AF - 39069� City of Fridley, Minn. �
BUILDING PERMIT N° 4o�i
,
Date: . .. ../.....� � . .../%.�..... �..
Owner: ..X!lifl'f�9._�,/.p(iG*�J^'�rr'ti. Builder _.,..�-�+?. —.,,...��,..
��
....... . � ......
Address____. __..__. .._..._... ........ . Address ..... .. .. ....... .._ ............. .... ..._. __ ___.
LOCATIO OF BUILDING
,(�,[/ i -
j -
No..J...J `� Street .. ... c�1.''��% _-: "� - .�/`l Part of Lot .. ._.
/ ,/-� %� '�.
Lot :� (�, Blcek h . Addition or Sub-Dieision�I.C��2L"<<f..'-./o"v".�.. . ._.
Corner Lot Inside Lot %�. Setback Sideyard _._...._......__..........._.._......_..
Sewer Elevation . . Foundation Elevation . _ .. _.... ...
DESCRIPTION OF BUILDING
To be Used ddas:
`��i-.t.t °'-�"' `i ^ Front �C " (: ' Depth��" � � 'Fieight . �' C�� Sq. FL K �r. t% Cu. Ft. �Y ��
____ . Front Depth ... Height Sq. Ft. ._. Cu. Ft. _ __._.
�-1 c�_�--�.
'rype of Construction Est. Cost �iF:x �' ' To be Completed ...
In consideration of the issuance lo me of a permit to construct the building described above, I agree to do
the proposed work in accm�dance with the description above set Corth and in com�liance with all provisions of
ordinances of the city of Fridley. �� ! � �� �
%� .
. X � L _�_ � ` l ' ...,A '���. /[ � c� ✓ ( S /�
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 is granted upon
the es�ress condition that the person to �chom it is granted and his agents, employees and workmen, in all a�ork
done in, around and upon said buildin�, or any part thereof, shall conform in a❑ respects to the ordinances of
Fridley, Minnesota regarding locatiou, construction, alteration, maintenance, repair and moving of buildings
within the ciYy ]imits and this permit may be revoked nt any time upon violation of any of the provisions of said
ordinances. � :��
�!// .eO `�. / � ,C.c.!/.._... _ Building Inspector
--- -- -- --�—�--� "�
NOTICE:
7tiis parmit does not cover ehe sonsfr��lion, installalion for wiring, plumbing, ges he�fing, sewer or waler. B� s�r� lo �••
Ihe B�ilding Inspector for separafe permils for these ilems.
.�.��c
APPLICATION FOR BUILDING PERNIT
CITY OF FRIDLEY� NINNESOTA
, �i �
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Owners Name .��}�f.K�t� l/i � C�1t;±3 �� �,�- , Builder .�-���r�
,
Address �l yc)
L`uCATIOV OF BUILDING
No, a`��� Street �` �`2�'-_1 /�%� �, Part of Lo�t ���� �,�-�2c-��
,{� ti � t �-.- �lf- -
Lot � (� Block � Addi+ion or Sub.Div. ✓� ' ����' ' '
Corner Lot ,>>�,• Inside Lot Set Fack ��� ;� Side-Yard
SEWEFi ELEVATION ���T I� FOLTIDATIOh EL�VATION ,
Applioant attach to this form Certificate ef Survey of Lot and proposed building
location.
DLSCRIPTIODi OF BUIIJING
To be used as:.
� �, >
�-`�� � ; ,;._ Front �� � Depth � U Height
r
Sq. Ft.�`-, ;J C' Cu. Ft. ,'Y" A �-
Front Depth Height
Sq. Ft. Cu. Ft,._
Type of Construction �iZCt >/�C Estimated Cost !� ,�
To be completed �'�i=�, 1 � '�e �_
V
The undersigned hereby makes aFrJ ication for a pernit for the work herein specified,
agreeing to do all work in stric', accordance with the City Ordinances and ruling of
the Department of Buildings� an3 herehy declares that all the facts and representa-
tions stated in this applicatior. �re �rue and correct.
DATE \ F� / �� " �� �TGiv1�TUfiE —i; ./? i ` !� , � _ / � �/l,.�:
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(A Sche3ule of ree co;t.s can b� fcund on the r�everse Side.)
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City of Fridlev �
.
°����'°�°`���'�;'�s� gUILDING PERMIT
,�
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� ___ GOMMUNITY DEVEIOVMENT DIV
� � � PROIECTIVE INSPECTION SEC
,
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� � i'°1 � CITV HPLL FRIDLE� 55<JI �+uMBEa aE�
�""'�"� '' 612-571-3450 910-F15
:OB ADDRESS 540 Dover Street N.E.
t LEGAL LOTNO. BLOCK TRALTORAD�ITION
oesca. Z3-26 &10,12 B1. L Riverview }Ieights
2 PROPERTYOWNER MAILADORE55
Irvin Lindstrom 540 Dover Street N.E.
3 CONTRACTOF MAILADDRE55
Same
a ARCHRECTORDESIGNER MAILADOFESS
ENGINEER MAIL
DaiE
5/14/90
ziv
ziv
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�._..... ._ _ �
�20354 `
�CEfPT Nd.
