AF - 43018�i
BUILDING PERMIT
Village of Fridle��, 11inn. No
Date �V.-. � �'.^. . . �. . l . . . . . . . . . .. . . . . .. .. . . . . . . .
' , ' Buildci• ... ... .k�!..�- j"°N
Okmer �A7-.�+v. �..-.'f�G�t�G4-u............ ,�'
........
Address ..�i ry_ i 3_. . �Y.CJr K.��. �'.. .. . . . :lddress
- } .•. .....................
t- -- — — — � --- -- ---
LOCATION OF BUILDIN ;
• �r/ i
No. .��Q.� .. .. . . . Strcet .,r�,( cy�;lfn':f! . . . . . . . . . . . . . . . . . . . . . . . . Yart of Lot . . .
Lot . ...�..� .. ..... Block . . �. ..... . .. .. . Addition or Sub-Division.�./,�a�y�Fir�u, , Iy
Corner Lot .. ..... Inside Lot .. � �
.}t �F."..... S:tbar,k .�.f..nr�. Sideyard�0.�1
DESCRIPTION OF BUILDING
Tu bc Used as:
h'-I'�/� �
/C',:�(/,�..�L.d�IL!�".... Front ./.�./f.. Depth .�.l�/..?Icight �.�.....
�
.................... Front ........ Deptli ........I�Ieigiit .........
Sq. Ft. ./.QS7
Sq. Ft. .......
ve
Type of Constivction ..�'forz.t�r.. Est. Cost ..,��0.4 ............. To be Completed
In consideration of the issuance to me of a per.roit to construct the building described a
the proposed work in accordance with the description above set forth and in compliance wi
ordinances of thc village of Fridley. �
....
' ... (
. r . . �....
� aTn nsic�eration of the payment of a fce of $. .� , permit is hcreby granted to .�
�-'�G�L�!•......... to eonstruct the building o�addition as described above. This pen
the express condition that the �erson to whom it is granted and his agents, emPloyecs and w
done in, around and upon said building, or any part thereof, shall conform in all respects to
Fridley, Minnesota mgarding location, construction, alteraYion, maintenancc, repair and movin
in the village limits and this permit may be revoked at any time upon violation of any of th
ordinances. '� � �
����
. . . . , . . , . . . � -. . . .� ' .t.W: cr'd�'
_ _ — __ _ — >--
NOTICE:
This permit does not cover the cOnstruCtion, installation or alteration for wiring, plum
sewer or water. Be sure to see the Building Inspector for separate permits for these item5
• •
�.,:..<<:�
�City of Fridlev
ArT�Er°`°`T�"�:�5- gUILDING PERMIT
�
COMMUNITV DEVELOPMENT DN.
r' �,.-------
i PR�TE�Ti�E �NSPE�.��N 5E�
i
� i i
5'""�'��'"'1,-� GTV HALL FRIDLEV 55a31 ^+-��ae=
612-571-3450 I 9 t 0-F i 5
�oenooaess 6308 Dellwood Drive N.E.
1 LEGAL ��T NO. BLOCK TRAGT OR ADDITION
oesca � 1 t�bore Lake H
Dalnen
a AACHITEGTORDESIGNEH
5 ENGINEER
6 USE OF 6UILpING
8 DESCRIBE WORK
9 CHANGE Of USE FqOM
ADDRESS
MAIL
Pf\' JRiE �ouE '�.'�
5/29/79 � �
Lands 3rd Addn.
ZIP PHONE
929—
ZIG VMONE
PERMIT
_ � ZZo
R EI T NO
�%'S�`/�
ppv�;:rEC Pv
SEEATTACNEO
SHEET
LICENSE NO.
LICENSE NO
LICENSE NO
J NEW 7 ADDITION n, ALTERATION C REPAIR C�. MOVE "_I REMOVE
� v 99�
STIPULATIONS
Construct a hard surface aI3cX�9¢Y$ driveway.
SEPERATE PERIvIiTS kEQUIRED fOR WfRIP{G,
t{FATING, PLUM8I�G AND SIGNS. �
TvPEOF WNST OCGUPANCYGROUG OCC�VaGC'r,rJpp
SEPAHATE PEiiMITSAHE REOUiRED FOR ELEGTRICAL, PWMBING. HEATING.
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL ANO VOID IF WORK OF CONSTRUCTION ZONING 50 FT GU FT.
AUTHpRiZED I$ NOT COMMENCED WITHIN 60 DAVS. OR IF CONSTRUCTION
OR WOPK IS SUSPENDED OR A6ANDONEO fOR A PERIOD OF 120 DAVS AT
ANY TIME AFTER WORK i5 GOMMENCED. N0. OWLG. UNItS �
I HEREBV GERTiFV THAT I MpVE READ ANO EXAMINEO THIS APPLICATION 1 STnLLS
FNDNNOWTHESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAWS yqWATION
AN� ORDINANCES GOVERNING THIS TYPE OF WORN NIILL 8E COMPUED
��^;iTH WHETHER $PECifIEO HEREIN OA NOT TME GPANTING OF A PERMIT $4,419
DOES NOT PRESUME TO GIVE AUTMORiTV TO ViO�nT CANCEL THE pERMRFEE
PFOVISIONS OF ANV OTHER STATE OR LOCAL LA REGUL TIN�p CON- p
S'RUCTIO\ OR TME PEAFORMANCE OfI�C9�ISTRUL ON. �// R�a�Xa�ai $Z1.12
IGARAGES
�TAX
$2.21
�' �,�q � �( �_ _ �.�-� lX-l� $23.33
�-r� vw �iwv-
�o-i=er,�rer.'�n[rG�9aa „ai.ECneEV " . ocOaG L'n , TEC NIS 5'�OUa aER�ni'
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0
CI�IY 01= 1-(tIUL[:Y
AI'{'LICI�"f1Oi! I�OR Itl_.`�11)f=(11�1/�f. PU11_ll111G f'I:RI•1ITS .
