AF - 40862sue�ecT PERMIT
City of Fridley � 12442
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
; � ECEIPT NO.
� �L _ COMMUNITY DEVELOPMENT DIV. �
r � � PROTECTIVE INSPECTION SEC. �
I .1 �
� 1 /�'�1 � CITY HALL FRIDLE� SS432 NUMBER REV. DATE PAGE OF APPROVED BV
�"-'� � ,�� 612-580-3450
910-F15 � 3 1 74 � �
108 ADDRESS 6661 East River Road N.E.
1 LEGAL LOT NO. BLOCK TRACT OR qDDITION SEE ATTACHED
oescR. 39,40 6 Fridley Park SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
S. E. Tem lin Construction 6909.Ashton Aveaue N.E
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS Z�P PHONE LICENSE NO.
8 USEOFBUILDING Residential
7 CLASS OF WORK
�] NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
e DESCRIBE WORK Construct a 36' x 24' Ihaelling and a 20' x 24' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS provide a hard surface driveway. Provide a verifying survey, before
capping.
SEWER LQCATION: 125' South of Manhole on Rice Creek Way
Wye Elev : 823 .09 '�
Top of Footing: 826.09 Minimum
South Inv. Elev. of Manhole on Rice Creek Way: 815:18
WATER LOCATION: 21' North & 50' Ea.st of Manhole
SEPERATE PERMITS REQUIREC� FOR WIR1N��
HEATlNG, PLUMBING AND SIGNS.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOd Fi$lIl@
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT R-1 I.] � 3SOi'1}� $O
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
1 HEREBY CERTIFY THAT I HAVE REAO AND EXAMINED THIS APPLICATION �. STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETH SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �23�3SS �-L.G$
DOES NOT SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIO OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- [F2 � OO 3OO .00
STRUCTI OR THE PERFOR CE OF CONSTRUCTION.
`��7�'G�L� � PLAN CHECK FEE TOTAL FEE ^
A,�'jyh $354.68
� SIGNATUREOFCONTRACTORORAUTHOR DAGENT IDATEI EN ROPERLY VALIDAT HIS IS YOUR Pe RMIT ,
Y
SIGNATURE OF OWNER IIF OWNEF BUILDERI IDATEI BLDG WSP DATE
APPI,ICATION FOR R1iSI1)ENTI/�L, ALT�Ra1'IUN,
UR �1i)lli"t'I01�` �UII.DING PERMIT
L I'1'�' OF 1-1:1 ULL:Y, �1r�°VfvESO'TA
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QWN�.R�S NAME• � � p $UILDER: �l,'° �� � /!�I �Oi1S�
,ADI?RES S : ADDRES S h0 � � %
���
N0 : . S TREET : ���vG /�P�� ��'� �
T,p�';,j �{"U SLOCK; � ADDITION: � �
/
CQRNER LQT: INSIDE LOT: � SETBACK: �a(�� SIDEYARD; �� �� � �
AgplicaA� attach to this form �ao Certificates of Survey of Lot and proposed
buildisig lvcation drawn on these Certificates. �
UESGRIPTIUN OF BUILDING
Be Used As:
�"�G"`'a""�°� � Front : �� Depth : � � Heigh� :
Square Feet• ��v � Cubic Feet; %� "� � �� °=� ��'
//S�
�Z���- � Front: � Depth: Z� Height: �'
•---
Square �'eet; �/�� Cubic Feet: =� �, ��'
�.`ype o� Gonstxuction: �-� Estimated Cost: $��i G° U
/ " � °� G �, ' �„ �
.� � �
To Be CcampleCed: � '�'
o� �� �
The undexsigned hereby makes applicativn fox a permit for the work herei.x�,
specified, agxeeing to do all work in st7tict accoxdance with the City af
Fxidley Ordinances and xulings of thc� Department of Buildings, and hereby
declarea that ��11 the facts and representations stated in this application
axe true and CJIT�•CC.
