AF - 40883�
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City of Fridley, Minn.
BUILDING PERMIT
Date: —. June 20, 1967
AT�
p��.; 0. F. Wilkie g��r _ Modern Bla�op Cg,
Adcireas 6795 Eas t River Road Ad�e 5 043 Os s eo Road
3� � �� �
9323
No. 6795 S�t
Lot � __ Block
LOCATION OF BUILDING
East River Road � p� af �t
Addition or Sub-Division
Coraer Lot _ 7nside Lot —. Setbaek � Sideyard
Sewer IIevation
Foundation IIevation
DESCRIPTION OF BUILDING
To be Used as:
Front _.._ Depth Height Sq. F't. C:u. P't
�%ont Depth fTeight Sq. Ft Cu, Ft,
�,� og �����Blacktop Drive ��_$300.00 _ To be Completed - 6/21/67
In cbns�lderatfon of the iasuance to me of a permit to construct the bwllding described above, Y agree to do
the proposed work in accordance with the d+escription above set forth and in compliance with all provlafona of
ordinaaces of the dty of FrYdley. ,
�� �� �
In consfderatton of the gayment of a fee oP $ 5.00 ���t � h� �lpdern Blacktop Co .
bY �ted to
to conatruct the building or addition as described above. Thia�� t ia granted upon
the exPress candition that the pereon to whom it is graated and i►ia agent�, employees an� worl�nen, in a]1 work
dame in, around aad upon said building, or any psrt thereof, shall conform in all respecta to the ordinancee of
Frld1eY, Minnesota regarding location, conatruction, alteration, maiatenaace, repair end mtovYng of build�ng�
within the dty ]imits and this permit may be revoked at any time upon violation of any of the provisiona of ea�d
ordinances.
CT.ARFNCE BELISLE B�� ��
Nonc�
71ds psrmb doa not eerer t6s com�rucHoe, lestallaHen h� �rirtng, pinmbina, ea 6�aHeg, �ru or waMr. B� wn to a�
�6a Buildfe� lesp�ela� for apsraM parmiy }ar �has ilfAa.
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' APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
P
OWNER'S NAME � � %t1 �� BUILDER
ADDRESS_ (; `�9�Sr �� /�� � ADDRESS
� LOCATION OF BUILDING
N0. �� fS STREET �, %'�e.c,,-�t, /��� PART OF LOT
LOT BLOCK ADDITION OR SUBDIVISION
�
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�"� ��� � � � �
� a
CORNER LOT ' INSIDE LOT SETBACK SIDE-YARD
SEWER ELEVATION TOP OF FOOTING
Applicant attach to this form two certificates of survey of lot and proposed
building location drawn on these two certificates.
� �DESCRIPTION OF BUILDING
To be Us ed as :
-_Front Depth
Height
Sq. Ft . Cu. Ft .
• Front � Depth Height
Sq. Ft. Cu. Ft.
� �
Type of Construction � �,G � Estimated Cost �� c�b =
To Be Completed_ ��� ! �� �`J
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridley Qrdinances
and ruling of the Department of Buildings, and hereby declares that a11 the facts
and representati:ons stated in this application are true and correct.
DATE � �� 8 �� rT SIGNATURE � �� � � - ���!/ c�� .
(Schedule of Fee Costs can be found on the Reverse Side).
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BUILDIIVG PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erection�of any building of structure, or for any addition to any existing
build�ng:or structure, or for any alteration or repairs 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 manner
herein provided to-wit; �
Ur.iform Building Code: Type 1,2, & 4- $1.75 for each onz thousand cubic feet, or
fraction thereof, in such cubical contents, Type 3& 5-$1.50 for each
one thousand cubic feet.
For the purpose of computing fees��for building permits, the cubical contents of
any building or addition to a uniform height throughout by multipluing the ground
area covered from a point six (6) inches below the floor line of the basement or
cellar to the average height of the upper surface or to the average height of the
roof surface of the main gable of a pitched roof.