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pF GPPROVEO 8�
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SEE FTTAGMED
SHEET
HONE
784-6656
'HONE LICENSE NO
'HONE IICENSE NO
IICENSE NO
6 USE OF BUII�ING
Residential
7 CLASSOFWORK
�� NEW C ADDITION C ALTERATION C REPAIR C MOVE ❑ REMOVE
8 OESGRIBEWORK
Construct an 8' x 16' Shed
9 CHANGEOFUSEFROM
STIPULATIONS
See notations on plan.
ro
SEPARnTE PERMITS AfiE REOUIRE� FOR ELECTRICAL PLUM8ING. HEATING,
VENTILATING OR AIR CONpITIONING.
THIS PERMIT BECOMES NULL ANO VDIO IF WOFK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT GOMMENCED K'ITHIN 60 DAVS, OR IF GONSTRUGTION
OP WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORk IS COMMENCED. NO OWIG. UNI'
I MEPEBY CERTIFV TMAT I HAVE READ AND E%AMINE� THIS APPLICATION 1
ANO KNOW THE SPME TO BE TRUE ANDCORRECT ALL GROVISIONSOF lAW$ yqLUAT10N
AND OFDINANCES GOVERNING THIS TvPE OF WpPK WILL BE COMPUED $(jOO
JJITH WHETHER $PEGIFIED HEAE�N OF NOT THE GRANTING OF q PERMIT
DOES NOT PRESUME TO GNE AUTHORITV TO VIOI./.TE OF CANCEL THE pERMITFEE
PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- $1'].00
STRUCTiON OP THE PERFORMANGE OF GONSTPUGTiON
^�CC'� «.*OaJa<J�Np0.1ZEC>6EN* .D�*E�
��: _ . � i. � � r' it i-.t� � � it ri �'/ - �V
OCCUPANCYGROUP OCLUPANCYLOAD
SO.FT CU.FT.
OfFSTREET PARKING
$TALLS GARAGE$
SURTAX
�.5�
$ACCHARGE
TOTALFEE
$1%.�J�
�RI V E HIS �5 YOUA PEAMIT
NEW [X] Effective 1/1/90
�� [ ] R-1 AND R-2
ALTER [ ] Building �xmit Application
Construction "�i�.
; � �,,." ,'t- i
IEQdl �725(,T1�10(1:
O�mer Name & JYidress: � Tel. # -
Contractor: Z+el. #
Address•
Attach to this application, a Certificate of SUrvey of the
lot, with the proposed oonstruction drawn on it to scale.
INa1G AREA: Letx�th
C�R7�GE ARF�: Length
DECK ARF�: Izrigth
OTt�R:
B
Width
Width
Width
. ��i�:•.,i��i�.��
Height _
Heic�t _
Hgt/Grwnd
Sq. Ft.
Sq. Ft.
Sq. Ft.
���
Corner Iot [] Inside Iot [, ] Ft. Yd Setback , Side Yazd Setbacks •. �-/�=
'Iype of Construction: � � .,._. Fstimated Cost: $ . .� .-, l� �
Approx. Cb�[q�letion Date:
Proposed Drivecsay Width If New Opening Is Desired: Ft. $ $
� (:' Width + 6' See Back Page
�ATE: '� � //%�%C, APPLSCANP: ,� } �,i.M�, LG� . ���ix�r���.. Tel. #
Permit Fee $ �
State Surr.hazge $
SAC C2�2Je $
Driveway Escrow $
Park Fee $
sewer Main �an�e $
y-`_` -r�:i
`mPAL $ � _ .
STIP[ILATZONS :
�� ..
CITY USE ONLY
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by II�4u�eruxl
Agreement Necessary [ ] Not Necessary [ ]
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� City of Fridlev
�
A'r�E `°° °` r�E'w'�5� gU ILDING PERMIT
•
COMMUN�TY DEVEL07MENT DN
r ��' PROTECiNE WSPECTION $EG
,
,
� � '-'1 � CITY MAL� FRIDIEv 55a32 ��'MBEa AFv
�°"�"' �' 612-571-3450 9t0-F�5
�oe nooaess 540 Dover Street NE
i LEGAL �OT NO BIOCN TRAGT OR ADDITION
oesca 23-26, 10— 2 L Riverview Hei
2 PAOPERTVOWNER MAILADDRE55
Irvin Lindstrom 540 Dover Street NE
7 CONTRACTOR MAIL ADORE55
Same
a AaCNITECTORDESiGNER M.51�ADORE55
5 ENGINEEA � MAIL ADORESS
6 USE Of BUILOING
Residential
1 CLASSOF WORN
I NEW
c�(:f
6/11/9 / /
P E R MYr-M1I@-�
��
RECEIP7 NO
,�a 7
q4VP(]Jf:] P♦
SEEATTALHEO
tS SHEET
ZIP PHONE
784-6656
ZIP PHONE LILENSE NO
ZIP PMONE LICENSE NO
PHONE LICENSE NO
C ADDITION ❑ ALTERA710N � REPAIR ❑ MOVE C REMOVE
e oescaieE woaK
Reroof House (15 Sq) Tear—off
9 GHANGE OF USE FROM
STIPULATIONS
ro
Underlayment must comply with the State Building Code.
rv
SEPARATE PERMnS ARE FEOUIRED FOR ELECTRIGAI, PLUMBING. MEATING.