s _:
DATE : `"�t`� � — ? 7' S IGNATURE • % .'`,/�✓'
� J � �, � ;� :�� `�i` � � f� . ' =:,�'� �. �
(Se� Reverse Side Fox Additiona.l Informa,tion.) V v-
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BUILDING k'�:I�L�1J'1' l��E SC:HrUUL�
S�GT�ON �. The Lnspect��x .,T Fitiii.ldin�s shall, before issuing permits f.ox the
e7C8Ct#.on of any buiiding or strurt��rc•, or Eox an�� addition to <�ny exi.st�.ng
buildfng ox structure, or Ior ..�ny .+�t�rati.on or r.:pairs to any existing
huil.din� or s�ructure, iipon application Lii�relor�, r�q�, irc the payment by the
applicanC fox such permit of fees to r.h�: amount herein below set forth and in
khs manner herei.n provided to-�ait:
[JNIFQRM BUILDING COAE: Type. 1, 2& 4-� $2.15 far each one thousand cubie
feet, o7c fxaction thexc:of, in such cubical contents. T,}•pe 3& 5- $1.85 for
��oh oae thousand cubic feet.
�1U])ITIONAI. tUPOR1�IATIUN
F'or the purpose of computing fees f�; building permits, the cubical coiitents
of any buildin� or .��dition, is determined by multiplying the ground area
c�ov�9C�:d fx'om a point six (6) inches below the flouX li.ne of the basement
4x Ch� Gallar to tl��� average llei�hts ,>f the upper surface or to the avexage •
h�;l�i►t �� the rooF surface of tii� main gable of a pitched roof.
Fox xepairs ox al.texations to an existing structure, the fee shall. be at �he
7CaC� o� $3.00 pex each f�.ve hundxed dollars ($500.Op) ax fraction therea� in
the �oa� of all pxoposed work.
Tn xit� case shall the fee eharged for any permit aa set forth in Section 2 be
la�e than $5.00. '
VERIFICATION OF FOUNDATION
NQT�� Pc�i'mi�s ior construction will be issued a minimum of 24 hours from th�
time of appli�cation, to allow �or proper review of the proposed structure and
of the cO;nst]ruGtion s1te.
A Gertified Survey of the lot, showing the location of the foundation, once �,�
has been constru�ted, will be required before proceeding witti the framing.
�'L'RTIFICATE Ul' t)CCUPANCY
Application for a Certiiicate o� Occupancy shall be made ten (10) days prior
tp the use or occupancy of any structure for which a building permit has been
1�+�u�d; �nd s.�id structure shall not be used or occup�Ced until a Certi�icate
of Aaeup�cy ha,s been isaued.
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��I.C. NOIUM aN� ASSOCIATES, INC.
10130 CENTRAL AVE. N.E. (H�yy. 65) - BLAINE, MINNESOTA 55434
CERTIFICATE OF SURVEY:
SAMUEL TEMPUN \� -�
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CIVIL ENGINEERS
LANDSURVEYORS
Telephone
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�ridtey Fark, Anoka ounty, �•iimiesota.
Subje�t to an easei�e�t for nzqhwzy purpo;e:
over the Soutnwes?erly .5 feee oj sa�d ;.ccs
39, 4p. C;, an� 42.
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w�:�s prrpered by mN a urdet R:y ducct super•
��i:ion and ;h.:: ! a::: a duly Regiscered Land
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� H.C. N01UM ANe ASSOCIATES, INC.
� D 10130 CENTRAL AVE. N.E. (Hwy.65)—BLAINE,MINNESOTA 55434
712 SOUTH MAIN ST. — CAMBRIDGE,MINNESOTA 55008
CERTIFICATE OF SURVEY:
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CIVIL ENGINEERS
LANDSURVEYORS.
1"elephone
784-5480
689-4798
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:ESr� Uc�CR:'"iJ�+: [)ENOTES �RaN
�ot 39 and 40, b;ock E, �r'atey �ark kdd;!r�n, JGALE �' 2`�
Ano�a �uunty, `1•nnesota. }?,�j–LOO–(o{
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1 hereby rert�ly thxt ttns survey, plan. or report
ua� prrpared by me ur under my direct super-
1•i.�un and thut I nm e duly Reg�stered Land
Sun�-yor under thq-dau�S o['the State of Mwn•
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L):str j� i qi �� ft��:. No. 442%
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9�EAi LOSS C/�LCULi1T60NS D�A►tST11AE�8T C�� ��40LDIP1Cr�i � FRIDLE�, M60 ,�
Weatherstrips A.S.H.V.E. Construction No. Ioaulacion �;�'
Guide °
Windows Doors Reference . Out. Wall 1nc. Wall C.eiling Roof Floo Kind How Applie 6'
Yes— N 19_._ Q �
Fl m � L.ength '��idth ''�leight Fl.� oom l.ength Wideh eight f
Windows and Doors—Crackage and Area Windows and Doora--Crackage and Area
tVidth Hel �t No. of Llneal tt. Area � Widch HelHht No. ot Lineal it. Acea ��
No, ot pape ot ne ❑gh e ot r eQ f N: -'of pa of Dane Ilghts o! cr eQ. tt. � �,
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Ceiling
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equir s t..R. or aq. ina. W.A. ader area
Fl.� m� Length Width .�Height '�
Windowa and rs--�rackage and Area
Wldth Hel ht No. ot Llneal tt. Ar
No. af ans o[ e 11 ht� ot crac W t.