({'��I:Id� nl_'fERr�'fl(�IdS� �1UUI'flOIdS� OR ��LP/�1RS�
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Tcl. IJo.: ��%�7�hg
,
i ������ �1 n�
170. : � � �' %S __ .`;t�_ ect:: --�-�-�-V�`r`z-1� ��/LW�`�
-��y� l� 1n (! ���CF%�ti
7�OT: __�__-- )1U.)Cl:: _�_ ADT)7.7.`701�1: 1 � /r`rr^ o c1� �' 0 1 C>-? �f' `l.kq.�vl� � �
� r
co,;i>>:;e L���: — n,s.rnr_ urr: ✓ s„�r�,r�cr.: .3S szv>>>�nlin�: � .
Ap;,].i.c;�i;t at.tach �t:o thi.� fo��n 7\ao Ccrt.ificatc:_of Sw'v
b»i.ldi_nq locr:ti.on di-a�-;n on Lhese CertiLic.�tes. --
ll[SCR] PTIOhd OF 13UI LllI1�G
of Lot and prol�sed
To 3sc Llsea As:
r
� r�
1CR P•rw1t: e� Dept.h: c��� _]3ci_c�;it: _
—�� ,
� . Squarc 2�'ect:: ��____ Cubic ]TCot: ��-� ��' (;
I'�-on t :
llel?t-.li: - lleighti:
S�ua�-e Pect: Cubi-c Fecti: �
� — y � .00
�/lk'S��1'Y`c� cx,
Tyye of Con�truction: ___ LsCimatcd Cost: $� --
iU ��e ca»;�ict�a: ��12`�j_-- �lt:. n ntt. �
1'rcipo;ed Drivr,vay t;id'd� f I�e�: Opcni.ny Is Dcsired ---- S $
(: Tili 32E1'7:;'S?: SIllr OI' :�311iE`P)
Ti�e u�idcr�iqned hc�'eLy m%ikes �l�i?li.cati.on f.cir a per�uit ior the wor}: herei�i
spcc:ifi.ed, agieeing to do all �<or}c in strict accardance �aith tl�e Ci_ty of
1'ri.dlcy Ordiu:uices and rulu�n;; of the De�,;�rt.;;�ent. of ]]uildings and !iereb�
dec)ai:es that all thc facts anu represcnt:atio�i: sL::tcd in C1;is applice .io
are tilue :md corrcct. See revcrse s,i,y� for t�Qdi.tion. C in on�.'t� i.
L 1 ��- U
�n�rL: S 29 7`� ssc.nr�ro�:�:• �.� -_ �
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Sriyulations: �
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OFFICE
929-7868
GORCO GARAGES
WORK OFiG�R
�os�_----!?aa — —
CONTRACTOR:__ _ - — _ DATE
CUSTOMER: DATF OF SALE S'�'� 1 STYI E� q-<-��L��
— --
NAME_ .'j",�� � q� Z�y� HOME PHONE ,rj'1 �-(o�y'J,S __. BUSINESS PHONE 2'�'j
ADDRESS_ (��Q$'_���w���,�-..yt, CITY__ �'�,���tY.- ___ ,_-.- STATE M?1 _.==-ZIP$$�
PROMISED START � PR0611SED PINISH SALESMAN
CONCRETE SPECIFICATIONS
s�na srzE � ��� x��• II ro��ourr
-� -
APRON SIZE— -- I�Q'_X�_. _ �' RODS - �— ,--
BUILD UP � Yt5 W/P-B/F
- --- -- -� - I�'- -- -- -- - - -
CUT DONiN � TREES
--------- � --- ------ --- -- --
FOOTINGS . � � ��� x ��' STUMPS I
- -- --- -- -- - - - � --
BLOCKS �_ _ _ _ BUSHES
BLOCK WALLS FENCE
DRIVEWAV �__ _ PERMIT _ ,-�Q----
PATIO SLAB 'STAKES_ _ ;d}g,1i���
LAWN WALK � SURVEY
._STEPS-=-- __-_ - - -� GRADE � _ YISS,__ �-.�
SQUARE WITH FROAA FRONT LINE --.