VENTqATING OA /+IR GONO�TIONING
TNIS PERMIT BEGOMES NULL AND VOID IF WORK OR CONSTRUCTiON Z�
nUTHOAIZED i5 NOi COMMENCE� WiTMIN 60 D?Y5. OR IG CONSiRUC�ION
OA WOFN IS S�SPENOE� OR 4BANDONED FOR A PERIOD Of 120 DAVS AT
ANV TiME AFTER WORN IS COMMENCEO ry�
i HEREB� GERTIFY THAT I HAVE REAp AND EXAMINED THI$ APpLICATION
aND KNOW TNE SPME TO BE 1AUE AND COFRECT ALL PFOVi510N50F LAWS y�
aND OAOINAlvCES GOVERNING THI$ TYPE OF WORN WILL BE COMPLIED
P�i'H WNETHER SPECIFlED HEAEiN OR NOT THE GAr1NTING OF 4 PERMIT
L�^ES NOT PRESUME TO GNE AUTMORITV TO Y�OIATE OR CANCEI TME pp
PROVi5iON5 OF ANY OTHER STATE OA LOCAL LAW FEG�LATiNG CON�
SIRUCTIpN OR THE PERFORMANCE Of CONSTPUCTiON
s�cvn,,iuE.,�c..� nrrar+nAn�i..oa�zeo.aen. �on.e�
_ ryl �11.n � � —c: _�ii: �.. Ci'ri..,_ �i ' .; /=�/
'E
1
ATION
�1,237
ilT FEE
543.00
OCCUPANCVGAOUP OCCUPANCVLOAD
50 FT CU FT
OFFSTREET PAPKWG
$TALLS GARAGES
$URiAk
$.62
$ACCMAaGE
Fire SC $1.24
TOTALFEE
$44.86
RLY 4 IOe�EO iNiS i5 YOUR PEAM�
�ti' 1: �4'
:�u��n
AL"1'LR
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CI"I'1' U►� I�RIULF,Y
SINGLE FAMILY ANU DUPLI;XES R-1 AND R-2
f3UILllING PERMff APPL[CA"CION
I?I�f�c�i��c I/I/97
�,�9a �
ConstructionAddress: ���' �'c '�-'c� i�' `, t i�° �(_" 7
L.egal Description: _ ;�,��� 1� �u r� i �)�, ni u�r f �� i�� �
Owner Name & Address: �k' �' i n. �,�/ I i ��: Y', `� `r' - r'� � 1'eL N - ") v�/ �. l, z-6
Co�tractor: MN LICGNSE1t
Addresr. Tel. q
Attach to this application, a Certificate of Survey of the
lot, with the proposcd construction drawn on it to scale.
DESCRIYCION OF IMPROVEMENT
LIVING ARI;A: L.ength _ Width Height
GARAGE AREA: I.ength . Width Height
DECIi ARF,A: Length Width Hgt/Ground
OTHER: J i' ;� , 1!i ,
Construction Typc:
Driveway Curb Cut Width Needed:
DATE
Permit Pee
F'ue Surcharge
State Surcharge
SAC Chargc
License Surchar�,e
Driveway Escrow
Erosion Control
Parf: Eec
Sewer Main Char��c
To r�v
s'rt[�ui_n�ri���uti:
APPLICANT:
Sq. Pt.
sq. r-c.
Sq. Ft.
, � �
Iistimated Cost $ �,� � � 'j 0
(Fee Schedule on Back)
Ft. + 6 Ft = Ft x$ _�
�''r '�
_.".� �C , , il�l'�.. �crr,
CITY USE ONLY
Tel. # - , -_
$ ��,U" Fee Schedule on Reverse Side
$ ��y .001 of Permit Valuation (1/lOth%)
$� $.50/$1,000 Valuation
$ $950 per SAC Unit
$ $5.00 (State Licensed Rcsidential Contractors)
� Alt. "A" or Alt. "f3" Above
� �450.00 Conservation Plan Review
$ Fce lleterniined by Gngineering
$ Agreement Necessary [ ] Not Necessary [ ]
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� City of Fridley 3 0 5 4 7
.
�, TME TOPOF.�E.W�NS gU ILDING PERMIT
� , No
,
' ' COMMUNITY DE�ELOGMENT DIV
. ��-------. 7 �a��
f � PROTECnVEiNSVECTION SEC �
�
i �
� �"'\ � C17Y MA�L FRIDLE� 55�]i NuMBEA aEV 0�*E o�Gf 0� �VaqOVFD !•
�----�•' '•' etz-5�i-3a5o a,o-F,s / /
11/24/99
IOBADORE55 540 Uover Street :VE
t LEG�I LOi NO 10-12 BLOCK TRACTOR �DDRION SEE ATTACHED
DESCA 23-26 & L Riverview Heights SNEET
I PRO�EfiTVOWNER MAILADORE55 Z�P PHONE
Irvin Lindstrom 784-6656
7 CONTRACTOR MAILADDRE55 ZIV GMONE UCENSENO
Seal Guard Systems 3770 Dunla Ave N Arden Hills 55112 717-0700 20093688
� AfiCMITEGTORpESIGNEN MAILADDRE$$ ZIP VHONE LICENSENO
5 ENGINEER MAILADORESS ZIP PHONE IICEN5EN0
6 USE OF gUILDING
Residential
7 CLASS OF WORIf
O NEW ❑ ADDITION ❑ ALTEFATION � REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORI(
Replacement windows
9 CHANGEOFUSEFROM TO
STIPULATIONS
dOteCtols
Provide smoke ���`���`���` in all sleeping rooms and on all levels of the dwelling.
