AF - 40811,-,n �-,�--,, �
City of F�idley, inn �"
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BUILDING PERMIT No _ s4�1
Date: '— °°°
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Owaer: Builder _._�.��. - � ,
Address � Address
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O I BUILDING
PTe. ...1���. street _ I�����______. Part Lot
Lot ��_ Slock � Addition or 5ub-Divssion °
B
Corner Lot _� 7naide Lot � Setback � Sideyard � �e
Sewer IIevatian ____— _... Founda.tioa IIevation
DESCRIPTION OP BUILDING
To Used �,�Q
t Depth � Height !2°� Sq. F't L��_� (�. F't��� ��
Depth � I�eight _.�C.�� Sq. Ft ��' �� Cu. Fk ��
t�
Zj►�e oE ction F�t � �°�e Completed
In consideration oP the issuance to me of a permit to construct the building descrlbed above I agnee to do
the proposed work in accordance with the description above set forth complianc:e wl'fh a�1 Provisions of
or8inances of the dty oP Fridley. @ ,
e
In conaideration oP the payment of a fee of $4��� , germit is hereby granted to
to construct the building or addition as d�crlbed above. This �ermit is granted upon
the expresa conclition that thepera�n to whom it fs gran,ted and hia agenta, employees and workmen, in all work
done in, around and upon said building, or anypart thereof, st►all cwnform in all reapecta to the ordinances of
Frldley� Minnesota regarding location, conatruct�on, alteration, maintenance, repair and moving of buflaings
witbin the dty ]imits and thia permit may be revoked at any time upou violat%n of aay of the provisions of said
ordtnanc�. _ � il s-1
Builrling Inspector
� NOflC�
11� p�rmtt does nef wrer t6s eemtruett�, �oe tor vdeieg, ptumbteg, eas heNteg, ww�e er w�er. B� sure to a�
tlw Buildt� lesp�ctoe tor uparai� p�An6s Mr fhu� �ms.
HARVEY q, CARTWRIGHT
ANOKA COUNTY BURVEYS
MENNEPIN COUNTT SURVEYS
MINNEAPOLI6 SURVEYS
H410 PALM STREET N.W.
SUNBET 4-7g$$
OWNER
INDUBTRIAL - JUDICIAL
BUSINESS - TOP06RAPHICAL
CITY LOTS - PLATTING
A1 '�Jilliam
CARTWR=G�IT & OLS0111
LA1VD SURV"EYORS
R6G1lTERiD UNDfiR LAW6 OF BTATE OF MINNE90TA
LICENGEO BY ORDINANCL Oi CITY OF MINNEAPOLIB
326 PLYMOUTH BUILDING FEDERAL 8-8721
HENNEPIN AT SIXTH • MINNEAPOLIS 3. MINNESOTA
l��rbepor's �ertif�catc _
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COMBINING TME RECORDS OF
J. E. HILL. Civi� ENGINEER
EBTABLI6NED IBOE
C. F. SANDHOFF
CIVIL ENGINEER
ESTABLI6FIE0 IGO&
JAMES NELSON
SURVEYOR
E6T4BLIBNED 1D22
METROPOLITAN LAND
SURVEYORS, ESTqBLISMED /p�1
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I hereby certiFy that thia fe a trae and correci representation of
the houndariee of Lot 2, Block 1, Schultq Addition snd of the locat3on
of all i�uildingq,if' any, thereon„and a11 �iaible encrcachmente„if any,
from or oa said laad. Ae snrveyed bF me this 10 th day oP Apr31 1959.
Sca le I'� 30' ,
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SIGNED�"'°�r��.�°� ��:.:;_ .;�'��,... - �;-: � , .
-��°°,s,% ��� C_ WRIGHT AND OL90N ��=��
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City of Fridley
AT TNE TOP Of TNE TW�NS � � I L D I N� P E R M I T
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� ; y ___.._ COMMUNITY DEVELOPMENT DIY.
r � � PqOTECTIVE INSPECTION SEC.
