AF - 39041�
Date:
Owner:
Addres
u
n
LJ
City of Fridley, Minn.
BUILDING PERMIT
�� S� _3S
N° '7228
,
/ // /^// 7 ,
Builder �'G �_ . .... _...�1..._....."�.5�...2�L�_L-�.�
Addresa
/ =
LOCATIO Q BUILDING
� ��-����
No. .�..L......%.......... Street .... :'. . . `-t_.'�...._ ..-.. ..... P Lot ....._....___..._...._..._....---..
-��-.... �� ---
/� i / --
Lot .:.j...:�..:-....�. Block ...._.......f�..........._.........._..... Addition or Sub-Division ._....C.L.:'L:LL='`rSLlL�. _..�.--
_..
n� —I ��
Corner Lot ....._ ............._........ Inside Lot ...._...<�._..... Setback ....,f..:.1_.........._....... Sideyard .........__'��.._.._.... ...r...._.._...---..--
Sewer Elevation
Foundatlon Elevation
DESCRIPTION OF BUILDING
Tyq//t���e Used[,�'¢(/Jj / /�/.S �j/
..(...'/.-����.. '��,.�!ti.��.,. y/,t. Front _��' DePth �.-(�..'.__ Height ��'_. S4. Ft✓.__4..:..l���C�. Ft �� _.�!l.J
..L.{.�....... �_ i..�� Fmnt �__.. Depth ._�.� Height ��:..._ Sq. F��.._� Cu. Ft.�.,,%r��J
� � i�
'Ij�pe of truchon ......-� ?�1:2i�Est. C�f�.�.�lt��.`-�`—.-3'o t�e com letea
p _____...... _—.._
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordence with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley. /� ,
� � . ../
_� � �,, ��� ��a
✓j�� �C 'L�
In constderation of the payment of a fee of 3,�i->-��...___._., pernit 3s hereby granted
-..-__ __... to cronstruct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees end worktnen, �n all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildinga
within the city limits and this permit may be revoked at any time upon violattox�of any of the proviaions of said
ordinancee. _ .. . / /
InsPe'ctox'
NOTICE:
Thia p�rmif do�� no1 cowr Ih� comhuHlon, inahllNion 1or wirinp, Plumbinp. a.� h•■xno, pwK or w�Mr. B� �un to aw
IL� BeiWiny In�p�HOr for wp�nh p�rmNs fer 1hx� il�ms.
PERMIT
� Cit� of Fridle�- 17220
.
""�ET°°°`r�E-J;'�5- gUILDING PERMIT
,
� RECEIPT NO.
i
� ' COMMUNITY DEVELOPMENT DN
� � PqOTECTIVE INSPEGTION SEG.
r , 0(
�
, , ,
� -'� � GIiV HALL FRIDLE� 55AJ2 rvuueea aEV onre �nac o� aav�vuveo er
'---�:' `.� 612-571-3450 9�0-F�5 8/29/83 � �
J08 ADDRESS X6XXXBXSX9S7SX�3�.X8Sif�ISX➢iY 515 Dover Street N.E.
1 LEGAL �OTNO BLOCK TRAGTOFA�DITION SEEATTACHEO
oesca 5,6,7 K Riverview Heights sHEET
2 �ROPERTYOWNER MAILADDFE55 ZIP PHONE
Norman L. Johnson 511 Dover Street N.E. 786-3822
7 CONTRACTOR MAILADORESS ZIP PNONE LICENSENO
James Connolly Contractor 16235 Kamacite Street, Anoka, MN 55303 427-1550
a ARGHITECTORDESIGNER MAILADDRE55 ZIP PHONE LICENSENO.
5 ENGWEEF MAILADDRESS ZIP PHONE LICENSENO
6 USE OF BUILDING
Residential
1 CLA$$OFWORN �
.. NEW C� ADDITION L' ALTERATION C REPAIR I� MOVE I1 REMOVE
8 �ESCRIBE WORK
Construct a 6' x 22' Garage Addition
9 CHANGE OF USE FROM TO
STIPULATIONS
Side yard variance approved by Appeals Coimnission on August 16, 1983.
Provide a hard surFace driveway.