Perr�it Inspec$ion Cards
Will Be Mailed
To Homeawner To Pflst
TYPEOFGONST OGGUPANCVGAOUV OCCUP�NC�LOAD
SEP4R4iE PERMITS ARE REOUIqEO FpR ELECTfiICAL. PLUMBING. HEATING.
VENT�UTING OR AIR LONDITIONING
in15 vERMiT BECOMES NULI ANO VO10 �% WOFK OR CONSTRUCTION 20NING 50 fT CU FT
/UTMORiZED i5 NOT COMMENCED W�THiN 60 04v5. OR IF CONSTRUCTION
OR WOAR I$ SUSPENDED OR AB�NDONED FOA A PERIOD OF tpp D�V$ �T
ANY TIME AFiER WORM I$ COMMENCE� NO DWLG UNITS OFFSTFEET PARKING
I HEAEB� CEFTIFV iHAi I MAVE AEAD AND EXAMiNEO TMIS �PPLIL/TiON ST4LL$ GAR/GE$
4N0 KNOW iHE SAME TO BE TRUE aND CORAECi A�� PqOVISIONSOF �AWS yA�U>TION SUFT�%
nND ORDiNaNGES GOVEFNING THIS TvvE Of WOPK WiLL BE COMPLiE� @
W'iTr WHEiHER $PECiFIED HEAEiN OA NOT iME GR4NTING OF A GERMIT �3SI� p1.HO
OOES NOT PFESUME i0 GIVE AUTnORITY TO �iOL�TE OR CANCEI THE pEqM11FEE $ACCMnRGE
PaOV1510N5 O� >NY OTHEA ST4TE OA LOCAL L>W REGUL�iING GON-
STRUCTION OA ir+E �ERFOAMAN�E Of CONSTRUCTiON �9�.ZS F1T0 C�3.60
PL4NCMELI(FEE LOi F E
Licen S SS 0 3 0.65
SL�+�UnED�CON'o��rJAOA�u�+Ca�:ED�GEa� - iO�•F� EN R VOL�D N�5 �S Y U=�Mii
4' �
SGro����af p� Owl+Fa �i OWnEPBVrtDEA� iD�1E�
Bl G �+5 ��I
NEW I l
ADDN
ALTER
Effective 5/10/99
[ ] CITY OF FRIDLEY
[] SINGLE FA.�IILY A:`� DUPLEXES R-1 AND R-2
BLTILDING PERMIT APPLICATION
Construction Address:
Legal Description:
�f(:� I>( l���r `
�.
�� �
,, `� �����-
��
Owner Name & Address: � b b I 1 I � i I��(���fY( /}�''I >>�i�' �k brl� ��� . Tel. 1/ ���/ �<?�i1�J�D
Contractor. ���Ii_� ��1(1�lYi� �I��fY1 �� MNLICENSE#-;i(���ji���
Address:�/I�i1- �JLII��(l�-� ������ �- �"�}ll�l � ��i���' <_f>l��i TeL# (i���,?'7/�)��%�C�_!
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
Length
DESCRIPTION OF L�IPROVEMENT
Width
W idth
Width
Height _
HeiQht _
Hgt/Ground
Sq. Ft.
Sq. Ft.
5q. Ft.
ConstrucCion Type: ����«� �� � f� � j t� �� 'I � ���L ���Estimated Cost: $ -����f � � , ( (�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$
_ $
n�.�: ' I � � � � ArrLica:�T: %�l I L�� `l ( l � l � �( � 7. ��� �. �J Te�. a � ' � ' ? I � l ! ��( �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ 97�.��
$ �, � 0
$ /, .�0
$
S �.00
$
$
$
$
$ /�'l �'���
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valua[ion (1/lOth%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
s�e�cc* MIT NO. `
��City of Fridiey � 3 0 6 3 7
.,THET070F,�E,W,NS g�ILDING PERMIT �,
� 'RECffPT NO. /
� . COMMUNITY OEVELOPMENT DIV
r � y PROTECTIVE INS�EC��ON SEC �/C�
1 �
1 �
� �•--1 � CITY HA�L FRIDIE� SS�72 NUUBEM AEV D�TF v��f O� �iVRpvED Bv
�""'�"� '' 612-571-3450 g�0-F15 1/21/00 / /
ioe aooaess 540 Dover Street NE
t LEG�L ��TNO BLOCK TRACTOAADDITIOH SEEATT�CMED
oesca 23-26, 10 12 L Riverview Heights sMeer
7 PAOPERTYOWNER MAILADORE55 Z�� PHONE
Irvin Lindstrom 540 Dover Street NE 784-6656
J GONTRAGTOR MAIL ADORE55 Z�P PMONE LICENSE NO
Seal Guard Systems Inc 3770 Dunla Ave N, Arden Hills, MN 55112 717-0700
� nRCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO
20093688
5 ENGINEER MAI� ADDfiE55 ZIP PMONE LICENSE NO
fi USE OF BUILDING
Residential
7 CLASSOFWOPN
❑ NEW ❑ AOOITION ❑ ALTERATION [� REPAIR G MOVE ❑ REMOVE
8 OESCR�BEwORR
Replace windows
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms attd on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
CALL fbh rll�l�HL Ir�a:3t �:'r;s,;,
WITHIN 10 DbYS pF INpp� perm�� �nsp�ciion Caeds
COMPp.�TrnN Wi11 Be Malled
��'p�' �� '`��� � ' """''°'�'" To Homeowner To Post
TVPEOFCON51 OCLU�ANCVGROUP OCCUOANC�LOnO
$EP/A4TE PEAMIiSAFE REOUIFED FOA EIECTRIGAL. PWMBING. MEATING.