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Net esp. wall
Int. wall
Ceiling
Floor
Total Btu.
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w�acn �
No. o[ p�JM �
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In6ltration
Glaaa
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Net exp. wall
lnt. wall
Ceiling
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ength �Width °'HeigF
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Zeiling
Floor A -
Total Btu.
quir . ft. . . or aq. ina. W.A. adtr area ' ,
fl.l oo� l l.ength �'�Vidth •� #leight �
Windows and Doora—Crackage and Area
Wldth Helght No. ot Linesl ft. Ar�a �
N. o[ ane o4 Dano 11� ot orack cp. tt.
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Infiltration � / � .
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Net exp. waDi '
Int. wall
Ceiling
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Total �tu.
Requieed aq. k. E.D.R. or sq. ina. \il.A. L.eader area
F7.� Room I Length Width Hei
Wiadowa and Doors—Crackage and Area
Wldth Hel�ht Na ot Llneal tt. Aret
No. ot pane ot pans Ught� ot er�ck p. tt
�.OtE. BtU
Infiltration
Gl���
�sp. wa11
Net exp. wall
Int. wall �
Ceiling u
�oor _
Total Btu.
Requiied tq. Et. E.D.R ar �q. ies. WA l,eadet area
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A. .H.V. .
Weatherstripa Conatruction No. lasulation -- ��P ��
Guide
Windows ( Doors Reference t. Wall Int. Wall Ceiligg Roof Floor Kind Haw Applie �
�'es—No es— 19_
F1.� m Length `Vidth °Reight FI.) Room Length ��ideh kleight
Windows and Doors—Crackage and Area Window nd Dooes—Craekage and Area . Y�
tVidth Hei t No. ot Llneal tt. Area Wldt � Hetg o. ot Lineal tt. Arae
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Wldt Hel�ht No. of Ltneal tt. Area
ot p ot tl� t� ot raek �p. t �
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Total Btu. � �
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Fl. m � L,ength Q/idth •�°Height
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Wldth Hel�ht No. ot Llneal tt. Area �
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Total Btu.,
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Required �. h. ED.R. or q. ias. WA L�ade� a�ea
City of Fridley
4T TNR TOP Ov TME TM►INP
------� GOMwIJNIT� DEV�I.O�MtENT QiV.
� MOT�CTINR Wl�CTpry �K,
r�-�` i pT► M�.L FAIN.RY �M�
.J W' b�0' � NO
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PLUM�I�r, PERP9IT APPLICATI�►�
J�b Address ,
� � � / � � � ��' �G' L %j�l�
ner
�f� .'y �C> � � L � ,/►s
Contractor /^�
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Kind of Building
F�r � � -e,
Comp etion Date
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Plumbing Fix ture Ratea: N0. RATE TOTAL
Number Fixtures � x$2. 00 �., o--a
Future Fixtures ,; x $1.50 ,S �
New Fixture-Old Open. x $1.50
Catch Bgsfn x $3.25
Water Heater-99,000 BTU _� x $3.00 �,�
Ground Run Old Bldg. x$3.25
Elec. Water Heater x $2.00
Gas Fittin Faes:
lst 3 �ixtures / x $2.00 � ��=
Additional Fixtures x $ .75
Gas Ra.nge-199,000 BTU x $5.00
Regairs � Alterations
See
Description; Code
State Surchart�e .50
TOTAL FEE $ �
The undereigned hereby makea application for a permit
for �he work herain specified� agreeing to do all work
in strict acco�dance w ith the City Ordiaancea and rulin,
of the Department of �ui7.dinge, and hereby declare that
a11�th� �acte and represantatione etated in thia
appl,ication are true and correct.