TVPEOFCON51 OCCUPANCYGROUP OCCUPFNC�.00D
SEPAFATE PERMITS AFE REOUIRED FOR ELECTRICAL. PLUMBING. HEATING.
VENTILATING OP AIR CONDITIONING.
THIS PERMIT BECOME$ NULL AND VOID IF WORK OA CONSTRUCTION ZONING SQ FT. CU FT
AUTHORIZEO IS NOT COMMENGED WITHIN 60 DAYS, OA IF GONSTRUCTION
OR WOAK IS SUSPENDED OR ABANDONED FOR q PER100 OF 120 OAVS AT
AFY TIME AFTER WORK IS COMMENGED. NO. DWIG UNITS OFFSTREET PARNING
i HEREBV CERTIFV iHAT 1 HAVE READ AND E%AMWE� THIS APPLICAiION 1 STALLS GPFAGES
AND KNObV THE SAME TO BE TRUE 4N0 GORRECT. ALL PROVISIONS OF LAWS VALUATiOh SURTAX
AND OR�INANCES GOVERNING THIS TYPE OF WOPN VJILL 8E COMPLIEO $1� 409 $• 7�
'rh'rtH WHETHER SPEGIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME Tp GIVE AUTHORITY Tp VIOLATE OR CANCEL THE pEAM'.TFEE SACCHARGE
PROVISiONS OF ANV OTHER STATE OR LOCAL LAW FEGULATING GON� �S`ZS. OO
STPl1CTION OR THE PERFORMANCE OF CONSTRUCTION.
PLANCHECKPEE TOTALFEf.
� �2rJ.%0
sicac'�;�E e� [Oa"ao--.e,ec d"r ��P ' v* ro<iE� �hHEh GPCPEA VALIDAT D'HIS i5 �OUR PERMIT
,� �--�-- „�"— ' � b' �' ,
=ec �:FQ � .ca _e= �o.re�
CITY OF FItIDLCY
APPUC/1T10'� FOk RCSIDCi�T1P,L [3UILDICG PCf�41TS
(Uc�•i, lllteratiuns, Additions, or Rcpairs)
Effective Aug. 1, 1981
o��,��ER: �.>;�z/�i�����/.. ��°/�,���,�� �aui�oEa: J�2�/ �'���1��,�G �
n�or,ESS: ,� // ./� � � ;_; i� _5i �-.2';�= n��2�ss: � �•�,/�� ,! �
T[L N0: 7 5' L .3 S� �� Z TEL 1l0:
Construction Location
sTruxT no: ,S i�j ss�aer:T: %% n �.�,,� ��> � T�'��
i.o��: ,j `�"'� si,o�c: /�_ nDniTio;�: �Z �-{-s-c�. �t�, � h�_�/_��'�--_
Corncr Lot: Insidc Lot: SetbacY.: Sideyards:
Apa licant attach to tliis form tw•o Certificates of Slirvcy of lot and
p�opo�ed building location dr�•.an on certificates to scnle.
DESCRIPT10�2 0� CO�JSTRIICTIOt�
C �'�(� CL/ � Fzont: � _ Depth: , L Height: J`"
Squarc Feet: /3,� Gtibic Fcet:
Front:
�Pth�
Height:
Square Fcet: CUbic Peet: _
l S�O�j.
��pe of Con�truction: i/�_�?�� -��„--,-- Estimated Cost: S%J '`' `"_
Rb Be Q�r.:pleted:
Alt. 1� Alt. B
Proposed Drivc�aa}� liidth If New Opening Is Desired: $ S
SEL PiVF.R;L' SIDE OF StIELT
7he undessioned hereby :n�l;e� applicaticn For a pernit fcr the �.ozk herein specificd,
a9recin3 to d� .all �•ork in strict accozd.v�ce with the City of T'ridlcy Ordinances e�id
rulin�� of Lhe Depart�ne��t of Dui:dings, and hereb}• declares that all tl�e fact� and
,i
reyre�c�Litiens stated in this applicntion are tzue and correct. �-
p t� �' � � � �� �-�--�-
D�TG: 0 � �� ' ✓ � SIGtI71T17� : ��-�%�t 'Zr� �/L'�✓ -
Stil.ula tions :
� � j . 06
.��
� �S� � �
� � ` I
CERTIFICATE OF SURVEY
JAMES �. KURTH '