�PROM SIDE LINE _______
GFADE POINT � FROM11 REAR LINE ____ --
DISTANCE FRO�,� HOUSE __ ____. Ii FROA1 ALLEY LIN[— _- ...�_TS —
Nel�s;
1►. 10'Kli'xa' Addii��av� %wu5+�n3 3Lo.b
rior� ore.nott �.�'"AI¢at.d S�u � 34'x.11'
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A B U WORKUP
NOT E :
_° _--�. _ -- -_ _ -° ° -_
IF THERE IS A QUESTION OR PROBLEM YOU NAME %i0» ,��,�,�{�I��_ __
WISH TO CHECK BEFORE OR AFTER OFFICE HOURS , COR�TACT PHONE
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PERM�ND_.__
,� Cih of Fridley � - 1522.d
A-'ME'°P°"HETw'"5 gUILDING PERMIT
�
� RECEIPT NO.�
� ' GOMMUNITY DEVELOPMENT DIV
i �V '
r � PROTECTIVE INSPEC�ION SEC � r�_C
� �Y f_��
� � �> -
` �"'1 � CITV HALL FRIDIE� 55472 vcmeeG Ae'; o>-E -,_ :�< <Praoeco a�
""�� �' 612-571-3450 9tD-F�5
5/31/79 � �
l0B ADDRE55
6308 Dellwood Drive N.E.
1 LEGAL LCT NO BLOCK TRACT OR ADDiTIOF SEE ATTACHED
oesca � 1 Moore Lake Highlands 3rd s"EET
2 PROPERTVOWNER MAILA�DRESS ZIP PMONE
Ter Dalzen 6308 Dellwood Drive N.E. 571-6975
3 CONTRAGTOF MAILADDRESS ZIP PHONE LICENSENO
Same
d ARCHITECTORDESIGNER MAI�AOORESS ZIP PHONE LICENSENO
5 ENGINEEF MAI�A�DRESS ZIG PMONE LICENSENO.
6 USEOFBUiL�ING
] CLASSOFWOFK
� NEW I:_ ADDITION G ALTERATION I�_, REPAIR ❑ MOVE � REMOVE
8 DESCRIBE WORN
Wreck 1 garage
9 CMANGE OF USE FPOM TO
STIPULATIONS Garage slab is to remain and new garage to be built on it (See Permit
#15,220 issued 5/29/79)
TYPEOFCONST. OCGUPANGVGROUP OCGUPANCVL04D
SEPARATE PERMITS ARE RWUIRED FOP E�ECTRICAL PLUMBING, HEATING.
VENTILATING OR AIR CON�ITIONING
iH15 PERMIT BECOMES NULL AND VOID IF WORK OP CONSTRUCTION ZONING 50 FT CU FT.
AUiHORIZED i5 NOT COMMENGED WRHIN 60 �AYS, OR IF CONSTRUCTION
OR WORN IS SUSPENDED OR ABANOONED FOR A PER10� OF 120 �AYS A?
ANV TIME AFTER W01iK IS GOMMENCED NO. DWLG. UNITS OFFSTREET PARKING
I HEREBV CERTIFY THAi I HAVE PEAD AND EXAMINED THIS APPLIGATION $TALLS GARAGES
AN�KNOWTHESAMETOBETRUEANDCORRECt ALLPROVISIONSOFLAW$ VAWATiON SURTAX
AND OFDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMVLIEO NONE
WITn WnETNER SPEQFlE� NEREIN OR NOT THE GRANTiryG OF A GERMIT i
DOE$ NOT PRESUME TO GIVE AUTHORrtY TO VIOIATE OF GANCEL THE PERMITFEE �SACCHARGE
vROVi510NS OF ANV OTHER STATE OA LOCAL LAW PEGULATING CON�
�STRUCT�ON OP THE PERFORMANCE Of CONSTRUCTION SI.O.00 NONE
PLANCNEGKFEE TOTALFEE
�LQ.��
ca��.a' aECC:O^.'e<�:_� cA<�-�oa.:E_>GP"i• ��Ai_� WHEN PPOPER�V'.eqL�D/TED THIS �5 VOUP PERM�I
� ." `._G c r�� �ll _ � � ,'c_t� � ��c1'�/ J' �4
�,��mo _-e�� .,E�, rowrvea_u�« �onrE, � e.00 �
Fee: $1.00 per 1,000 cu. ft. or fraction thereof. Minimum fee $10.00. No surcharge,
4' � �Fi��y' �1 i:"I� i,i�rc:_';y'
� .� -
�'a
aT THF. TOP OF T✓.E T1Y1Nu
, --,
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� j 4 � GOi£M�IkITY C:Vi'I.C:ti[H7 pIY.
� � PRCYCCTrvc C.•�.r:_'TIOY [::i+T.
� � � CITY IIf.LL F.`,10:.3Y BJ+�2
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�"'"1`..� `.J B!2'30J'3�h1C
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�,!i',CC'r:I(�G PERMIT APPLIC,!1TIO�J
_— _ _ �r. v
e�r
L'CT7111Y. jV�O.
eceipt no.
1 � ��V
Jol> Address [:;�0� ,,/�-i�(��c,.-t--,nz� !�h/�
Leg<cl LoL P2o. Blocl: No. Tract or Addition��
Desc. — � �--�/%Ctinz�� ,.��� N'/����nCL�.2/ .�"2c�,
Prope.rty Ocaner /1 Address Phone
---�-E''E'�v ��r/S'/ UAC Z t_�v L,.jGd' „C�c,LCciircr�� oG�'t � 7/-
ConLractor ��y`t� Adciress Phone
Description Pront Depth
of �ldg. �'� � L Z '
� «`"� No, oi U:�elling UniCs
LT'Cc2 � yL—
�stireated Cost oi G,recking
Ileight -- Sq. Ft. Cn. Ft.