' I II � I a�l �l AI �) �II � I,,,� I�
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560-3450
�if o ����e
� �
ANOKA COUNTY
6431 UNIVERSITY AVENUE NE January 2, 19�5 FRIDLEV, MINNESUTA 55Q32
Mr. Sam Templin
Inger Road
Deer Ri.ver, Mi.nnesota 56636
Re: 6661 East River Road N.E.
Dear A4r o Templin :
An inspection of the above property on December 31, 1974 noted the
following items must be completed before we can final out the building
permit;
l. Install a P.C. alarm in hallway ahead of -the bed.rooms.
2. Install a self-closing device on the fire doar between the house�
and the garage.
3. Caulk or paint up crack at tub in bathz°oome
4. Our Envisonmental Officer requests that the �veeds on the property
be maintained.
If you have any questions on the above items, and r,vhen the above items
are completed, please call me at 560-3450, ext. 41.
SincerelyP
CLARENCE J. BELISE,E
Building Inspector
CJB/mh
��
:.` _
°h :
C' ` ` Vs
F[ZIDLEY
CIV1C CENTER •(r131 UNIVERSITY AVE. N.E. FRIDLEY. MINNESOTA 55432 • PHONE (6121 571-?�350
October 11, 1985
ELgene and Crystal Anderson
6661 East River Road N.E.
Fridley, N�1 55432
Dear Mr. & Mrs. Anderson:
It has been brought to my attention and verif ied by an on-site
inspection that you have a used vehicle parked on your premise.
Vehicles stored in the open and not used for normal use
constitute a nuisance and violates the City Code.
The City of Fridley is determined to avoid having East River Road
become a strip for used car sales. Your assistance in this
matter will be appreciated.
If you have any questions or conerns please contact me at the
Fridley Civic Center, 571-3450.
Sincerely,
,��I��� ' 1/" ' �/u� Z,O�IMdJI,
Richard W. Wiersma
Code E�forcenent
1�n1W/�n
C-85-264
sue�EtT PER
City of Fridley 22�2
AT THE TOP OF TNE 7WINS � � I L D I N G P E R M I T
�
RECEIPT NO.
� � ���°���� � �V
� ; y __��� COMMUNITY DEVEIOPMENT OIV.
r � � PROTECTIVE INSPECTION SEC.
� . �
� _ �'�'1 � CITY MALI fRIOLEV �jS132 NUM�HN pEV OATE pAGE Oi AVPROVEO B�
���-"� � �'' 612-571-3a50 s�aF�s 10/11/01 / /
JOB ADDRESS 6661 East River Rd NE
1 LEGAI ��T NO. BLOCK TPACT Oq ADDITION SEE ATTACMEO
oescR. 39,40 6 Fridley Park SMEET
2 PROPERTY OWNER MAIL ApDRES$ 21P PMONE
Gerald Thompson 6661 East River Rd NE 763-571-8788
3 CONTRACTOR MAIL ADORESS ZIP PNONE IICENSE NO
Cedar Valley Exteriors Inc 9920 Zilla St NW, Coon Ra ids, MN 55433 763-755-2221
a ARCMITECT OR DESIGNER MAIL AODRESS ZIP PMONE LICENSE NO.
20177285
5 ENGINEER MAII ADDRESS 21P PMONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (21 5q) Tear-off
9 CHANOEOFUSEFROM TO
STIPU�ATIONS
Underlayment must comply w�th �he State Building Code.
��r►nif Inspectlon �a���
�o Will �e �ailetl
Hom�ow�er �'o ���� .
TVPE OF CONST OCCUPANCY GROUP OCCUPANCV �OAO
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAI, PLUMBING. FIEATING,
VENTII.ATING OR AIR CONDITIONING.
TMIS PERMIT BECOMES NULI AND VOIO IF WORK OR CONSTRUCTION IONING SC. FT CU FT.
