AF - 40229City of Fridley, Minn..
6431 University Ave. 1�. E., Minneapolis, Minn. 55432
BUILDING PERMIT
aate: A�� * 2s,�] sz�
p��; __ Ha.rland Berry g�� Same
Address —�29 H� kC o� Drive N_E. Ad� S mP
784-2879
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LOCATIOiV OF BUILDING
No. 6931_� g.�t East River Road N.E. p� �g ��
Lot ._._.._ 4._.._.__ Block 4' __.__.__ Addition or Sub-Division Ostmants 3rd Addit�Lon
Corner Lot ___.�____ Inside Lot _..._ X Setback Sideyard
$��b�/ne�a�o� __s3.Q.93._.. .� �bvbd�/�:tbb��d� ����-��s�X.
�Tve H Top of Footing ,
DESCRIPTION OF BUILDING
To be Used as:
Dwelling __ Front 41 � Depth 25 � Height 20' gq, �, 1025' �,yi, �, 7680'
�=a7C8ge Froni �_ Depth � Hei�ht ��. Sq. F'� ..525 � Cu. Ft ] R 7 5
Ty►pe of Constructfion Wnnd gram - �, Cost .` �.� 2�.�,f35 To be Completed 1��v
Stipulation: Pxovide a hard surface driveway. Provide a verifying survey before capping.
WATER L(1CATION: 10� South of Sewer Service
SEW$R LOCATION: 43' South of Manhole
In consideration of the issuance to me of a permit ta c
� proposed work in accordarice with the description above
Ordinancea of the dty of Fridley. t
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e building descn'bed above I agree tp do
and in co�plian�vlth a'11 prov3sions oE
In con�ideration of the payment of a fee of $�e� , permit is hereby granted
to construct the building or addition as described above. This permit 3s granted upon
the express condition that the person to whom it is granted and his agents, employees and worl�nen, in sII Work
done in, around and upon said building, or any part thereof, shall conform in all respects •to the orclinanC� oP
ls'ridley, Minnesota. regarding location, construction, alteration, maintenance, repaiT and moving of btlildiIIge
Withiu the city limits and this permit may be revoked at any time upon violation oE any of the provisions of �id
ordinances.
a
CLARENCE BELIS •
NOTICE:
This permif does not eove� the eonstruetion, installafton for wtring, plum6ing, gas 6eating, sewer or water. Be sure io tas
ths Building InspeeFar for aeparate permits for theae hems.
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AP.PLICA�ION �OR RESIDENTIAL, A�T�RATION,
OR Allll�TION BUILD�NG P�RMIT
CITY OF FR�D�EY, MINN�SOTA � �p�� ��'��
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�Q : • l I ►S �'� .� : L�Q.$ T �/ � �°� ,(�^ A /'l /Y s.�.�
I� ; � BLOCK ° � ADDITION t� //� �'[��7 �» � h :s � �` �
. . � � � � �• �1 A�R�R �1
CORNER LOT : INS IDE LOT : /\ SETBACR: SIDEXA�tp g,�
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ppp�.i.caat attach to thia form Z�o Certificates of Survey of Lot aad pxop��e+d
building location drawa on these Certificates.
HESCRIPTION OF BUILDING
To Be Used As:
.
��lRd����h g Front: � Depth: ��i�tl� Height: `=�T :.' _
,
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Square Feet: �6�=- Cubic Feet: `7,68'c�
� � a �. ��
��g�� ' Front:_ �a ` Depth: a� � Height: ' �,. "
��s �wa m
Square Feet; �,r�'- �-� Cubic Feet: �-�-� �T' T� '�,
` .� m:.�.. �
'�rpe of Construction: ��`y, � Eatimsted Coet: $ .�,���oo
To Be Comnpleted: /973 '� r� � ..� .
The undersigned hereby makes applicati�n for a perpdt for tt+,e .w�7c1� ��7���p
$pec�f�,ed, agreeing to do all work in sttict accordaaca with the G��r�p�
F��d�ej► Osdinaacee and sulis�ge of the Department of Buildiags, aad '�e��bT
d�+cla�es that all the facte aad representationa stated ia thie ap���,e���,�
s�re t�cue and correct. �
�1TF : � oz 3
(See �tever�e Side For AdditionaY Information.)
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$UILDI�G PERMIT FEE SCHEDULE
S�CTION 2. The Inspector of Buildings ehall, before issuiag penait� for the
exectioa of aay building or structure, or for any addition �o any exist�n$
buildin� or structure, or for any alteration or repairs to aay exiating
bui,lding or structure, upon application therefore, require the payme�t by �h�
applicant for such permit of fees to the amouat herein below set fo7rt13 and i.r►
the manner herein prwided to-wit:
UIVIFORM BUILDING CODE: �pe 1, 2& 4-$2.15 for each one thousand cubi.c
�e,�t, ox fraction thereof, in such cubical contents. 1jTpe 3� 5-$�.$5 f4r
each one thousand cubic feet.