VENTIIAT�NG OA AIR LONDITIONING
THIS PEAMIT BECOMES NULL ♦ND VOID IF WORN OA CONSipUCTION zONING 50 Fi W FT
AUTNOA4ED I$ NOT GOMMENCE� WITMIN 60 DAY$ OR IF GpNSTRUCTION
OA WORK i5 SUSVENDEO OR nBANDONEO �OR � PER100 OF tzp D�vS AT
nNV TiME �FtEA WORM IS COMMENCED NO DWLG UNITS OFfSTFEEi GARKING
I HEREB� GERTIFY iHAT I NAVE FEAD P.NO E%P.MINED THIS APpLiUTION 1 STALL$ GORAGES
RNpKNOW iHE 54ME TO BE TRUE ANpCORAECT ALL PROVISiON50F LAW$ VAWATION $UAT�%
nN0 DAOINnNCES GOVERNING THI$ TYPE OF WOFN WI�L BE GOMP�IEO Q
WiTH WMETHER SPEG�FIED MEAEIN OA NOT TNE GFANTING OF 11 pERMIT SS,997 y�2 • JJ
DOES NpT PRESUME i0 GIVE AUTHOAIiV TO VIpLATE OA G4NCEl 1HE pEqMITFEE $AC�M4RGE
PaOV1510N$ O< <NV OiNER $TATE OA IOCAL LAW REGUTAiING GON-
STqUCiION OP TNE �EAFORMANCE OF CONSTAUCTION ySiZS.ZrJ T'1T C$5.99
PLANC�+ECMFEE TOT �EE
Li $5 $139.23
S�G�r��bef O�:OV'A�Ci0A0A�v•�OAKED�GEat i0�*E� HE 1' V L E Tw5 �S _UA PEA=�
S�Gw�o4fO�OwmEP���Ow�.EaOW��EA. �D��F B� G �n5� •�!
I`�' [ ]
ADDN [ ]
�-'I'� [ l
CiTY OF FRIDLEY ':. 6�t
SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
Effective�/1/99
�
�
BUII.DING PIItMIT APPLICATION i � �
�
ConsavctionAddress: ��� �''� �' �` t' � �% Y� F'. �
Legal Description:
Owner Name & Address: �� }' l i"� � i 1
�� F �' Tel. /!
Contractor. �� � j' i , `� � `� ' � iL MN L.ICENSE�f ���LU��(L ���
Address.���%�%f�� �JL�ILjC� � L�"L ��� � '��1'/� ��/��.`� Tel.lf %/� �%��7�7�L.'
Attach to this application, a C'ertificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Length
I.ength
Length
DESCRIPTION OF IMPROVEMENT
Wid[h
W idth
W idth
Height Sq. Ft.
Height Sq. Ft.
HgUGround _ Sq. Ft.
Construction Type: ;�F �C(,��'I%ZE'/ � t ��ll�u,{,� �� j Estimated Cost: $ � ��� � � � �%
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x$ _$
DATE:
APPLICANT:
CITY USE ONLY
Tel. 11
� �- � -
Permit Fee $�.� ��� Fee Schedule on Reverse Side
Fire Surcharge $� .001 of Permit Valuation (1/l0th%)
State Surcharge� �fCI$ $.50/$1,000 Valuation
SAC Charge $ $1050 per SAC Unit
License Sureharge $ J�� $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary []
��.��.,
STIPITL,AITONS:
$ � ��1 � �
sva�ecr PE .
�City of Fridley 3 0 8 6 5
�TTMETOPOFTMETWiNS gUiLDING PERMIT
� � RECEIPT NO.