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L._-_�� �"' �'� CITY NALI FRIOLE� SSIS2 NUMB@N pB�
t 612-571-3450 91Q-F15
JOB ADDi;ESS 6190, 6192 East River Road NE
t LEGAL ��T NO. BLOCK TRACT OR ADOITION
oesca. 2 1 Schultz's Addition
2 PROPERTY OWNER MAIL ADDRES$
Robert Fetrow 7061 Hickory Drive NE
3 CONTRACTOR MAIL ADORESS
Same
d ARCMITECT OR OESIGNER MAIL ADORESS
5 ENGINEER MAIL AODRESS
8 USE OF BUILDING
7/26/00 � /
21P
ZIP
ZIP
PERM��� _
I =31252
RECEI�T NO.
���
o� �OnnovEO er
/
SEE ATTACMEO
SFIEET
PMONE
763-572-8641
PHONE LICENSE NO
PHONE LICENSE NO.
PMONE IICENSE NO
7 CLASS OF WORK
❑ NEW O ADOITION O ALTERATION [� REPAIR O MOVE O REMOVE
8 DESCRIBE WOflK
Reroof Duplex, 37 Sq, Tear-off
9 CHANGEOFUSEFROM TO
STIPU�ATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PIUMBING, MEATING,
VENTILATING OR AIR CONOITIONING
TMIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTFUCTION 20NING
AUTHORIIED IS NOT COMMENCED V�fITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOF A PERI00 OF 1p0 OAVS AT
ANY TIME AfTER WORK IS COMMENCED NO. OWLG. UNITS
I MEREBY CERTIFV THAT I HAVE FiEAD AND EXAMINEO THIS APPIICATION 2
AND KNOW THE SAME TO BE TRUE AND CORFiECT. ALL PROVISIONS Of LAWS VAlUAT10N
AND ORDINANCES GOVERNING THIS TVPE Of WOFiK WILL BE COMP�IED
WITM WHE7HER SPECIFIEO HEREIN OR NOT. TME GRANTING OF A PERMIT �3sOOO
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEL TNE pEqMIT FEE
PROVISIONS OF ANY OTNER STATE OR IOCAI LAW REGULATING GON-
STRUC ION OR TME PERFORMANC� OF CONSTRUCTION ��3.25
� � -��/��--��� � ,r PLAN GMECK FEE
� �rv �° � Ci ic�
SiGNATUAE O� CON:AACTOp OA AUTNOp4ED AGENT DATE� M p �
S�GNnTUaEO�OWNEa��fOWNEp8WL0@A� � •TE� OG �N5�/
� _ �
STA�LS
r
PANCV�OAD
CU iT
OfFSTREET PARKING
GARAGES
SURTAX
� $1.50
SAC CMARGE
F re SC $3.00
T A� FEE
$87.75
�
NEW []
ADDN []
ALTER [ ]
Construction Address:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
�� l %/�f 9"� ��-5�- �l ��Y ��
Effectivve 1/1/2000
(763) 572�604 Bldg Insp
P � ����
��
Legal Description:
Owner Name 8� Address: %���v� �� %^�-�G'� � Tel. # ��v� �8
Contractor. 5��7- MN LICENSE#
Address: v �(� ��� y %t�d, Tel. #��� 7$
LMNG 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.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length
Length _
(�-e.
Width Height Sq. Ft
Wid Hgt/Ground Sq. Ft
�' � � �_S'�' ���o�
Construction Type: Estimated Cost: $ �
b�D �
;>,
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
J� DATE: � APPLICANT: Tel. # � �` ���`` �
/�
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ .� o?s� Fee Schedule on Reverse Side
Fire Surcharge $ �� (�O .001 of Permit Valuation (1/10th%)
State Surcharge $ /, �7� $.50/$1,000 Valuation
SAC Charge $ $1100 per SAC Unit
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
Sewer Main Charge
TOTAL
STIPULATIONS:
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
�
$ - %s
,
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BUII.DING PERMIT FEE SCHEDULE
The Cluef 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 fee,s to the amount herein
below set forth and in the manner herein .provided to-wit:
TO'FAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,0�
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1;000,0�
$1,000,001 and up
��
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,(�0
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
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 $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $SOO,OQO
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,OQ0 or fraction thereof, to and including $1,000,(�?0
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1, 000 or fracdon thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete C�ub Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it .has it has been constructed will
be required before proceeding with the framing. New Houses Onlv