� For repairs or alterations to an existing structure, the fee shall be at the
, rate of $3.Q0 per each Five Hundred Dollars ($500.00) ox fraction thereof
in the cost of all proposed worka
In. no case shall the fee charged for any�permit as set forth in Section 2 be
less than $5.00. �
NSSSD Connection Charges based on location- Area 1 or 2.
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�5� id�a��gher Ap�l�caaa� is c���t�uctinu �c�� in ��ea?�'� —
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datiom o; scta� 2os�ic�g At1:�at�i.��r�tc�r randJ�r Fiu�ldi�r� Z����cto�. ..
P1���Q fiead a�tac:�ed ch�ect; i�e taa� .�r�ou*at e�� f��SoQ�D for �aa�Isi�a�j t$25a[�0 go�
occ�apy��i� a h��±�� t�Gil�re
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� SA�dDP,l� J. LI�dD��IAN
Notary I'�::'i�, A�cl:� Cou�ty, Minn.
�---•� NIY Cmrrmissi:�n Expi�es April 7,,1975.
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REGULAR COUNCIL MEETING OF FEBRUI�RY 28, 1972
LICENSES CONTINUED:
General Contractor
Multiple
Dwel.lia�gs
_ For:
Dalberg Builders Inc.
1121 SOth Avenue N.E.
Minneapolis, Minn.
Samuel C. Dalberg
PAGE 22
Approved by
Building Inspector
Ulmer Constructi,on Inc. Building Inspector
103 East �Golden Lalce Lane •
Circle Pines, Minn
Allara E. Uliner
Giertsen Company
28g0 Chicago Avenue
Minneapolis, Minn.
Hugo Mostrom
Renco Builders Coxp.
811 West 50th St,
Minneapolis, Minn.
Roqer E. Nelson
KBM Inves�nent Co.
3005 Ottowa Ave. So.
Minneapo�is, Minn.
1619 73rd Ave. N.E.
F�uilding Inspector
Building Inspector
unita F'e�
_.�..e...
Fire Prev. Hureau 24 524.00
1+l��ION by Councilman Breider to approve the licenaes as submitted, w�t1z �Y'be
ex�eption of the dance license requested by St. Williams Catholic C13u7��1'3.
Th� �nati.on was seconded and upon a voice vote, all ayes, Ma�yor Lie#��. de�l�ed
'�hQ mo�i9n carried unanimously.
CON�TDERATION OF APPROVAL OF TRAILER LICENSE: (Al1an N. Puro, 6795 ��st l�,i,V6r
��c�)
�p�+�p� �X Councilman Mittelstadt to approve tbe trailer license rsq�e�'��d bx
1�x'. P�l1an N. Puro. Seconded by Councilman Breider.
Cotir�,ci�nan Mittelstadt coffiented that this gentleman should be co�ten$ed �o�'
�p�,gp�gl��Ia�g the City to see if this would be all right and if the�e axs �g
���n�,�� r�ecessary. There are a lot of trailers parked in the Cit� o� �x�d1�y
w,��QU'� any permission being asked.
� y��� j7POly THE MOTION, being a voice vote, a11 ayes, Mayor Lieb1 d�a�.ax'�d
�� anQ�ipz� �arxied u.nanimously.
INC.
Vo�.untee�r k'i�'emea�'s Reli.ei As
1���91� �� Cca�nailmaa� Mittelstadt to approve tlle P$Ymer�t o� $200 �ca�' �7ariu�a:�►
����a���io� t.a �atch, ���ckson�, Madson and Hanaon, Tnc. }�y ttie Vol�a�eeg E'i���
Ep�n�� RQlief �Association• Seconded by Councilman Kel�haw. Upon a yoice vote�
,�2� ����, i��Qr Lieh1 sleclared the motion carried unanimously,
REGiJLAFt COUNCIL MEETING OF FEBRUARY 28, 1972
PAGE 21
RESOIrUTION #32-1972 - A RESOLUTION IA�OSING LOAD LIMITS ON PUBLIC STREETS AND
HTGHWAYS IN THE CITY OF FRIDLEY:
MOTION by Councilman Mittelstadt to adopt Resolution #32-1972. Seconded by
Gouracilman Kelshaw. Upon a voice vote,all voting aye, Mayor Liebl declared
the motior� carried unanimously.