� ��__.____ COMMUNI�Y DEVELOPMEN7 pIV ��� n
r � PROTECTWE MSPECTION SEC �y
�
� �
� �"'1 � C�TY MALL FRIOLE� SSQ7 NuMBfP aEV O�iE P�GE Oi •vnnOVEO B•
l--°�' ,•' 612-571-3450 9t0-Fi5 4/26/00 / /
lOB ADDRESS 540 Dover St NE
1 LEGA� LOT NO. BLOLN TRACT ORADOITION SEE ATT�CHED
oesca. 23-26,10-1 L Riverview Heights SNEET
2 PRO�EfiTYOWNER MAI�ADOFE55 ZI� vHONE
Irvin Lindstrom 540 Dover Street NE 784-6656
] CONTRACTOR MAIL r1DDRE55 ZIP VMONE LICENSE NO
Seal Guard Systems Inc 3770 Dunlap Ave N, Arden Hills, MN 55112 20093688
� ARCHITECTORDESIGNER MAILA�ORE55 ZIP VNONE LICENSENO
�1%—�%0�
5 ENGINEER MAII �DDNE55 ZIG iMONE IICENSE NO
6 USEOFBUILDING
Residential
] CLASSOFWORK
❑ NEW ❑ ADDITION ❑ ALTERATION �7 REPAIR O MOVE ❑ REMOVE
8 DESCRiBE wORR
Replace windows within existing openings
9 CHANGEOFUSEFROM 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.
SEPARATE �ERMd�3��
Per�it Insp�ctd�n ��r�s REQUIRED FOR:
Wili Ba Maiied V1►�RING, NEATiN6,
To Hors�eowner Ta Pasf �'�uMa�n�c A�� ��1�:��:
TvPEOFCONST OCCU�ANCYGAOUG OCCUPANC.L04D
SEPARAiE �ERMrtSaRE HEOWAED �OR ELECTH�W�, P�UMBING. MEATING.
VENiILATING OR AIR CONDITIONING
iH15 PEAMIT BECOME$ NULL eND VOID IF WOAK OA CONSTpUCTION ZpNING $O FT CU FT
4UTHpqiZED IS NOT COMMENCED W�TMIN 60 �f Y5. OR IF GpN$iRUGTION
OR WORN t5 SUSPENDED OR ABANOONED FOR A PERIOD OF 170 D��S AT
ANY TIME 4FTER WOFII IS COMMENCED NO DWLG UNITS O�FSTHEET i�RNING
i NEREBY CEFT6v THAT I HAVE FEAO ANO ExAM�NEO THI$ AGGLiC�iION 1 STALL$ G�AAGE$
ANOKNOWTHESr1MET08ETRUE�NpCOAAECT �LLPPQVISIONSOF��y�$ y1LUATiON $UAT�%
nND ORDIN4NCE5 GOYERNING THIS ivPE OF WOAN WILL BE GOMV�IED
WiTn WHETMER SPEGFiED HEAEIN OR NOT THE GR�NiiNG OF q pEAM1T �4,998 SZ.SO
DOE$ NOT FFESUME TO GIVE AUiHOAITV TO VIOUTE OA C4NCEL TH! pEpMIiFEE SACLHARGE @
PROVISIpNS OF qNY OTHER STAiE OR IOCAI LAW REGUUIING CON- Q111.ZS F T'2 SC y�S.00
SrRUCnON OA THE oEAFORMANCE OF CONSTRUCTION w
PLON CHECN FEE T i>� FEE
License C $5 $123.75
c�py�•�oE 0� COn"a�f•OAOAw��OP�tED�GEV� ���*E� ME �QO � V4 ED TH5 �S YOU P Mli
� ��
SGrvat'�qEO�OWNfo,.[ON�+EABV��DEa� �O��Ei p.y5� ��t
NEW []
ADDN []
ALTER [ ]
Construction Address:
Legal Description _
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-'1 AND R-2
BUILDING PERMIT APPLICATION
!
Effective 1/1/2000
(763) 572-3604 Bldg Insp
���� ���
�-, `� C I �, r� �
OwnerName&Address:�( V'�(l Li�lc''�f-('(;(Yi ��� `��Ie('<�j-� Tel.#l�l�'12��i• �n�,�S�O
Contfactor: �����._� � ��1 �( iV C� �7) ����-� -{�{� MN LICENSE # �L��% ( �J �r � �
Add�ess:����>>����n\c�,��1��c .�1.A�-�A�r� R��\I r^n�� ��,Ilhre�.#L �� ���-u70c�
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIP?!C1N pr IMown�iF�ycNT
Length Width Height Sq. Ft.
Length Wdth Height Sq. Ft.
Length Wdth HgUGround Sq. Ft.
Construction Type:tt� ����Ce iY-k' �1� ��i �� t1c� C>U=f�Estimated Cost: $� CC� ��; O
Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x$ -
DATE: � I I �� 1�� APPLICANT: C -(��� G � � ����i" �� � i � i Tel. #�,,� I � �� � � C��C��
I
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
Call (763) 572-3604 for Permit Fees if mailing in application
$/l/� �.5� Fee Schedule on Reverse Side
$_�. O6 _ .001 of Permit Valuation (1/10th%)
$ �J. �v $.50/$1,000 Valuation
$ / $1100 per SAC Unit
$�� Z> � $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$
$
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ - °�� �� � %S—
STIPULATIONS: �Ov/�� c���/�� �iC(��/z� /.�! /i � G
G �
���i�� ��� i..� �q� �_ l�v�G� a� �-��- l��J�
��–L �� . 3�� . 5? i. �—. i�' 97 �.,� ��.