/o ' 3�'%� 3c>�a
es Paid Tax l:eceipt P�o.
1 To P,e Completed �o c i a.<�y
Utilities Notilied: StaL'e �lliether notified and date .
Aii.nneapolis Gas Cor.�pany
Endi�teatin� Department
372-4550
NoYthcr.n StaCes Po�aer Cempany
Customer Busi_aess Offi.cc
330-5540
�orth�>esL-ern �c11 Teleplione Co.
13usiness Office
332-4112
[lppreved �;y ld.tter � See:er Department:
All Sills Are Paid
Services Are Discom�ected
_ � _ —_ _ —_- -_—
The unciei�,�.gned hereby mai:es appl�cation for a permi_t to wrecic the buildi.ng�
described above, agrecin;; to do all caorl: in st:ri.cC accordance �oith the City
Ordinzuces and rulin;;� of the nepartnient oL F>iiildin;;s, and l�creby decl.ares that
al'.L facts aucl represenCnLions staCed in this application 2re true aud correct.
;!
// � -� � �/` �`C"C�
(
ContracLor
h -.3� �`J
Dale
5„A�ECr PERMIT NO.
City of Fridley � �
ATT�ET°P°F'�E'W'NS gUILDING PERMIT ; 21�32
� � �REC£IPTNO.
� �
� � . __._ COMMUNITV DEVELOPMENT DIV.
r ;
�' PROTECTIVE iNSPECTION SEC. ' 7 �
�
� � �"'\ � CITV HALI FFIDLEY SSdJi NuMBEP AEV D4iE o<GE �� /PPAOVED B�
�""�"� �� 612-571-3450 9�0-F�5 9�8�9z � �
IOB ADDRE55 6308 �ellwood Drive NE
1 LEGAL LOT NO BLOCK TRACTOR ADDITION SEE ATTACMED
oesca. 7 1 Moore Lake Highlands 3rd s"EET
� PRO�EFTY OWNER MAILADDFESS ZIF PHONE
Ruby Dalzen 6308 Dellwood Drive 571-6975
3 GONTqALTOR MAILADDRESS I�P PMONE LICENSENO
D& D Home Improve�nent Inc. 7401 Central Ave NE, Fridley 55432 784-7543 4840
d ARCMITECTORDESIGNEF MAILADDRESS ZIP 7MONE IICENSENO
5 ENGINEER MAILA�DRESS ZIP PHONE LICENSENO
6 USE OF BWLOING
Residential
� CLASSOFWORK
C NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 DESCFIBE WORK
Reroof House (15 Squares) Tear-off
9 CHANGEOFUSEFROM TD
STIPULA710NS
Underlayment must comply with the State Building Code.
iVPEOFCONST OGCUPANCVGROUP OCCUPANCVLOAO
SEPAFnTE PEFMITS ARE FEOUIREO FOF ELECTRICAL. PLUM6ING. HEATING,
VENTILATING OR AIp GONDITIONING
TNiS PERMIT BEGOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SO.FT CU FT.
AUTHORIZED iS NO� COMMENCE� WITHIN 60 OAYS, OR IF GONSTRUCTION
OR WORH IS SUSPENOE� OR ABANDONED FOR A PERIO� OF 1P0 OAVS AT
ANY TIME AFTER WORN IS GOMMENCED NO DWLG. UNRS OFFSTREET PAPNING
I HEREBY CERTIFV THAT I HAVE READ AND E%AMINEO THIS APVLILATION 1 S1ALL5 GARAGES
ANO KNOW THE SAME TO BE TRUE ANDCORRECT. ALL PROVISIONSOF LAWS ypLUATION SURiA%
ANO ORDINANGES GOVERNING THIS TYPE OF WOPK WI�L BE COMPLIED $'795 �S. SO
WiTH WHETnER SFEGIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLAiE OR CANCEL THE pERMIiFEE SACCMARGE
PROVI51 OF ANY OTNER STATE OR LOCAL LAW REGULATiNG CON- $z 1. Q� Fire $C $. %9
STRUG I�� THE �ERF� WCE O�CTION
� PLAN CNECNFEE TOinLFEE
� License SC $5,00 $27.29
cicmn�uAEOFCOnxnncrpapan�rHO4�zE�<aErvi ioniE, -� WH�N P}/q9PEFLY VALiQATED THIS iS ��+OUR PEFM/IT'
�'�' � (7� � ¢. � / � � �/ �
-.�.tA ��.tmE�B_�_�Ea� •DaiE� 3�pG�mSO i'f
NEW I 1
ADDN � J
ALTER � ]
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Suilding Permit Application
Construction Address: � �y����%��l(���U / /��U'E'
Legal Description:
Effective 3/1/92
Owner Name & Address: p1 ��i1 ✓JA/�['R� Tel. #,.S,rl���%S
Contractor: D& D Home Improvement, Inc. MN LICENSE # 4840
Address: 7401 Central Avenue N.E., Fridley, P1N 55432 Te(, �/ 7E4-7543
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
GARAGE AREA: Length
DECK AREA: Length
OTHER:
DESCRIPTION OF IMPROVEMENT
W idth
Width
Width
Height _
Height _
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot � J Inside Lot �] Ft. Yd Setback Side Yard Setbacks
Type of Construction: A/Z-E�� �/���-s/iiA%:h�� EsGmated Cost: $
Approx. Completion Date: S� 5p��qy��'�5e �� �� ��--
(Cost on Back)
Driveway Curb Cut WiJth Naeded: Ft. + 6 Ft = Ft x$ _$_
��DATE: APPLICANT: J//J� _ Tel. !/
Yermit Fee $
Fire Surcharge $
State Surcharge $
SAC Charge $
License Surcharge $
Driveway Escrow $
Park Fee $
Sewer Main Charge $
TOTAL
S7'IPULAT[ONS:
$
CITY USE ONLY
Fee Schedule on Reverse Side
.00] of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary I I Not Neces�sary I I
s�e�e�� PE WO..