RESOLUTION #33°1972 - R RESOLUTION AUTHORIZING AND DIRECTING THE SPLITTINC3 OF
SPECIAL ASSESSMENTS ON PART O�' LaTS 2 AND 3 PARCEL 505 AUDITOR'S SUSDIVISION
#8�:
MO�ION by Councilman Breider to adopt Resolution #33-1972. Seconded by Councilman
ICe�.aha�w. Upon a voice vote, all ayes, Mayor Liebl declared the motion aaxr�.ed
unani�aously.
RESOLUTiViV �f34--ty I L -
COI��NING OF SPECIAL
� LpW�LL ADDITION:
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�O��p�T bg Councilntan Breider ta adopt Resolution #34-1972. Seco�ded by Councilma�
K�l�haw. CJ,�an a voice vote, all ayes, Mayor Liebl declared the a�otio� ca�ieid
�aaa�i�us 1y .
REacOLUTION #35-1972 - A RESOLUTION AUTfiORIZING AND DIRECTING TF� TRANSFERRING
pF SPECIAL ASSES3MENT8 FOR TI� 1969 SERVICE CONNECTIONS FROM PARCEL 60QQ,
SECTION 2� 'I'U �OT 1, BLOCK 1, EAST RANCH ESTATES 1ST ADDITIONa
i�OTTQN l��[ Cour�cilmar� Breidex to adopt Resolution #35-1972. Secand�d by Gouriai�.�
� acelaiaaw. Upon a voice vots, all ayes, Maayor Liebl deolared the ��ion
e,�x�.ed t�an�mously.
CT��aTNJS t
�
NiC1��p1� }�� �otu�cilman Kelahaw to approve payment of General Claims #2765F �liroug�l
�¢Z7856 aaad Lic�or Claims #6395 throuqh #6460. Seoonded by Couracilman Bxeidert
iJ�� a Vo�.� Vote, all ayes, i�yor Liebl declared the motion aarried
t�.r���u�l�►.
�+TGENSES:
�ae p� �+icense B,�+,
C�g��tt� �rontier Steak Houae
7373 C�tral Ave. N.E.
Fr�dley, Minn. 55432
Ruth Arthur
�'uia].io Aa�ac�, St. Williams Catholic
ChurcY�
Approved By
Ch�.ef of Poliae
Fee
$12.00
�'a�
Waivec'�
i
�- -�_
sue�ecT PERMI
City of Fridley , 13218
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV. �
� �y-------�
r � � PROTECTIVE INSPECTION SEC.