LAND SURVEYOR
4201 N.E.S�" ST.
MPLS.,t-(�NK• SS42,1 `� ' ` " � ^fs8-�oo4
1 MEI�EGY CCRTIFY THAT TMIE 6UIIVEY, PLAN, OR RC►OI�T WAS ►I�EPpRlD �V ME OR UNOCI� MV DIRiGT fUKRV��iOn
AND TNAT 1 AM A WLV 1�EGI�TCREO LAND 3URVCYOR MDEq TME LAW6 OI TN! STAT[ Or MINME6pTA.
— � MINN. REG. NO..`�� � �y
i � - • , ,i3-_
SCALE 1'- 30� DATE_•�� y �yi � � I
- ' • _ d;�' � I
\ `
�
/ ,�
/ �
�;
. ,
' O
I � ,� .$a.0
,
1l� �
--� ,0� 1
1 \,
Ki �
1 , \
aa� �
` �1 �
ub � ib e (
�
A
,
,
�,
�
,�
� \�`
%- I
� �a ,� a z� . `
� d � � t�
o ��` � �b X yo
�'� � - °
1� ° ` V� � C
�� �� :
, o , .�-
, /�•-
i ��'
� ��`✓�
J o.
.� � 5 �
lozs s,c.,�'T 3�oc�c K �
R�vErcv�ew ����c,Kza J�S�
ANOK/> COVKrY � M��tK.
,�
1
ll
Appeals Cocmnission Meeting - August 16, 1983 Page 3
MOTION by Mr. Betzold, seconded by Mr. Barna, that the Appeals Crnunission reconcnend
to the City Council, appzoval of a 5 ft. variance to increase the maximum size for
a free standing signs to BS sq. ft. to allaw the cronstruction of a free standing sign
on Lot 1, Block l, Co�erce Park Addition, the same being 7600 University Avenue N.E.,
Fridley, Minnesota, and th at approval of this variance is based upon the Commission's
interpretation of the City Sign Code, Section 214.02, Definitions, Paragraph 32
"Sign Area" as well as Section 214.045, Paragraph 6"Gas Stations" which they interpret
as the pricing signs aze not included as part of the overall maximlan sign area;
and upon the stipulation that Petitioner work with City Staff on additional land-
scaping around the perimeter of the pzoperty. UPON A VOIC£ VOTE, ALL VOTING AY£,
CHAIRPERSON GABEL DECLARED THE MOTZON CARRIED UNANIMOUSLY. (This Item goes to
Planning on B/24/83 and to the Council on 9/12/83).
/
1. REQUEST £OR VARIANC� PURSUANT TO CHAPTER 205 OF THE FRIDL£Y CITY CODE, TO
REDUCE Tt� SIDE YARD SETBACK FImM 5' TO 3' TO ALLOW A SINGLE CAR GARAGE TO
BE A DOUHLE CAR GARAGE, I,OCATED ON LOTS 5, 6 AND 7, BLOCK K, RIVERVIEW
HEIGHTS, THE SAME BEING 515 DOVER STREET N.E. (Request by Nornian L.
Johnson, 515 Dover St. N.E., Fridley, Md 55432).
MOTION by Mrs. Gerou, seconded by Mr. Barna, to open the public hearing. UPON A
VOICE VOTE, ALL VOTING AY£, CHAIRPERSON GABEL DECLARED TE� PUBLIC HEARING OPEN AT
8:15 P.M.
Chairperson Gabel read the Staff Repozt:
�DMDI3TRl7IV8 STAPF AEPORT
515 ��er Street N.E.
�, POBLIC POAPOSE SERYED BT REQOIA@!SN'f:
Sectlon 205.OT3. �B� �2). mQuirea a aide yard ad�oining an attached garage
to be not lees than 5 feet xide.
Public purpose aerved by thia requirement 1� to provide apace Detween
individual atructures to reduce conflagration of fire, to provide access to
Lhe rear yard for emergenclea and to limit the conditlon of crowding in a
realdential neighborhood.