�City of Fridley 2 7 2 5 0
ATTHETOPOF,�E,W�NS gUILDING PERMIT
� � RECEIPT NO.
� ` _ GOMMUNITV OEVEIOPMENT DIV
� � PROTECTrvE1NSVECTIOH SEC �
i � :J= +�J �
�
� � �"9 � C17V MALL FRIOLE� 55172 uuMBEP MEV D�TE o��E OF �onROVED B�
�----�'� ,'� 612-571-3450 9t0-Ft5 � �
8/18/98
�oe P.DDRESS 6308 Dellwood Drive NE
1 LEGAL �OTNO BLOCN TRACTOR�DDITION SEE�TT4CHED
oescA 7 1 Moore Lake Hi hlands 3rd sNEET
1 PROPEFTVOWNER MAIL/DORE55 Z�P PMONE
Terry Dalzen 571-6975
] CONTRACTOR MAILADDRE55 Z�P 7MONE LICENSENO
Renewal by Andersen 350 73rd Ave NE !18 Fridle MN 55432 502-
e ARCHITECTORDESIGNEF M�ILADORESS 21P PMONE LICENSENO
5 ENGINEEF MAILADDRE55 ZIG GMONE LICENSENO
6 USEOFBUILDING
Residential
] CLASSOFWORK
L NEW O ADDITION ❑ ALTERATION pX REPAIR ❑ MOVE ❑ REMOVE
B �ESCRIBE WORK
Re lace 12 windows in home with ocket insert windows
9 CHANGEOiUSEFROM TO
STIPULATIONS
Install smoke detectors to meet the State Building Code - in each sleeping
room and on each level of house.
TVGEOFGONST OCCUPANGYGROUP OCCUPANCVLOAD
SEPaRnTE GERMITSPRE REOUIRE� FOR ELECiRIGAL. PWMBiNG. HEATING.
VENTiLqTING OR AIR CONDITIONING
TMIS PERMIT BEGOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SO.FT CU FT
AUTHpqipED IS NOT COMMENCED WITHIN 60 DAVS. OR IF CONSTRUCTION
OR WORK i5 $USPENDED OR ABANDONED FOR A FERIOD OF 120 DAVS Ai
P.NY IiME 4FTER WORK i5 COMMENLED NO DWLG UNI7$ OFFSTREET PARNING
I HEPEBY CERTIFV TH4T I MAVE AEAO ANO E%P.MWED THI$ AOPLICATION $TAl�S G<RAGE$
AND NNpW THE SPME TO BE TFUE ANO CORREGi ALl PROVISIONS OF �AWS yq��pT10N $URTA%
AND ORDINANGES GOVERNING THIS TYPE OF WOFK WILL BE COMPLIED
WITH WHETHER SPEGFIED MEREIN OF NOT THE GAANTING OF q PERMIT $6325 �3. ib
DOES NOT PRESUME TO GIVE AUTHORRV TO VIOLATE OF CANCEL THF pERMITFEE SACCMARGE
PROVISION$ OF ANY OTNER STATE OR LOCAL LAW REGULATiNG CON�
SiRUC�ION OA iHE PERfORMANCE Of CONSTRUCTION �1ZA.]5 F1I'e SC �6.3Z
P�ANCHECMFEE TOi fEE
Lice 5.0 9.23
S�GN>ruAEG�CCMAnC*OAOAS�rH0a4E0eGE�+� - iCaiEi EN R P V4LIOAT D ISISY U=PE(� %S-�
/ �
SGVaraaEOrpwvEO �O.vmEaeWiOEai .D��E Bi �m5o c�!
NEW � [�]
ADDN [ ]
ALTER [ �
ConstructionAddress: �
Legal Description:
CITY OF FRIDLEY
SLVGLE F��iII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Owner Name & Address: f�
;
Contractor: J j_� �,� ,;,_ �; r` �
Address: ;��(- �7�<"'��
LIVIl�G A.REA:
GARAGE ARE�:
DECK AREA:
OTHER:
Construction Type:
; , ��� r � / '��%�
�
�,
Effective 1/1/98
���J
� � ��
, ,�
6i �
_Tel. �l S%l-lr'`�75
LICENSE lt��C�O�-l�1(c30
Tei. n �_Z�:�-c;�-� �
Attach to this application, a Certificate of S(irvey of the
lot, with the proposed construction drawn on it to scale.