1 . �
�� � /'��1 � CITY HALL FRIDLEY 55432 NUMBEH REV. DATE PAGE OF APPROVED BY
""� � ,�� 612-580-3450 •
910-F15 9/22/75 � �
JOB ADDRESS 6795 East River Road N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. � � � Scherer Addition SHEET
2 PROPERTYOV�f1ERro. Puro MAII„���e�sast River Road ZIP PHONE
/� E) /
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Wanless Construction 1046 Rice Street St. Paul, Mn
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Cj� REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
reroof
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPERATE i�E�l1Al�'S ��: �!► : ��;��� �pR VIIIRd���
�i�T1,IV� PL'U��1�� �ir� �lG�t�
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. Sh�n �e
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ 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�OI�QIEjE� ��339.ZZ .G�
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF lAP��tI�A7
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 8�00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �
PLAN CHECK FEE TOTAL FEE
��� �� c° Q� � �� �j - � z P � s— ,, , 8 . 67
SIGNATUREOFCONTRACTORORAUTHORI2EDAGENT (DATEI WHE PROPE Y VA THIS �YO RMIT
/ � �'
SIGNATUREOFOWNERIIFOWNERBUILDERI IDATEI BLDG INSP DA7E
� v �
APPLIC�TION POR RESIDENTIAL, ALTERATION,
OR AllDITION BUILDING P�RMIT
CITY OF FRI�DLEY, MINNESOTA
� OWNER'S NAME: � %��� BUILDER: ��������� �'-��
' ADDRESS : /.p � U' S � �.�z /'� ADDRESS ; r'� �Ce ��-c-c /%� ���c�//
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NO:. STREET•
LOT: BLOCKt � ADDITTON:
CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDa
Applicant attach to this form Two Ceri.ificates of Survey of Lot and proposed
building location drawn on these Certificates. �
To P,e Used As :
DESCRIPTION OF BUILDING
Front: Depth: Height:
Squa�e Feet: Cub'ic Feet:
Front° Dep�th• • Height:
Squar� Feet; C�bic Feet: - -
Type of Construction; ��-�� •. Estianated Cost: $%�� T���_
To Be Completed: _ �v -/- 7S� . ,
The undexsigned hereby makes applicatinn for a permit for the work herein
specified, agreeing to do all work iri stxict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
'declares that'all the facts and representations stated iu this applicatian
are true and aorrect.
DATE : . � - Z Z .� � S � S TGNATtJRE : �-�'--e.�' � �%" .��v�:�:- �'�'� .
(See Reverse Side For Additional In�ormation.) ' _ �
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BUILDING PERMIT FEE SCHEDULE
�SECTION 2. The Inspector of Buildings shall, before issuing perniits for the �
erection of any building or structure, or for any addition to any existing �
building or structure, or for any alteration or repairs to any existing
' building or structure, upcn 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 pxovided to-wit:
iJNIFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic
feet, or �raction thereof, in such cubical contents. Type 3& 5-$1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, �the cubical contents
of any building or addition, is determined by, multiplyi�g the ground area
covexed from a point six (6) inches below the floor line of the .basemen�
ox the cellar to the average heights of the upper surface ox �o i:he average.�-
•height of the roof surface of�the ma.in gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the
��rate of $3.00 pex each five hundred dollars ($500.00) or fraction thexeof in
,• the cost of all proposed woxke �
e
In x�o case shall the fee charged fox any permit as se�� forth in Section 2 be
less than $5.0�. �� ,
` � VERIFICATION OF FOUNDATION
NOTE: Permits fox constxuction will be issued a minimum of 24 hours from the
ti.me of application, to allow for proper review of the proposed structure.and
of the canstruction site. .
A Certified Survey o� the lot, showing the locatioz of the foundation, once it
has been constructed, will be requixed before proceeding with the fxaming.
� �CERTIFICATE�OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for which a building permit has bean
issued; and said structure shall not be used or ocGupied until a Certificate
of OccuFancy has been issued. �
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CHIMI�EY ANJ STACK VERIFICATION
The undersigned hereby verifies that the existing chimney o� stack;
1. Has been carefully examined Yes (,� No ()
2. Is free from rust or deterioration Yes (�' No ()
3. Has no foreign objects lodged within Yes (�j No ()
4. Is securely supported
5. Meets all current Code requiremen ts for size and
tC�s3� —Q�� L$fie^.EE��-- --
6. Ha s To ta l hea ti ng BTU S s of �� (�f � p )
Al l other BTU's _�� ,� c� c>
— - ,
TOTAL / ��s D p �J
Rema rk s
. , � � .
0
Ye s (� No ( )
Ye s (/) No ( )
)
Com pa ny .�.d ,���� j�s�
Signed By _� ���
Da te � ,s— 3 V-- �� ; - - -
sue�ecr P .
City of Fridley 2 5� 51
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T
r
� i RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
� ; L ----- , la 7�
r � � PROTECTIVE INSPECTION SEC.
