT c�j� �V � NEW [] ADDN �] n�.�R Il �CohsVuction Address: Legal DescripGon: i( Owner Name 8 A� � Contractor. Address• l LMNG AREA: GARAGE AREA: DECK AREA: �, OTHER: CITY OF FRIOLEY EifeCtive 1/12002 6431 Universiiy Ave NE, Fridley, MN 55432 (763) 572�604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION sa//,',%i�''��i►L:�l,'l�/1��Y-raR:�// i.; � / � I� _�� a � MN LICENSE # �Tel. �� °�� Attach to this application, a�ertficate of Survey of the lot, with the proposed constructio� drawn on it to scale. DESCRIPTION OF IMPROVEMFWT Leng� Width Height Sq. Ft Lengtl� Width Height Sq. Ft Length Vlfidth HgUGround Sq. Ft ��F� L; � Construction Type� � Estimated Cost $ '�-'7 d"7 Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$ , �DATE: �-T�-Dz APPUCANT: f � Tel. � ��f� a� Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Pennit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $ ��i .Z � Fee Schedule on Reverse Side $ 2,°� °1 .001 of Permit Valuation (1/1 Oth%) $ � .� $.50/$1,000 Valuation $ $1200 per SAC Unit $ �--- $5.00 (State Licensed Residential Contractors) $ AI� "A" or Alt "B" Above $ $450.00 Conservation Plan Review $ . Fee Determined by�Engineering $ Agreement Necessary [] Not Necessary [ J � � STIPULATIONS: BUII.DING 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 $ t to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $SO,Q00 $50,001 to $100,t�0 $100,001 to $5(�,000 $500,001 to �1,000,000 FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $1� or fraction thereof, to and including $2,000 $69.25 for first $2,�0 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 $1,0� or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $�00,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $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) Removal and replacement of curb and gutter only - Driveway width plus 6 feef times $17.00. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the rime 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 l�ation of the founda.tion once it has it has been constructed will be required before proceeding with the framing. New Houses Onlv � Building Inspections 763-572-3604 DATE " 1 1 i�(3� 1� SITE ADDRESS Se.uw c ��i � PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS June Delacruz THIS APPLICANT IS: ❑ OWNER �ONTR.ACTOR 112 Crown Road PROPERTY N�; Fridley, MN 55421 OwNER/ �D�S: 7635742350 TENANT SUBMTf A COPY OF YOUR STATE LICENSE WITH PERMIT TYPE TYPE OF WORK: PHONE: STATE LICENSE #� ADDRESS• PHONE a- ],i�SINGLE FAMILY �- 0 NEW . DETAILED DESCRIPTION OF WORK EXP DATE � / .S CITY� F.�x 2 � ❑ TWO FAMILY �REPLACEMENT O TOWNfiOUSE Permit No.: Received By: ztP 'ATE�LIP SSyO� PER MS 16B.665 the permit fee is a minimum of $15.00 or �% of the total cost up to 5500.00; whichever is greater, for the impro�ement, installation or replacement of a residential fixture, excluding the fixtures. (This.should.Teflect only.the cost of labor ) Labor cost under �300 =$15.00. Labor cost between $300 to $SUO = cost of labor x.OS = .=•FOR�ROJECTS WI�RE L,4BOR EXCEEDS�iUO;�FEES ARE BASED ON $10.00 PER FII�'URE,'EXCFP�T:�:f�xENCL'[�I�.:R[�C'FLII�£�:.,(II�TDIC�,A.TE TO�TAL NUMBER OF EACH BELOV� � � ' � _ _ BATH SINIVLAV - - - _FLOOR DRAINS _ SHOWHR - - --- -_ WATER PII'II�1G _ BATHTUB _ GAS PIPWG (rrEeo cr�rrrc�rsE) SWTNA�DJG POOL WATER SOFTNER ($35) _ CLOTEIES WASHER KITCf�N SINK WAT`ER CLOSET BACKFLOW PREV. ($1� _ DISIiWASHER =-LAUNDRY TR AY ,LWATER I-�ATER ($35� FOR IRRIGATiON _ WATER MEfER OTHER `� TOTAL DUE Number of fixtures @ $10.00 x $10,00 = $ .50 Number of fixtures @ $15.00 x $15�00 = $ Number of fixtures @ $35.00 __�__ x $35.U0 = $ - � , State Surcharge = 9 Total = $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID U1�IT1L PROCESSED I hereby apply for a building permit and I aclmowledge that the informarion above is complete and accurate; that the work will be in conforma�ce with the ordinances and codes of the City of Fridley and with the Minnesota Co`nstruction Codes; that I understand this is not a permit but only an applic " n for a permit and work is not to start without a permit; that the work virill be in accordance with the approved plan in the case 1 o w' r uires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME Je. /t/O/�IOYYI DATE V�� ✓ City of Fridley Building Inspections Department 6431 University Av�nue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977