Lenath
L.ength
L.ength
D�SCRIPTION OF t�iYROv�vIEN3'
Width
W idth
Width
Height Sq. Ft. _
Height Sq. Ft. _
HgdGround _ Sq. Ft. _
if , /=/
i� ��,,, ,,
ci`.2 �: `C , ✓�c! �'_ '
Estimated Cost: $ �� � t� S
O
�
(Fee Schedule on Back)
/;'
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x� = S
DATE: ��' �r�, APPLIC��'T: ��� !'�C%- �� TeL # �'K; `/" ��5�/
,
Permit Fee
Fire Surcnarge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Char;e
TOTAL
STIPULATIONS:
$ l�'I �l�
5 c- "3:�
� } Il,=
�
� "> � ,
S
$
�
$
� _!- _
/ )�l � i
CITY USE 0�1LY
Fee Schedule on Recerse Side
.001 of Permit Valuacion (1/lOth%)
$.�0/�1,000 Valuation
�1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ J Not Necessary []
soe�ec* PEfiMIT NO.
City of Fridley 2 7 6 1 1
A""ET°°°"HETW'NS gUILDING PERMIT
� � RECEIPT N0.
� _ COMMUNITY DEVELOPMENT DIV
r ��' PROTECiWEIN57ECT10N SEC � �� 9
�
�
� �
� "1 � CRY MALL FRIOLE� SSA7 NUMBFe AEV DeiE o�GE O� ♦vaROVEO Bv
�""'�'� �' 612-571-3450 gto-Fi5 9/8/98 � �
lOB ADORESS
6308 Dellwood Dr.
1 IEGAI LOTNO BLOCN TRAGTORADDITION SEEATTACMED
oESCa. 7 1 Moore Lake Highlands 3rd s"EET
2 PROPEFTV OWNER MAII ADDRESS 21P VMONE
Ruby Dalzen 6308 Dellwood Dr 55432 571-6973
7 GONTRAGTOR MAILADDRESS Z�P PHONE LILENSENO
New Haven Construction 4208 83rd Ave N Brookl n Park 55443 66- 22 2
� ARCHITECTORDES�GNER MAILpDDRESS IIP PHONE LICENSENO
5 ENGINEER MAIIADDRE55 ZIP PHONE LICENSENO
6 USE OF BUI�DING
Residential
] CLASSOFWORK
[l NEW ❑ ADDITION ❑ ALTERATION fAl REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof �RSxg �x�tg�tKxggB house & ara e(25S Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPEOFCONST OCCUPANCYGROUP OGLUPANC�LOAD
SEPnRATE PERMRS APE FEOUIREO FOR ELECTPICAL PWMBING. HEATING.
VENTI�ATING OR AIR CONDITIONING
THIS PEFMIT BECOME$ NULI ANO VOID IF WORN OR �pN$TRUCTION ZONING 50 FT GU FT
nUTHOFIZED i5 NOT GOMMENGED W�TMiN 60 DAVS, OR IF CONSTRUCTION
OR WORK I$ $USPENDED OR ABANOONEO FOF A PERIOD OF 120 OAVS AT
ANY TIME AFTEH WOFK IS COMMENCED NO DWLG. UNITS OFFSTREET PARRING
I MEFEBY CEFTIFV TMAT i MAVE READ AND E%AMINED THIS APPLICATION STA��S GnRAGES
AND NNOW TME SAME Tp BE TRUE P.ND COARECi ALL PROVISIONS OF LAW$ yp�U?TION SURTAX@
PND ORDINANLE$ GOYERNING THI$ TYPE OF WORK WILL BE COMPLIED �Z�OHS.00 y�1.O�4
WITM WHEiHEA $PECIFIED MEAEiN OA NOT TME GRANTING OF A PERMR
DOES NOT PRESUME TO GIVE AUTHORRY TO VIOLAif OF CNNCEL THk pEFMITFEE SACGMARGE
PPOViSiQlQ� pF ANV OTHER $TA�E OR LOCAI lA EGUUTING cor,. $74.75 F1T2 SC �2.�$
STRUCT�QN OR TN �ERfORMP�ICE OF CONST U I N
� GLAN CHECKFEE �OTA EE
� �-i
License $5.00 $gZ•$�
�;iGNeivaEO� ON'AaUOAOAS�irOai2E0<GErvi iD�iE� P Vl�LIOAi H151$ �P�
��Ne'�REn[n��.qEa���OW"�Ea9V�[]f4 iO�iE� DL�aSO f
Ru6 19 98 06:58a
NEW [ 1
ADDN [ ]
ALTER [ ]
ConsuuctionAddress:
Legal Descripcion:
Kerri
566-7183
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
r
i ,
�
P. 1 ... .....
Effective 1!1/98 \
�
� ��1v � ���
�
i.
I "
i
Owner Name & Address: ,�; /� U U G1 / K.c�t`i� �`�� �o � Tel. !! S 1 I� iC �� 3
Contractor: /�/� � �!'�7�� ��Y��S T MN LICENSE 1i �o0 77 i S-O
Address:��- jC� ��,3'-`� �i'� )l�' /-� Tel. N; 6G' S ZZ�
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:
I.engtn
Length
L.ength
DESCRIPTION OF L�iPROVEMENT
w�acn
W idth
VJidth
Height Sq. Ft.