B. STATED HARASHIP:
"I need a tro car garage for more �torage. Present garage is only 16 feet
rlde and set back 9 feet from side property line."
C. IDMIIiISiAA?IYE SIIFP HEVI6Y:
She existing single car garage (16'z22') i� 9•1 feet from the east aide
property line. The property to the ea�t of the applicant'a has an existing
eingle family house with an attached douDle garage. The double garage Ss 7
feet from the line. Peducing the nide yard setback from 5' to 3' would
etill maintain a distance of 10 feet between �tructures (aee survey maD)•
If the Board moves to approve thls request, we recommend that the status of
�indows on Lhe east rall be discussed. The overhang should De constructed
Lo ensure all roof xater falls on ;he ap,plicant's property.
Appeals Commission Meeting - August 16, 1983 Page 4
Mr. Clark stated that the Covm�ission probably did not have to address the issue
of the windows because the garages will be 10 feet apart and he believed that the
roof structure on the house had a gable end on the side property line so there
wuld not be any water running off next door. Mr. 7ohnson was present and showed
the Cou¢nission his plans and stated that a rnntractor would be doing the work.
He also stated that the siding will be matched as well as the roof. He also stated
they had more than one car and they need additional room for storage. The Commi-
ssion members agreed that everything was in ozdez.
MOTION by Mr. Plemel, semnded by Mrs. Gerou, to close the public heazing. UPON A
VOICE V02'E, ALL VOTING AYE, CHAIRPERSON GABEL DECLAR£D Tf� PUBLIC HEARING CLOSED
AT 8:20 P.M.
MOTION by Mr. Barna, seconded by Mr. Betzold, to approve the variance request to
reduce the side yard setback from 5 ft. to 3 ft. to allow a single car gazage to
be a double car garage, located on Lots 5, 6 and 7, Block K, Riverview Heights,
the same being 515 Dover Street N.E., Fridley, Minnesota, 55432. UPON A VOICE VOTE,
AT.T, VOTING AYE, CHAIRPERSON GASEL DECLARED TF� MOTION CARRIED UNANIMOVSLY.
REQL'EST_FOR VARIANCE PCRSL'A.'�T TO CHAPTER 205 OF 7HF. FRIDLEI' C7T5' CODE,
REDL'CE THE RE C�IRED FROtiT YARD SETBACF: FROM 80 FT. TO 75 FT , REDUCE
- ---------5-------------
TH RE��I'IRED SIDE YARII SETBACK 0!� CORSER FRON 80 FT. TO 60 FT., REDCCF
THE RKING LOT SETBACF: FROM 20 FT. T� 5 FT., TO ALL01: THE�CONSTRL'CTI(15
OF A 5_ SQ._ FT._ ADDITI01 Oti LOT 2, BLOCK 1, AUDITOR'S SL!ADI1']5701 N�.
153, 7'HE '�TE 981KG 5277 CESTRAL AVE�i'E R.E. (Request b�� Richard J.
Polk, Jr., 70 Gilhite Drive, LexinRton, KY 40503)
MC�TZON by Mrs. Gerou , sec ded by Mr. Barna, to open the public hearing. UPON A
VOICE VOTE, ALL VOTING AYE, AIRPERSON GABEL DEC7.ARED Tt� PUBLIC HEARZNG OPEN
AT 8:23 P.M. ��°�,
Chairperson Gabel read the Staff Report:
IDMLISTHl2IyE ST1FY YEPORT
5277 CentrLl A��nua 11.E.
l. PSJBLIC PORP0.TE SER�SD BT EEQOIfl�RT:
Ssction 205.153, 3�. reQulree a oinim� front yard aetDac� of 80 teet for
all permitted building�.
Public purpo�e aerved by Lhia requirement i� to p�ovide adeQuate parking
and open landscaped areas a� Mell a� to avold congeetion and to provide
adeQuate �ight clearances in commercial areae.
Sectlon 205.153� 3B, (2), r'equires s minlm� �lde yard �etbacic of 80 feet
for all permitted buildings, vhere a slde yard abuts a street.on a corner
lot. ,
Public purpo�e aerved by tGis requirement Sa to maintain adequate � e yarC
eetbacks and aesthetically plea�ing open areas around oommercial
structuren.