soe,cc* fnG1T NO:
City of Fridley 3 i 6 u 3
AT TME TOP OF TME TWINS
; BUILDING PERMIT
� REG�IP7 NO. �
� � _ ____ GOMMUNITY DEVEIOPMENT pIV
� PROTECTNEINSPECTIOH SEC
r � L � �,
�
, ; ,
"'� • C17Y MALL FPIOLE� S5�]2 NuMBEa AF� D�if P�LE O� ♦GVNO E� B+
�•---�.�' •.' 61�-571-3450 910-F15 3/6/O1 / /
lOBA00RE55 540 Dover Street NE
t LEGAL ��TNO BLOCK TRACTONADDITION $EE�TT�CNED
oesca 23-26,10-1 L Riverview Heights SNEE7
i PROPERTYOWNEA MAI�AODRESS ZIP PMOHE
Irvin Lindstrom 540 Dover St NE
� CONTqACTOR MAIL ADDRESS ZIP PNONE UCEHSE NO
Seal Guard Systems 3770 Dunlap Ave N, Arden Hills, i�IN 55112 651-481-7888
a ARCHI7ECTORDESIGNER MAILADORESS ZIP VMONE IICEN5EN0
20093688
5 ENGINEER MnIL R�DRE55 ZIi GHONE LICENSE NO
6 USE OF BUIID�NG
Residential
7 CLASSOFWpRK
❑ NEW O ADDITION ❑ ALTERATION j7 REPAIR O MOVE ❑ REMOVE
8 �ESCRIBE WORK
Replace doors
9 CHANGEOFUSEFROM TO
S7IPULATIONS
Provide smoke detectors in ali sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Any
change i.^, header size or change in door opening needs to be submitted
for a plan review.
�er�i� ��s���;tian Cards
Will Be Mailed
�v� .��ir���n,rs��',:,?: '�at d��St
TVPEOFGONST OCGU�AHCVGFOUP OCCUPpNC�l04D
SEPnRnTE PERMITS r1FE AEOUIRED FOR EIECiRIC4L. GLUMBING. MEATING,
VENTILAiING OR AIR CDNDITIONING
THIS PEAMIT BECOME$ NVLL AND VOID IF WORK OR LONSTRVC�ION LONING 50 FT LU FT
/.UTHOF4E0 IS NOt COMMENCED WITHIN 60 DA�S OR IF CONSTRUCT�ON
OR WOAK i5 $US�ENDED OA ABANDONED �OR � GER100 OF 110 DAVS Ai
ANY iIME AFTER WORI( IS COMMENCED NO DWIG UNITS OfF$TNEET ��RKING
I HEAEBI' CEFTIFV iHqT I MAVE FEPO ANO E%<MINED THIS ACPLIC�TIQN 1 ST�lLS G�AAGES
AND NNOW THE Sr1ME TO BE TFUE ANDGOFREC� ALL PROVISiONSOF �AW$ yq��ATION $URiAx
nND OFDINANCE$ GOVERNING TNI$ TVPE OF WOAN WILL BE COMPUE� G
WILM WMETNER $PEUFIE� HEAEIN OA NOT TME GR4NTING OF � pERMIT �S p VOL �Z.BO
OOE$ NOT vRESUME TO GIVE AUTHOAiTY TO VtOI�TE OA CANCEI THE vERMi�FEE 54CCMARGE
PAO'+i510N5 Of 4NY OTMER $TATE OR LOCA� L4W REGUL�iING CON- SI25.25 F1Te SC �S.CJO
S�RUCTiON OA TNE �EAFpRMANCE OF CONS�AUCTiON
PLAN CHECN FE TqL �E
Lice S $5.00 $1 .65
S�Gw��UAEO�COF"a�fr0404����0AiZED�GEh* i0�*E� EN O�EAL� >TE 515 YOUA PEAMii
—_ � / ��/
— �cfp ,mEC �O.vnFCB��iJfa� iD�+C. Bi0 m5o ail
NEW []
ADDN [ ] CITY OF FRIDLEY
ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: �� L> 1J( j�,� f' ���i
1 \E _.
Legal Description: _
Owner Name & Address:
!_ , .
��
LIVING AREA:
GARAGE AREA
DECK AREA:
OTHER:
Effective 1/1/2000
(763) 572-3604 Bldg Insp
e �; �,
:„' � ) Tel. #
. MN LICENSE #�(� �� � � p
, N rI I�Te�. #1�`� 1 y(1 � 1 d 4 O
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IM°ROVEMENT
Length Width Height Sq. Ft.
Length
Length
Wdth
�1�9C:iii
Height _
HgUGround
Sq. Ft.
Sq. Ft.
Construction Type: �P��(� 4(1'���1� I X�i���Estimated Cost: � �,� 9 Ur� ���
Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x S = 3
DATE: _� ' (% � � U T APPLICANT� � l � o � 4 \-iu �'.P % Tel. # � I '� � � � Q � �
�G
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
Call (763) 572-3604 for Permit Fees if mailing in application
$� r�`� a� Fee Schedule on Reverse Side
$`.5 �c� C� .001 of Permit Valuation (1/10th%)
$ c� - � �% $.50/$1,000 Valuation
$ $1100 per SAC Unit
$ � • ��� $5.00 (State Lic�nsed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ 3 � � l� `�
STIPULATIONS: �p y/�C �-�-o,�� �ET�G! o�� ���-
S�c. 3�0. 9. / Y,�95'7 � .�,C• �,✓� �f/A�t��
i.� ��-s�o�- ��zE �� �'.�/-9-��" /.� �°° a�_
�-s...,�� •ci�-�D ,�1.4-�' ��1���,G�/.
SaB�EC*
� City of Fridley
�
�.TNETOPOfTHETWINS gUILDING PERMIT
,
.