Height Sq. Ft.
Hgt/Ground _ Sq. Ft.
�/ np
Construction Type�Ql=u�'-f l'eroo ZS s�, Fscimared Cost: $ '��5�� — �_
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x$ _$
DATE: �-/ �S- S6' APPLICANT: T7�c, L- j�c 7�J2'r�;,fG�c� �=-�- Tel. fl S�'6 -52 Z- S
Permit Fee
Fue Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Convol
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
3
$
$
$
$
5
$
5
3
S
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1i1Qth%)
$.50/$1,000 Valua[ion
$1000 per SAC Unit
55.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary ( ) Not Necessary [ ]
- �- /
;
soe,tcr PERMIT NO
,� City of Fridley
ATTHETOPOi.�E.w�NS g�ILDING PERMIT 31158
�
� � _ COMMUNITY DEVELOPMENT DIV
� i � PROTEGTIVE INSPECTION $EC ��`�`�
i
� "1 � CITY MA�L FRIOLE� SS�J7 Nu4BFA nEV 0�*E v�Lf O� •ovPOVED !•
l-'--�'�I `'' 612-571-3450 9�0-F15 7/11/00 � /
lOB�00RES5 6308 Dellwood Drive
1 LEWI LOTNO BLOCI( TR�CTORI.DO�TION SEEATTACMED
oesca. 7 1 P9oore Lake Highlands 3rd SNEE7
2 PROPENTYOWNEA MAILAODRE55 2�P PHONE
Terry $ Ruby Dalzen 6308 Dellwood Drive 763-571-6975
J CONTFACTOR M�ILADDRE55 Zli pNONE LICENSENO
Renewal by tandersen 350 - 73rd Ave. NE Fridle PW 55432 612-502- 77 20130983
� ARCMITEC70ROESIGNER MAILADDRESS ZIP FMONE LICEHSEHO
5 ENGINEEfi MAIL A�DRE55 ZIP FHONE LICENSE NO
6 USE OF BUILDING
1 CLrI$SOFWORK
❑ NEW ❑ ADDIT�ON O ALTEHATION W HEPAIR ❑ MOVE O REMOVE
e DESCRIBEWOAK
Replace 3 full framEwindows witliin existing openings
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
�ermit Inspection Cards
Will Be Mailed
To Homeowner'Co Fost
TYPEOFCONST OCCU�ANCvGROUP OCCUPPNCVLO�D
SEVqqqiE �EAMIT$ APE AEOUiRED FOR ELECTRICAL PLUMBING. HEATING.
vENiil,qilNG OA AIR CONDIiiONWG
iH15 PEFMiT BECOME$ NULL 4ND VOID IF WORK OF CONSTRUCTION ZONING $O fT CU FT
4l1THpqiZE� i5 NOT COMMENGED W�TH�N 60 �AVS. OR IF GONS�qUCTION
OA WORK 5 SUSPENDED OA aBANDONED FpF A FERIpD OF f7p DAYS �T
ANV TiME 1FiEA WORN I$ COMMENCED NO DWLG UNIiS OFFSTREET V4qNING
I MEREBY CEFTIFV THAT I MAVE READ AND E%AMINEO 7H15 APP�ICATION 1 STALL$ GAR�GES
nNDeNOWTHESAMETOBETRUEANOGORRECT 4LLPROVISIONSOF�AW$ yqWATION SUATA%
nND ORDiNANCES GOVERNiNG TMiS T�PE OF WORr( WI�� BE COMVLIED @ �n
Wi'� WNETNEA SPECIFiEO NEAEIN OA NOT THE GRaNtiNG O� � PEAMR y�Z,953.00 .p1,4S
OOES NOT PaE$UME TO GNE AUTHOAITY TO VIOLAiE OA C4NCEl THE pEAMITFEE $A��HARGE
vROV1510N5 OF nNY pTMER $TnTE OR LOUL L4W REGUL�iING GON� g83.Z5 Flr SL, QZ.95
S'AUCLION OP iHE �EAFOAMANCE Of CONSTaUCTION 4
G�AN GHEGKF E iOT� fEE
Lice C 45.00 92.68
S�GV�'�AEO�CON'a�C�0A0u��rr.OUiZED�GE�+� �0��6 HEN GRO�E ��4�IDAT p Hi515�%7� UA P MI�
_ L � �
��AEJ�O�vrF4��0innfoBw�OFA� �O��E� Bi0 �+SP •�t
rrEw � �
ADDN
ALTER
Effective Si 10/99
[ l CTTY OF FRIDLEI'
[/r S�1tiGLE Fr�III.Y A:�iD DUPLEXES R-i AND R-2
BITILDING PERNIIT APPLICATION
� \�
�I� j,,�l
,,� ,-�
, �
, i,
�onstruction Address: lD����o ��1��. �'� ���). `Q
Legal Description:
Owner Name & Address: �C �2X C� �. �> >b � � G� �X� Tel. t� �(o � • S� I �0� ��
Contractor: R�NEWAL BY AND`cRSEN MN L.ICENSE #
Address: 350-73RD AVE. NE
FRIDLEY, MN 55432 Tel. #
� (612) 502-4777 iurvey ofthe
1, LICENSE #20130983
-- r--r---- ------ OR li LO $Ca�O.