Section 205•155, ♦E, (1), requirea dll' parking areas to be a minimum of 20
feet frox any atreet right of vay.
,
RE:
Date
. T�� �... ��r.
��S�ATE OF MINNESOTA
D[►ARTM[NT pI NUMAN t[11VIC[•
��4 LA/AY[TT[ 110AD
iT. �AUL. MINN[fOTA �5101
Citv of Fridley
Zoning Authority '
6431 University AVe. IJ.E.
Street Address
Fridlev, MN 55432
City State Zip Code
ZONING NOTIFICATION OF APPLICATION FOR LICENSURE
Subject: �� i,,
Name o Day Care Home Applicant
- . �c %.
Street Address
i c.���� ', �
City State Zip Code
o;. �r��' �'-�e �js�
D9S-2722 (9-BS)
PZ-02722-02
ir - � 3 - I��
Type of License:
Eamily Day Care �_
Group Family Day Care '
Licensed Capacity
Phone No. '�
This is to inform you that we are in receipt
licensure under Minnesota Rules, parts 9502.0300
Rule 2), Family Day Care and Group Family Day Care
this license is subject to compliance With the
Statutes, Sections 245.781 to 245.812 and 252.28,
the Public Welfare Licensing Act and the rules of
Services.
of an application for
to 9502.0445 (formerly
Standards. Issuance of
provisions of Minnesota
subdivision 2, knovn as
the Department of Human
You should note that under Minnesota Statutes, Section 245.812, Subvision
3, a licensed day care facility serving 12 or feWer persons shall be
considered a permitted single family residential use of property for the
purposes of zoning. Subdivision 4 of the same section indicates that a
licensed day care facility serving from 13 through 16 persons shall be
considered a permitted multi-family residential use of property for
purposes of zoning.
If we do not hear
vill consider the
your local zoning
Sincerely,
from you vithin
above-mentioned
code.
,� - i � . ' i � -
.��' ' _.i.<; � i- -.!_�._.,. ; , .
Licensing Worker
Street Address
30 days after receipt of this letter, ve
day care home to be in compliance vith
COMMUNITY H�ALTH & SOCIAL
SERVICES DEPARTh1ENT
COUNTY OF ANOKA
COURTHOUSE,FOURTHFLOOR
Name o A ency Organization
City State Zip Code
�� �,
f'�
� �� -,� 1.
Date
. i�� ,� , �;,
�1 S�ATE OF MINNESOTA
D[►A11TM[NT 0/ MUMAN �[IIVIC[•
��1 LA►AY[TT[ ROAD
fT. rAUI. MINN[�OTA sN01
Citv of Fridley
Zoning Authority
6u31 University AVe. N.E.
Street Address
Fridlev, MN 55432
City State Zip Code
ZONING NOTIFICATION OF APPLICATION FOR LICENSURE
Subject: �� I l w��_�� `�� .-,�-�,..�U.,_,
Name of Day Care ome Applicant
�
� ,,`
�� � ��� t.-� . . � ,� - V.J �
Street Address
�� l' �2� G'fl �U ; � �_� 1
� �t,. � � ��—
City State Zip Code
, ,� �'�t' �' �'zr ,�', j7
D9S-2722 (9-85)
PZ-02722-02
., � s � �'��
Type of License:
Family Day Care
Group Family Day Care
Licensed Capacity ��_��
Phone No. � �S' �' -' % b' � �'-
This is to inform you that ve are in receipt
licensure under Minnesota Rules, parts 9502.0300
Rule 2)� Family Day Care and Group Family Day Care
this license is subject to compliance vith the
Statutes, Sections 245.781 to 245.812 and 252.28,
the Public Welfare Licensing Act and the rules of
Services.
of an application for
to 9502.0445 (formerly
Standards. Issuance of
provisions of Minnesota
subdivision 2, knovn as
the Department of Human
You should note that under Minnesota Statutes, Section 245.812, Subvision
3, a licensed day care facility serving 12 or fever pecsons shall be
considered a permitted single family residential use of property for the
purposes of zo:ing. Subdivision 4 of *_he same section indicates that a
licensed day care facility serving from 13 through 16 persons shall be
considered a permitted multi-family residential use of property for
purposes of zoning.