AUTHORIZED IS NOT COMMENCEO VyITHIN 80 �AYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 1Y0 OAVS AT
ANV TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OfFSTREET PARKING
I MEREBY CERTIFV TMAT I MAVE READ AND EXAMINEO TMIS APPLICATION 1 STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND COFiF►ECT. ALL PROVISIONS OF LAWS VA�UATION SURTAX
AND OROINANCES GOVERNING TNIS TYPE OF WORK WILL BE COMPLIEO @ r
WITM WHE7HEii SPECIFIED HEREIN Oii NOT. TME GRANTING Of A PERMIT `P��2S1 �1.13
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OFi CANCEL THE pEqMIT FEE SAC CMAFGE
PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGUTATING CON- @ @
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION y�S.3.2S Fire SC y�2. LS
PLAN GMECK fEE TOT FEE
Lice SC $5. 0 1.63
S�GNOTUAEOFCONCFACTOAOAAUTMOA�2EOAGENT iD�TE� yyM pq �Y VAUOAT 7N15 IS VOUR P RMIT /
� � ��
S�GN4TU�7E O� OWNEA��f QWNEpBU0.0Hp� iDATE� wB �NS� � QGif
�. � �,a :
t � ! "
: �
� �
- $ 'f i�"''.
_,.r �;9 ,�
z, . . . _ --
Mail
To: Fridley
Building
6431 University Ave NE
Fridley
MN 55432
NetClerk ID# 100796
7635723604
7635711287
' � oat`ract�� I:n�a�ma�t%an
Cedar Valley Exteriors Inc Te�: 7637552221
9920 Zilla Street NW Fax: 7637555390
Coon Rapids MN 55433 Email: aberglund@cedarvalleyexteriors.com
_. ______._„., � _ _ _ � _
� __ �- �
�; ;� Worlre���c:m�nensaiion � I, ` ; E�t�sinessiaraca�re l�ce�s� ` '
Carrier: WORKERS COMP INS Number:
Number: APP121338 C/ass/type:
Eup.: 04/06/2002 Exp.:
5tai`e ConiraC�ot's fi�ense t�fher licenses: T
_
_ ' . . ,,,_ _ : _ __ _
Number: BC-20177285 Number:
Class/type: RESIDENTIAL BLDG C/ass/type:
Exp.: 03/31/2002 Exp.:
Prajecfi Inf��nrat�g,n
Homeowner name: Gerald Thompson Homeowner teL• 7635718788
Project address: 6661 E RIVER RD FRIDLEY MN 55432
Job description: tearoff/reroof Valuation: 4958.90
Fayxaent �nfor�a�Cii�n '
Payment Type: Check Credit card number:
Card holder name: Ex iration date: /
:lteq�c�red �oc�x�nentafiic�a
720 Dubuque Ave., • South San Francisco, CA 94080 • Govemment 5ervices: 888-330-� � � i
NetClerk Fax: 877-846-5888
xsi_9rn
NEW
ADDN CITY OF FRIDLEY
ALTER ❑✓ SINGLE FAMILYAND DUPLEXES R-1 AND R 2
BUILDING PERMITAPPLICATION
ConstructionAddress:6661 E RIVER RD
Legal Description:
Effective 1/1/2000
(763) 572-3604 Bldg Insp
Owner Name: Gerald Thompson Tel. # 7635718788
Address:6661 E River Road Fridley MN 55432
Contractor: Cedar Valley Exteriors Inc MN LICENSE # BC-20177285
Address: 9920 Zilla Street NW Coon Rapids MN 55433 Tel. # 7637552221
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LMNG AREA:
GARAGE AREA:
DECKAREA:
OTHER: tearoff/reroof
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
Width
Width
Width
Height
Sq. Ft.
Height Sq. Ft.
Hgt/Ground Sq. Ft.