� i �
� /"'1 � CITV HALL FRIDLE� SS432 NUMBER REV OATE PAGE OP APPROVED BY
�""�' �'' 612-571-3450 970-F15 3/16/98 / /
JOB ADDRESS 6795 East River Rd NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO
DESCR. 1 1 Scherer Addition SHEET
2 PROPERTY OWNER MAIL AODRESS ZIP PHONE
Will Cichy 6795 East River Road NE 574-0833
3 CONTRACTOR MAIL ADDRESS ZIP PHONE UCENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PMONE LICENSE NO.
e USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW C� ADDITION � ALTERATION ❑ FiEPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOHK
Construct a 6' x 10' Three-Season Porch
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan
�,�q �AR�I�
�!�'! � Before d;g��ng ca�� for
��'• y�� � R��. atl +�tility (ocatiolts
����- P� �FPUi RE UI � Sa-aoo2
c����NR�o � Q ED BY LAW
GA��S
1
SEPARATE PERMITS ARE REOUIHED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCV LOAD
VENTIIATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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
WITM WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A PERMIT �1,566 �.75
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION �S L. ZS Fire SC � L. S J
PLAN CFIECK FEE T07AL FEE
$53.60
SIGNATUREOFCON"RACTORORAUTMO i2EDAGENT �DATE� WHEN PROPERL ALIDATED THIS IS YOUR PERMIT
�
' p \ ` �1�° G "
s �
S�GNATUAE OF OWNEA �iF OWNER B DEHi �DATEi B G�NSP � OFTE
�w [ ]
ADDN [ ]
ALTER [ ]
ConstructionAddress: �
Legal Description:
Owner Name & Address:
Contractor• �(�i�
Address: ��
LIVING AREA:
GARAGE AREA:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�
.�
�
Effective 1 / 1l98
$�, �
�� 01
�
Tel. # �7 L1 �o �'"3..�
MN LICENSE #
Tel. #
Attach to ttus application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DECB AREA�.,,.-
OTHER: 1 ��`. ��';
Length
Length
DESCRIPTION OF IMPROVEMENT
Width Height Sq. Ft.
Width Height Sq. Ft.
Width Hgt/Ground Sq. Ft.
>U� D� 2 C� � � �C �� r = � o S',�' ..�,
.�o �/,S°I_ l_�
,
Construction Type: U�% �/��-�3'� �. Estimated Cost: $ �, �� �.�
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
. `
DATE: °— 63--�� APPLICANT: .,z��� Tel. ���%� � 4� 33
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ �.�
$ �� �
$ ?
$
$
$
$
$
$
$ o ��
CITY USE ONLY
Fee Schedule on Reverse Side
.�1 of Permit Valuation (1/lOth%)
$.50/$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 [ ] Not Necessary [ ]
Q _
e
!
BUII..DING PERMIT FEE SCHEDULE
The Chief 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 pemut of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,(}00,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additianal $1,0(}0
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,0�
$2887.25 for the first $500,000 plus $4.25 for each°additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Altemate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
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 $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it ha.s be�� constructed
will be required before proceeding with the framing.
�. 2 ..
SuB�ECT p , '
c�ty of Frid�ey "2 7 85�2
AT THE TOP OF TME 7WINS � � I L D 1 N G P E R M I T
�
; � RE IPT NO.
� ; .���_ COMMUNITV OEVELOPMENT DIY. � /� !/
j �, v ± PR��� I���OJ� SEC.