If ve do not hear
vill consider the
your local zoning
Sincerely,
from you vithin
above-mentioned
code.
Kathy Speggen/pf
Licensing Worker
Street Address
30 days after receipt of this letter, ve
day care home to be in compliance vith
CORIMUNITY H'�ALTH & SOCIAL
SERVICES DEPARTI�"ENT
COUNTY OF ANOKA
COURTHOUSE,FOURTHFLOOR
Name o A ency Organization
ty
AN EQUAL OPPORTUNITV EMPLOYER
State Zip Code
r
�
N
�
�
�
�:
�.
/� W
I�
�A
yV�
V
V
4�
�
�^/
, \
Z
O
�
U
w
a
�
Z
�
Z
�
J
�
m
� w
w z
J �.
� Q
� �
L.L �
LL >
O �
� �
.i
�
U c�o
z
0
�
�
Z
W
�
i�
Z
J
O
O
U
�
Z
�--
_
0
Z
a
�
F--
z
�
�
W
3
0
a
�
0
�
z
0
�
Q
U
J
d
a
¢
�
w
W �
� �
� �Z
Q �
�c �
L _
�
�
Z
Z
0
�
0
Z
�
U
�
Q
0
z
¢
z
0
a
�
w
c7
�
LL
W
�
x
nl
'i
�
�
Q
ry LL
f`7
In V
N O
Z (���
� N
T r
� N
_ m
= �
�
�� � �
��
\ u�
� �
�
N N uDi
w \ �n
� �
o m
o �
Q y r
� z �
_ o m
�
Z
�
�
a
1
tir
�
�
O
U
�
w
Q
�
�
W
�
W
z
�
��
m
�
Z
Q
W
U
Q
z
�
�.
�
�
Z
O
~
al
�
U
��
w
�
� ��� � �
,
�I ��
� � �
.. �
�1r �
�
�o �
�Z
��
��� Qo
3 N ° z w
C � N
= a in
J
� �
ti
� U
� C
�
� a c�
O = �o a
�, g x
U
U
G
N
y r E
� . � m
� �
y7 N� �
� Z�� �
� �
_�
� � J C �
O ,
h H �1 l� �1 C7
�
� � �
a, o 0 0° °o °o
°' �ri o 0 0 �ri
� m .-i .� .1 c�
tn w va w u�
wlJ
�i
wi
U
N
w
Q
�
�i
0
�
m
s
O �
3 �
�
U �
�
O LL
c �
N E
NI � U
Ni � �
c
a7 � aai
a � �
��
J O
� � m
C
�
U
Q
�
�
v
�
c
J
3
N
Z
bL
Q
a
fJ
�
�
N
�
�
O
N
O
U
Y �
U c
� N
m
� O
o @
� G
� -Y N
o �
c 3 �
N O O �
� � � �
� N U
C
a a "-' o
O a ln
m N d � 1
C a Ep
C � O N
O � � LL
� �
�
� o � > >
� U L a �
N � � c C
U : Q .-I �
�
�
�
�
�
�
�
N
a�
`m
U
N
�
�
N
N
t
a
c
�
C
O
>
�
�
C
j
m
�
Y
0
nNO ,,
=a
��
p D
c C
r ,,
�
�
�
�
0
_
N
C
Y �
U
� �
m '
C N
O �
N C
J �
s �
o =
� �
E
o E
u U
C
�a `o
Q �
a O
Q �
o m
N �
� �
N �
> �
o �
� E
N C
N
��
�
Z
�Q
W
�
�
s'
�
F-
o�
�
v
M
�
L
` w
] W
� LL
N Q
(0 ~
� O
�
�
�x
LL
�
7
0
_
O
O
O
N
�a
W
Z
�
H
U
a
�
Z
W
a:
�
U
O
T
a
O
U
`m
c
3
0
C
a
O
n0
C
C
0
a
�
E
O
�
LL
yI
�
0
L
OD
O
�
n
�
�
>
0
Q
�. � _ alea /8 pau6ig
�ad/�l w��alawei4 �;�— yl6ua� u ly6iaH �oi�auuo� �ua� £# a�uei�ddy
ad�(1 w� �alaweia u� yl6ua� u ly6iaH �ol�auuo� lua� Z# aouegddy