Number of Squares: 20.66
Construction Type: residential Estimated Cost: $ 4958.90
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$
�
DATE: 10/04/2001 APPLICANT '' �"" °'""
�r�
1�
CITY USE ONLY - Call (763) 572-3604 for Permlt Fees If mailing In application
_$
Tel. # 8883301777
�
Permit Fee $ ��-�� Fee Schedule on Reverse Side
Fire Surcharge $ � • �� .001 of PermitValuation (1/10th %)
State Surcharge $ 1 - � � $.50/$1,000 Valuation
SAC Charge $ $1100 per SAC Unit
License Surcharge $ ,; .� v $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 Necessary0 Not Necessary❑
TOTAL � �
STIPULATIONS:
�
R37_6/15
SUBJECT
c�ty of Fridley 33852� �
AT THE TOP OF THE TWINS g � I L D I N G P E R M t T
�
� �
� �
• COMMUNITY DEVELOPMENT DIV. �f /
� ; V �'��• , '7�/ L./
f � � PiiOTECTIVE INSPECTION SEC. S
1 i �
� /�"1 � CITY HALL FRIDLE� SSIJ2 NUMBEN REV DATE PAGE OF APPROVEO BY
�""� � �'' 763-571-3450 910-F15 9/3/03 / /
JOB ADDRESS 6661 East River Rd NE
1 LEGAL �OT NO. BLOCK TRACT OR AOOITION SEE ATTACMED
DESCR. 39,40 6 Fridley Park SMEET
2 PiiOPERTY OWNER MAIL ADDRESS ZIP PMONE
Gerald Thompson 6661 East River Rd NE 571-8788
3 CONTRACTOR MAIL ADDRESS ZIP PMONE IICENSE NO
Same
4 ARCNITECT OR DESIGNEfi MAIL AODRESS ZIP PNONE IICENSE NO.
5 ENGINEER MAIL ADDRESS tIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CIASS OF WORK
❑ NEyy C� ADDITION 0 ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
8 OESCRIBE WORK
Construct a 10' x 18' Shed
9 CHANf3E OF USE FROM TO
STIPULATIONS
See notations on plan.
/�RIV1�11G
�efore diggih8 c�ll for
all utility locations
454D002
RE��11RED �Y LAIIV
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY l.OAD
SEPARATE PERMITS AFE REOUIRED FOR EIECTfiICAL. PLUMBING. MEATING,
VENTIIATING OR AIR CONDITIONING
THIS PERMIT BECOMES NUIL AND VOID IF WORK Oii CONSTRUCTION 20NING SO. fT CU FT
AUTHOR12ED IS NOT COMMENCED WITHIN 80 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAVS AT
ANY TIME AF7ER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING
I MEREBY CERTIFV THAT 1 MAVE REAO AND EXAMINED TMIS APPLICATION 1 57A��S GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING TMIS TYPE OF WORK WILL BE COMPLIED 1.10
WITH WHETHER SPECIFIEO MEREIN OR NOT. TME GRANTING OF A PERMIT �2�211 �
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CMARGE
PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON• �83 � 25 Fire SC �Z . ZO
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION
PIAN CMECK FEE TOTAL FEE
$86.55
SiGNATUAE OF CO ACTOp Op 4UTHOp�ZED sGENT iDATE� EN PROPERIY VALIDATED THIS I, V UR P'�
� li
_ �-- ..�-- �3 '
SGN4TUAEO�OWNEA� OWNEpBU�LDEA� �DAfE� iNSP qitE
i l
NEW
ADDN
ALTER
[] CITY OF FRIDLEY Effective 1/1/2003
[] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg In
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax (�
BUILDING PERMITAPPLICATION ' n ���i�
Construction Address:
�
�
Legal Description: �`
Owner Name & Address: �e �u /� � o �.�,�,� 1�1�/ E � n Tel. # 5 7 / - � � ss �'
Contractor. ��;A � �^ � MN LICENSE #
Address: f� �/ �. rt 2 Tel. # � �-��� v
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.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Wdth Hgt/Ground Sq. Ft.
/�
.-� �
Construction Type: G�u�� � �.�� � 4 Estimated Cost: $�� D o •-
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
� Tel. # 5��' 678 D
DATE: � ✓ vo3 APPLICANT: `^�
Call (763) 572-3604'for Permit Fees if mailin i application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
� �a� �
$ � ��`�
$ � o � i�
$
$
$
$
$
$
�
� � � J�'�
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 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 [ ]
_ •.
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 e�cisting 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 ma.nner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,�
$2,001 to $25,000
$25,001 to $50,�0
$50,001 to $1Q0,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,OQ0,001 and up
FEFS
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fracdon thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional$1,000
or fraction thereof, to and including $25,Q00
$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,Q00 or fraction thereof, to and including $500,000
$3,233.75 for the first $SOO,Q00 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1, 000, 000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
CURB CUT ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate.
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the. proposed stntcture and of the construction site.
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the existing foundarion will be required before
proceeding with the framing. New Houses Onlv
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�Lot�3�9�and�40,._Block 6, Eridley Park Addition,
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I hereby certify that ch�s survey, plar
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