� i �._. ; �
l.--_� , ,', c� p � �js�3i NUMBHN NEV DATE VAGE OF APPROVEO BY
1 612-57�-3a5o s�aFis 9 17/98 � �
JOB ADDRESS 6795 East River Rd
1 LEGAL �OT NO. BLOCK TRACT OR AOOITION SEE ATTACMEO
oesca. 1 1 Scherer Addition SNEET
2 PROPERTY OWNEii MAIL AODR�S$ 21P PNONE
Wilfred Cichy 574-0833
3 CONTRACTOR MAIL ADORESS ZIP PMONE LICENSE NO
Suburban Design 13418 Crooked Lake Blvd Minneapolis 55443 755-0423 20144882
4 ARCHITECT OR OESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII ADDRESS tIP PMONE LICENSE NO
8 USE Of BUILDING
�Residential
7 CIASS OF WORK
O NEW O A�DITION O ALTERATION � REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house garage (21SQ) Tear-off
9 CHAN(iE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST OCCUPANCY GROUP OCCUPANCV LOAO
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATINO,
VEN7ILATING OR AIR CONOITIONING.
7HIS PERMIT BECOMES NULL AND VOIO If WORK OR CONSTRUCTION 20NING SG. FT CU FT
AUTMORIZED IS NOT COMMENCED V,IITNIN 80 DAYS. Ofi IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED FOR A PERI00 OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. OWIG. UNITS OffSTREET PARKING
1 HEREBY CEi;TIFY TMAT I HAVE READ ANO E%AMINEO TMIS APPLICA710N S7A�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORflEC7. ALL PiiOVISIONS Of �AWS yALUATION SURTAX
AND OROINANCES GOVERNING TMIS TYPE OF WORK WILI BE COMP�IED $1,799.00 �.90
WITH WHETMER SPECIFIED HEREIN ON NOT. TNE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHOqITY TO VIOIATE OR CANCEL TME pERM17fEE SAC M RGE
PROVISIONS OF ANY OTHER S7ATE OR LOCAL LAW REGUlA71NG CON• �56. 7S ��re SC � 1. SO
STRUCTION OA TME PERFORMANCE Of CONSTRUCT�ON
PLAN CHECKFEE TOTALFEE
'r' q� Li nse S $5.0 $64.45
�GNATUpEO�CON'FACTOAOpAUTMOA�IEDAGENT O�iEi yy N P ERL`I V L ATED THIS I OUR PERMIT
S�GNO�UAE O� OWNEA ��� OWNEA BU40@Ai �O�fE� �, �/ '
lDG �NS� � r�art
�� s
�w [ l Effective 1/1/98
ADDN [ ) CITY OF FRIDLEY
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION ��7 �
� ��
ConstructionAddress: �, s � ; � � �,,�-� ,�; ,,,_ _ j���, � �
Legal Description:
Owner Name & Address: /-��2 =✓ e' . �. Tel. # .,�- �y _ �.� ; Z
Contractor: .� �'�,�,�,, ,.> �., � �e �; a �, , ., MN LICENSE # � �� ; y�-� �,�.`
Address: ., ���,� ��-� ��F �1 �,� � l3��! Tel. # �� _� =��r � �
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
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 Height
Width Height
Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
,�
�' c, o � • ���t� �-cz .-r� -�� �i e.> :r .; z � �''° � � ��- G' / � �� .
Estunated Cost: $ � l �9
(Fee Schedule on Back)
Driveway Curb Ci�t Width Needed: Ft. + 6 Ft = Ft x$
_�
DATE: � , � �; �> APPLICANT: _ Tel. # �� s �' �`� z a
s',�'S`- �7� j
CITY USE ONLY
Permit Fee $ �Cv -��Fee Schedule on Reverse Side
Fire Surcharge $ / Q.�1 of Permit Valuation (1/lOth%)
State Surcharge $ Q $.50/$1,000 Valuation
SAC Charge $ $1000 per SAC Unit
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ .S�Uo
$
$
$
$
$ C� S�
$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 [ ]
� �
BIJILDING PERMIT FEE SCHEDULE
The Chief 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 fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$SO1 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,(�0
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for fust $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000 �
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,0(?0 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
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 $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site. -
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
�
' sue�etT p
c�ty of Fridley
AT THE TOP OF THE TWINS g � I L D i N G P E R M I T. 2 8 � 19
;,
,� .