� ad/1 ui � �alaweia u y�6ua� u �y6iaH �o��auuo� �ua� �# a�uei�ddy
say�w /—% �aaawei4 � 146iaH �ua� � v� ad�(1 luan uowwo�
/�
.��� "�,N ';rdu� n}g �e�l sa�ueiidd�d lel�i
_, ,v �eN �o pa�sissy ue� '�1 � �lndul f118 S ad�`l £# a�uei�ddy
�-._(u�✓ / leN �o palsissy ue� �C�7�indul (118 % ,�, ad/,l Z# aouei�ddy
— leN �o palsissy ue� �� �� / lndul f118 j i ad�l l# a�uei�ddy
!�
�
uoi3ew�o;u� �o��auuo� lua� pue lua� uowwo��azig pue a 1 aouei� y
� � oN ;X �a� sapoo lua�m� �ad se l�a�e�edas
�� ,�
/ paluan pue luan uowwo� ay� wa} panowa� uaaq sey a�uei�dde ue
�aue R�;�a��oo pa��e;sw pue pazis s�oi�auuoo �uan pue luan uowwo� ayl s�
�N �� SaA sa�uei�dde ue�p �e�n}eu pue paasisse ue� �o; sa�qel 6wlua�
a�ewn� �e�iva� �/�o6ale� yWy�-y�b' apn�oui saop siyl suopeoi�i�ads
s,�a�n�oe�nuew pue sapo� aua��n� au� slaaw pue ��qwasse paisp e si li
ley) sai�uan �(qa�ay pau6is�apun ay; 'wa3s s ui3uan mau e uipelsui uay/�/�
� � oN � sa,�
' �oN ( ) saJ.
( ) oN
�oN
suoge�i;ioads s�amloe;nuew pue sapoo �ua��no ayl �aaw ol
Pall�isui pue pazis aq pu�n 1! ne uogsnqwo� mau e ��e3sui ol pa�mba� uay/�/�
suoileo�i�ads s�am��e;nuew pue
sapo� �ua��n� aU� �aaw o� pa��e�sw, pue pazis si �ie uoi3snqwoa uilsixa ayl
i7isa�, sa�uei�dde ue�p �e�n;eu pue palsisse
,� � ue� �o; sa�qel 6wlua� a�ewn� �e�iva� �/�o6a�e� yWy�-y�y apn�ow
saop siyl suoi�e�i;i�ads s�a�n��e�nuew pue sapo�;ua��no ayl s;aaw pue
�t�qwasse pa;sg e si jwn ivawa�e�da� ay� ley� sai;uan os�e pau6is�apun aUl
O sa,� uoileww�al pue snnoq�a �o �aqwnu 'yl6ua� '6uizis 6uipnpui suoiae�yioads
�a�nl�e;nuew pue sapo� �ua��no pe slaaw pue �ndl�llse�d si wa�s�(s 6wauan ayl
�� oN �j sa,� pannba� a�ayM paddo�sa�g pue pauoddns ��am�as si pue
�% � 'suogon��sqo 'uqi�e�oua�ap '�sru wa; aa�� si pue pawwexa uaaq sey 6ui;uan
ay� leyl sai�uan �qa�ay pau6is�apun ayl 'aaeu�n; ui;sixa ue ui�e� a� uay/�
NOIl`d�I�Rl3A bl`d NOIlSf18W0� dNtJ a01�3NN0� 1N3A 1N3A NOWWO�
S11W213d 3�N`dllddtl JNINa(18 �3f1� 1N3W3�tf�d321 2i0� �11313�dW0� NI "I"11�
Building
Inspections
763-572-3604
763-502-4977 FAX
SfT[ ADDRESS ��
THIS 3PPIJGU"I Iti�.
BiJILDING
RESIDENTIAL APPLICATION
CITY OF FI2IDLEY
�.trecri�e i-i-us
���-�.