COMMUNITY OEVELOPMENT DIV
� � y PROTECnVEINSPECTION $EC
�
i .
i �
� �'^� � CITY MALL FRI�LE� SSA2 nuMeEU AEv
�'""'�" �' 763-571-3450 910-F15
lOB nDOAE55 540 Dover Street NE
� LEWL LOT NO BLOCK TRACT OR ADDITION
oesca. 23-26 & 10 12 L Riverview Hei
7 PNOPERTV OWNEF MAILADDRE55
Harriet & Irvir, Lindstrom 540 Dover Street NE
7 CONTPA�TOR MAILAODRESS
Seal Guard Systems 3770 Dunl2p Ave N, Arden H
� ARCMITECT OR DESIGNER M�IL ADORES$
5 ENGINEER
MAII A
Residential
1A550F WORK
G NEW ❑ ADDITION ❑ ALTERATION
ESCRIBE WORI(
Replace wir.dows within existinQ openings
9 CHANGE OF USE FROM
To
D�iF
2/6/03
/ /
33339
_55�
OvE� B�
SEE �77�CNED
SNEE7
763-784-6656
ZIP vMONE LICENSE NO
5112 651-481-7888
21v VMONE IICENSE NO
20093688
ZIG vHpNE IICENSE NO
❑ FEPAIR ❑ MOVE ❑ REMOVE
Yt
STIPULA710N5
Provide smoke detectors ir. all sleepir.g rooms and on al: ieveis of the dae'_iing
per Sectior. 310.9.1.2 0: the 1997 Uniform Building Code. Caulk and flash ail
e::terior openir.gs.
�'e��pa �nspectian �����
4Uill Be Mailed
�o �i��;�Ro�+�t�� % Pas�
ivPEOFCONST
SEPI RATE PERMIiS ARE AEOUIRE� �OA ELECTRICAL, PLUMBING. MEATING.
VENi1LATING OR AIR CONDIiIONING
THI$ PEAMIT BEGOME$ NULL ANO VOID IF WORK OR CONSiFUCTION ZONING
/UiHOA4E� i5 NOi COMMENCED WITHiN 60 Da'/5. OR IF �ONSTRUCTION
OA WORR IS $US�ENDED OA AB4NDONEO FOA A 7ER100 OF tjp D��S AT
ANY tIME AFTEA WORn I$ COMMENCED NO OWIG UN
I NERE9Y CERTIFV iHAT 1 HRVE READ AND E%AMINED TMIS APP�IC4ilON 1
aN0 KNOW TME SAME TO BE TRUE ANO CORAECT �LL PROVISION$ OF �AWS ypLU/.TipN
4ND ORpiN<NCES GOVERNING THiS TVPE OF WpRN WiLL BE COMPUED @
WiTN WHEi„EA SPEGFiED HEAEiN OP NOT THE GA4NTING OG � pEAMIT WZ�OOO
DOES NOT vaESUME TO GrvE �UT�OARV i0 viOLaiE OF C�NCEI iwE pEqMiicEE
vqOyl$ipN$ O� 4HY OTHEF Si4iE OA LOUI lAW AEGUlAi1NG CON-
SiRUC1iON OA TNE PE(iFOAMANCE OF CONSTFUCTION $69.25
�ic
S�Gn�•�nE] COa'ac^OOOO��r..CA':EC�uEM1� �G✓b
OCCUPANCYGAOUP OCCU�>NC�1040
SO FT CU FT
O�:STAEET P�RKiNG
ST�LL$ G�A>GES
$URiAX
�1.��
S�CCMARGE
Fire SC $2.00
TOinl/FEE
5 0 $ .25
�v v>�iDAiED N6 �5 YOUA �EAMI'
A/_ l' �- � � � �V
NEW []
ADDN [j
ALTER ( ]
i
Construction Address: %'�t�
Legal Description: I�'i_! �'
Owner Name(& Address:
Contrector. )� �': � �
Address �? �� U b i:
LIVING AREA:
GARAGE AREA
DECK AREA:
OTHER:
1(' t �i'4 ��
Effective 1/1/2001
CITY OF FRIDLEY (763) 5723604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
�r �1jL� l ;'.t�
�
ii �"
� '>�:��)Tel.# �'�.� ����r; } ��(�r�J(�
MN�LICENSE # � i ( �1 �( / � `
r��(� •�}�'i �' Tel.#��.i°�I�`�\� 1��` �
1,�1 r I i�J ��� I l! -
Attach'to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
Width
Width
Wdth
Height _
Height _
HgUGround
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: � �� � ��V� (: � b' � '��� �(,( �' (� % j'� i��l Estimated Cost: S ���� �� �� �-'� � � �� �
Driveway Curb Cut Wdth Needed: _Ft. + 6 Ft =_Ft x S =
DATE: �I` i��� ) APPLICANT: ��� I� I- �� '�' 1I C� �iL {,�
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Tel.# ��� ���� 1����
Permit Fee (� %�� �� -� �� Fee Schedule on Reverse Side
Fire Surcharge ,,' p6� �-,{; 001 of Permit Valuation (1/10th%)
State Surcharge � �Y�$ ���� $.50/$1,000 Valuation
gqr �h?��A ��_g���n ror �p,C i i���
License Surcharge'� $� ;,-{�--$5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge � Agreement Necessary [] Not Necessary []
TOTAL
STIPULATIONS:
I'l .-1 $ c�+� ��L�
�; / a/Gl 0 3