� `L __��_ COMMUNITY DEVELOPM�NT DIV.
r � � PROTECTIVE INSPECTION SEC. � / ��
1 . i (1 6 !
i_--.� ��"' �•� CITY NALL fR10LEV SS�a2 Nu4BEn pEv D�TE vAGE Oi �nvnOVEO Br
t 612-571-3460 s�aF�S / /
12 7 98
JOB ADDRESS
6795 East River Road
t LEGAL �OT NO. BLOCK TRACT Oii ADDITION SEE ATTACHED
oesca. 1 1 Scherer Addition sr+eer
2 PiiOPERTY OWNER MAIL ADOR�S$ 21P PMONE
Wilfred L. Cich 574-0833
3 CONTRACTOR MAIL ADDRESS ZIP PHONE IICENSE NO
Owner
4 AHCHITECT OR DESIGNER MAII AODRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAII AODRESS 21P PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WOpK
O NEW � ADDITION 0 ALTERATION O REPAIR O MOVE • O REMOVE
8 DESCRIBE WORK
Construct a 3 season orch (16' x 16' • Deck 2' x 16'
9 CHANOE OF USE FROM TO
STIPULATIONS �
See notations on plan.
�������
Before di��i�g r�lB �or
a{I u�ilit�r l�caiions
454-Q002
REQUIRED BY L�q�
TYP�OFCONST. OCCUPANCVGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIqEO FOR ELECTFICAL, PLUMBING, FIEATING.
VENTILATING OR AIq CONDITIONING
7HIS PERMIT BECOMES NULL AND VOID IF WORK OR CANSTRUCTION ZONING SO. fT CU FT.
AUTHORIZED IS NOT COMMENCED Y�IITHIN 80 DAYS. OR IF CONSTRUCTION
OA WORK IS SUSPENDED OR ABANQONED fOR A PER100 OF 120 DAYS AT '
ANY TIME AfTER WOqK IS COMMENCED. ' NO DWLG. UNITS OfFSTHEET PARKING
1 HEREBY CERTIFY TNAT I HAYE READ ANO EXAMINEO THIS APP�,ICA710N STA�LS GARAGES
AND KNOW THE SAME TO BE TF1UE AND CORRECT. ALL PROVISIONS OF LAW$ yp�UATION SUR7AX
AND OR�INANCES GOVERNING TMIS TYPE OF WORK WILL QE COMPlIEO
WITM WMETMER SPECIFIEO MEREIN Oii NOT. THE GRANTING OF A PERMIT 6881 3. �F�F
DOES NOT PFESUME TO GIVE AUTMORITY TO VIOIATE OR GAMCEL TME pERM1T FEE SAC CMAFGE
PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGUTATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION F'�r SC 6. $8
PLAN CNECK FEE TOT EE
S�GNATUpE OF CO I�pOC A O�i AUT Op�2E0 AGENT �O�fE� E PR VALI MIS IS YOUq PERMIT
. ! � ♦�'�' ��
L
.� �GNOTUAE f OWN 17af O N A WLDER� �O�f i. � B G�NS� - p�iE
NEw �=
ADDN
ALTER
[]
Ll
Ll
ConstructionAddress:
I.egai Descr:pti���:
� CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
����'s
Owner Name & Address:
Effective 1/1/98
��
. �,� ��
� ��
Tel. # ��7�
Contractor: ` MN LICENSE �
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF INiPROVENIENT
Te1.1i
�
s P ( ( ��'�.0 �
LIVING AREA: Length 1( Width ��_ Height � Sq. Ft. �� / Z�
GARAGE AREA: Length Widt Height Sq. Ft. � ��
DECK AREA: Length '� ��3�Vidl� Hgt/Ground � Sq. Ft. ��
� �; �Z
THER• ����
o . 3 ����
Construction Type: Estimated Cost: $.3 � Q���
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$
_$
�
DATE: ���" APPLICANT: ` Tel. # S ��-D$"3�
,
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ /�� �'
$ '���
$ � '%�
$
$
$
$
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$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 [] Not Necessary [ J
$ / 3,��
�
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BUII,DING PERMIT FEE SCHEDULE
The Chief 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 fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000, 001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $SO,Q00 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,Q00 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
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 $15.75.