.'� �� �, -iL
❑ OW!JER
FROPERTY OV1'NF.W
TEN.ANT
CONTRACTOR
SUI3MIT A C'OPY OF'
YOL:R STATE LICFNSE
PROPERTY
PERMIT TYPE
TYPE OF WORK:
YOOR E-M.41L ADDR855
. 1.' _ . I" /�'
ITY
6
/L!�
, t
PHONH L'r � ` L' � G —�U / Z PAX
ST.ATE LICENSE d ��- �J ��� �'�� EXP DATE
� SINGLE PAAIIL}'!hEW' CO1�Sl�R�iCT10N SIZE _
❑ TWO F?.INIL\'�?1HW CONSTRUCI'ION STORIFS
❑ ADDITION ❑ G:ARAGGSHED ❑ �4'INDOWS
❑ BASEMENT FINISH �q ROOF ❑ DRNN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SW'IMMMG POOL
❑ NEU- HObIF CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELMG
DESCRI6E WORK H61NG DOXE�
SIZE UF IMPRO�EMENT
ROOFING ^ •'�
RUMBER OFSQUARES L L�_
C4RAGES
FROFOSED SIZE
PROPOSED HEIGHT�
StDING
❑ Vinyi
❑ Aluminum
❑ Other
\17NUON`S
IN EXISTING OPENI\GS OYes ONa
OR FOR NF.W OPENINGS-DESCRIf3L SI7.E OF
OPBNI��G CH.4NGE5 &
TYPF OF WINDOW' "f0 BE INSTALLED
\4' I
❑ HOUSE ONLY
`��HOUSE � GARAGE
❑ ATTACHEDGAAAGE
❑ DETACHED QARAGG
�
,
Yennit No.: . ��•
Received By:
�; ,� . �.
, �
ATE ZIP
FT
55 3
BASEMENT REMODELfVG SU6MIL
I. Existing Floor Plan
?. Proposcd O�r plan
3. Lis[ of struaural memAers to be used
FOR NEW WNSTRUCTION MCLUDING DECKS.
❑Sofft ADDITIONS & PORCHFS SUBMIT�.
❑ irim 1. Si[e Plnn/Survey showme the existing 5truc�ures
❑ Fasda end proposed proiect.
� Two scts of consvuciion pinns
.. [necgy Calculations
I.00ATIOV OF �1'IkDOWS
NUMBC-R OF N'IN
ALI. FEES ARE BASED ON VAI.U.4TIOY, I\CLCDI\G TIIE COST OF LABOR AtiD MATERL�LS:
(USINC THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION � OCCIiPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
�� Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ >' ��� �/, 5 See Dack Page for Fee Schedule
$ 65% of 6uilding Permit Fee
$ � �� .001 times the total job valuation
� I`f S .0005 s Permit Valuation Minimum $.50
$ ��.(J�. $5.00 (Siate Licensed Residential Contractors)
$ $1825 per SAC Unit (Plans to MWCC for de[ermination)
$ ft+6ft= ftx$21 S _
S 5450 Conservation Plan Revie«�
$ Fee Determined by F,ngineering
$ Agreement necessary ( ) Non Necessary ( )
C ,l i i��f� Make checks oa��able to: Citv of FridleV Attac
TH1S IS .AN APPUCATION FOR A PFRM11IT-NOT VALID l"'VT1L PROCGSSED
lations
] hereby appty for a huilAing permi� and I acknowledge Ihat the informatinn above is complete and acnrtnie�. lhat [he work will be in con(ormance with ihe nrdinances and codes
of [he C.ity of Fridley and wi[h tlie Minnesota Construction Codes, tliat I understand this is nol a pennil hut only an applicntion for a permit and work is nol to slart wi�houl a
permit on site:. that the work will be in �ewrdance ��nh tht appro�ed.pl�n in�the ease ol zll �vork which reqmres review and appmval of plans,
SIGNA'fUREOFAPPLICANT _ - � �<" `��.t � PRINTIVAME_ � '��'''�� �� '��'���`����� DATE_� � ���
�`
APPROV6D BY
ITS ARE
DA'�E