LIVLriG AREA:
GAR-IGE AREA:
DECK AREA:
OTHER:
Construction Type:
DESCiiIPTIOY pF i1-fPR()VElYl�NT
Length Width Height Sq. Ft.
L.ength Width Height Sq. Ft.
Length Width Hd Ground _ Sq. Ft.
Driveway C�rb Cut W idth Needed:
.�
Estimated Cost:
Ft. + ti Ft = Ft x
_$
DAT'E: �-•�U� . APPLICA.V'T: �Q„\fi��n�i-� Te,. #9sa �s�l��gs�l
��y�
Pernut Fee
F+ae Surchaz�e
State Surcharge
SAC Charge
License Sarcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Chazge
TOTAL
STIPULATIONS:
$ ��a�
$�J�
� / ��
$
$ ��
$
$
$
$
$qaJ
CPTY USE ONLY
Fee Schedule on Reverse Side
.001 of Pernut Vaivation (1/lOth%1
$.50/51,000 Valuation
$1050 per SAC Unic
$5.00 (State Licensed Residenual Coniracters)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Deteruiined by Engineering
Aa eement Necessary [] Not Necessary []
Building PLUMBING Perm��tvo.:�OC�-�i� l
Inspections RESIDENTIAL APPLICATION Received By�1���
�63-s�2-3604 CITY OF FRIDLEY �ateFtec'd�'
763-502-4977 FAX i �-�-�,c.��,,•�„-iy-,,,�
on�rE y��s�° i ����ukr-M:w.nu��ui[ss
SIl'E ADDRFSS ''� S ` 7 "'r_< ` �. � `. 1 ^t �`
7fIIS:1PPLICANI IS ❑ON'NER �Z1CON'iRAC'i'OR
PROPERTY NnMF�. l•<.. � ,C•'n 1.,. �, �
O�i'NER/ ADDRF55�. �� i C :i nk...1_i-..�.•-rt �f /.:I., �.�.�.y. ,'N��i:+. STA E`{' ZIP `S )�JG
TENAVT �)G t 5���. 4 S �S" --- � —
PHO�E:
CON"1'RACTOR y,�,,,it:
su�Mrr n co�v oF �Tn1�E �icENSES G� 5 ti i F.�n ����rry Overacker Plumbing Inc
vo�-H s��n rt: 502 G Main St
I.ICI3NSF:. I30ND AND STATf I30ND �
craTiricaTFOF Anoka•'�1V 5�303
ADDRFSS ZIP
ihs�:aavice (763) 572-8880
PHONE
PER�11T TYPE � SINGLG PAMILY ❑'�W'O FA�11LY ❑ IOWNII0U5[
Tl'PE OF �4'ORK: ❑ new �9 Kr:ai.:ur:tit[n..i.
DET.AILED DESCRIPTIOV OF \4'ORK ,'ic� �� « � �'-��- ��" r�+ »- C�!. /J.�.�:� ; %� � �._t
FGGS ARG I3ASED0� $IUOU PER FlXTURE. EXCEV7 N'HfiRL' VOTYD. PIXTURF.S (INUICAI�E TOl'AL RUMBER OF EACH BELOW). MINI!NCM FEE
Si�50
BATH SINK/LAV FI.00R DRAIVS SIION'FR N'ATER PIPING
BATHlUB GASPIPIVG(kI�.EUCI'PYLIC� SUlIMMIM1CiPOOL N'ATERSOFTNFR($35)
CLOTHESW'ASHE2 KIICHEVSIVIC WA'll`.HCI,OS�I' BACKFLON'PREV.�51�)
DISH\4'.�SHFR _L,IUVDRYTRAy �U'A7FRIII'A7'GNI$3i) FORIRRIG:ITIOK
N'.AI�I�:NMI�'f[R OTHER
Number of fixtures @$10.00 � x$10.00 =$ l d c' d
Number of fixtures @ $15.00 _ x $15.00 = $
Number of fixtures (c�r, $35.00 �_ x $35.00 = $ 3 5 � � �
State Surcharge $ .50
MINIMUM $35.50 To[al = $ �1 � S 1
'I IIIS Iti AN APNIJI'All11N POR A PIiKMII�-NO'f VAI.ID UNTII. PROCI:SSGD
I hereby apply for a plumbing permit and I acknowlcdgc that the infbnnation above is' complete and accurate; tha[ Ihe work will be in
confom�ance with the ordinances and codes of thc Ciry of' Fridley and with the Minnesota Construction Codes; that 1 understand this is
�, not a permit but only an application for a pennit and work is not to start without a pennit on site; that the work will be in accordance
wi[h [he approved plan in Ihe case of all work which requims review and approval of plans.
SIGNATUREOFAPPLICANT .`�<ei ���r-��. PRIN'f[.�MI�. I a�le �- /C " ". �A�� `'�S�
���
PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHAMCAL WORK
City of Fridley
Building Inspections Department
6-3iI Universit� Avenue NG Fridlev. M\ 55432
763-�72-3604
FAX: 763-502-4977