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.
OCT-17-2005 13�04 CITY OF FRIDLEY
�U.Y�a.��l.g
n�pecti.ons
'63-572-3604
a.� I O- l �l -U
rrE ,e,n�x�ss _(�
HIS APPLICANT IS:
�RO���r�r a�
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SUBMJT A COPY OF
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�UILDING
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RES�DENTLA.II AP'�"LYCATI�JN ��i�'�,s CT �,�-- .
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sTArE 1�c�rrss � av sssCo s(o � na�
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C7 BASEMEt�ti' FWISH � ROOF
❑ DECK ❑ SIDWG
� S'�►�vauIDJG POOL
7ESGRIBE �VORtC. BE1NG
3I2E OF II►�ROVEN�_
SQUAR�S
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?RQP(75�D S.IZE:- —
'ROPOSID F�iGHT: —
BII�YNG
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7 Alueninum
Q Other �.
� OP�1CrS � �No
OR FOR I�iEW OPENINGS-DESC1uBE SIZE OF
QPENm1Cr CHANGES &
TYPE OF W�T�OW TO BE dVSTALLED VWI !
ALL FE�S ARE BAS�D ON J�
A
V.
Permit k'ee
Plan R�cview
Swclaarge
Fire Surcbarge
�.icense Stu�charge
SAC Charge
Curb Cut Escraw
Erosion Control
Park Fee
Sewer 1V�ain Charge
Total Due
�v�dvw
C3 HOUSE & GARACr�
C] ATPACFIED GA�4ACrE
❑ UEfA�I� GARAGE
oso�'�
� Tev�t
0 Fascia
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■ • ��•
LOCATIO OF WII�TDOWS
i � rtv�� o� �►n�aaws /5 --
ALUAT�4N, YNGZUAA�i'G'i� COST O�
USA�TS'c T�E 1997 j1.B.0 FEE SG'�+ �iTL�
,� 5sy3a
A� znP 55 l 13
r � �M�
BASETVID�T'i' REM�DELWG SUBMiT:
1, �gFloorPl�
2_ A'opo^.�d 800r plae
3. List of s�cnual mnmi�ers to }u uscd
FOR AiE9V CONS17tUCliON Aiq.UDING DECKS,
�DITIOl�iS_ &,�ORC1�S SUBM1Tc
1. Sitie PimySurvry shorwing tht existing structuras
�d ptaposcd projeet
�. Twa sets of conaauct�an pfans
3. Enclgy C8lmslations
AND MA
�- j� j � _ See Back Page for Fee Scbtdule
$ �� , 65°/a of Buitding PeTmit Fee
$ �� {.0005) tinaes the total job valtretion � Minimum S.SO
$ 5D0_ .QO1 x �ermit Valustion (1/10%)
y$ ' - $5.00 (State Licensed Resideadal Co�tractors}
$ $1450 per SAC Uait {Plans t4 M'WCC for detcrrnination)
$ �t+6ft= 8x�20=�
$ $450 Conservatian Plan Zteview
$ Fee Detenrni�ed by �ngiAtteering
$ _ . Ageement necessary ( ) Ne�a Necessaty ( )
THLS IS AN APPLICATiON FQR A PERMiT NOT VALiD UNfIL PROC'BSS�D
I hereby apply for a bui.ldin� per�nit and i ac�ut+wledge tbat tlye iaformation above is cam�ple#e and accurate; that the work will be in
conformance with the ordin�anees ead codes aftl�e City of �ridley and witb the Mmiaesata Csnstructio�x Codes; thax I understand this fs not a
permYt bttt o�y ea application for a pern�it and work xs not to start without a permit; t1�at the wark will be in accordance wit� the approved
pian i� the case of all work }�hieh requires review and �apprp,v,al of pian�.
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