ADDITIONAL INFORMATION
Far the purpoae of computing fees for building permits, the cubical contents
of any building or additioa, ie determined by multiplying the ground area
covered from a point aix (6) inches below the floor line of the baseaeent �
o= the cellar to the average heights of the upper aurface or to the average� �
height of the roof aurface of the mein gable of a pitched roof.
For repairs or alterations to an existing structure, the fee ahall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all propoeed work.
T.r► ao case ahall the fee charged for aay permit as set forth in Sec�iQ� � b4�
lese than $5.00.
VFRIFICATION OF FOUNDATION
1�pT�; Permits for eonstruction will be issued a mini�um of 24 hours fYOwR Ghs
�ime of applicatioa, to allow for proper review of the proposed structu�e aad
of the construction eite.
�1 Ce7ctified Survey of the lot, ehawiag the location of the foundat�,pt�A q�t�� �,�
hga been constructed, will be required befo�e proceeding with the f;am�ng•
CERTIFICATE OF OCCUPANCY
Applicatioa for a Certificate.of Occupaacy ahall be made ten (10) days px�,AL
�� the use or occupancy of any atructure for which a buildi�g pesmit �as b�sA
iseued; and said atructure ahall not be used or occup3ed until a Certific$t�
o� Occupancy has beea isaued.
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INDUSTRIAL JOHN A. PETERSON FRANK R. LENZ, .JR. �� �;�_ .'Q�?Tr�"'��. �` '''
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eusiwess LANG SURVEYORS ` 1pqaM 5uctvEVS 't �
CITY �oiS . REGISTERED UNDER LAWS OF STATE OF MINNESOTA '���AK�sttoRE��'
TOPOGqAPHIC MAPPING LICENSED BY ORDINANGES OF CITY OF MINNEAPOUS �? � ��7UDICtAL ��.
3300 LYNDALE AVE. SO, MINNEAPOLIS, MINN. 55408 � t>;
` 824-0370 - �- _"+
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I hereby certify that this is a true and correct plat of a�urvey bf: ' �` �r
Lot 4, Block 4, OSTMAN'S THIRD ADDITION, Anoka County, Minra�sota, subjeCt to '� �
easements and restrictions o£ record, i£ any; that the buil�ing is enti�ely wi,thin� -
said'property and there are no visible encxoachments onto o� from adjoining properties -
other than as shown. . -
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� g hereby certify that this surve�9 Plaa, �� ' �� - � '
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•'� ; report was prepared b� me or u3ider rn� ;� �, .
direct aupervision �.nd th�t I am a dul� - � �"
Re�istered Land Surve�ror under tli� Ia�c�->�� ?�� '` �, tr ,; -
' a , °' � the �ate f B� e�o . � , -
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BUSiNE58 + C • 1� •
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CITYLOTS. LAhD SURVEYOR �
TOPOORwrr�c wwppina REGISTERED UhDER LAWS CF STATE OF MIhtVE50TA
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' LiCEKSED BY OR�iNANOE OF CtTY OF M(NNEAPOLIS
3300 L.YNOALE AVE. 50. MINNEAPOLIS 8, tv11N(V.
� ' TAYLOR 4-0370
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PLATTING
FARM SURVEYS
LAKESHORg
JUDICIAI
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I hereuy certi;y that t:�e ai�ove is a true ana correct pla� ci a surv�y cf;
Lot Four (4) , 31ock Four (4} , OS^I�,AN'S T';IRD �':DDI'�IO2], A;,oYa Caur.ty, ;•I?_�:i:; .;�,; .
As surveyed by m� tnis 30th. dai� af :•iarc:i 1�55 �. D,
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HOUSE HEATING TEST RECORD
6931 E. River Road NE. Fridle�r
)RESS APT. FLOOR CITY SUBURB
,:tJPANT �e Hammerstrom ONMER
:AT LOSS DATE HTG. INST.
s�LD BY �-�egasCO INSTALLED BY � � � � � � � � �. �
Electrical Work By Gas Line By � / � � � � � `��
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER fire�alace
GAS DESIGPt CONVERSION
MAKE Temco MAKE OF BURNER
Modet FP-2035-2 FPBlt-1 blower Model
Serial 7� �� �% 1- J Max. BTU Rating
INPUT �,� �'� � � �-�'� MAKE OF FURNACE
Model
CONTROLS
THERAAOSTAT� Heat Plug
Valve � �• �'� � �� �
Limit —
Limit Sstting
Fan Setting —
Pilot Type �° � � � P `' a � ��
P�ilot Make —� �
Pilot Model y � �
Pilot Timing � ✓� s �' �
La.W. Cut Off
Prassure �" � PereentCO�
Input CFH %�l'� Percent OZ
Staek Temp. Percent CO
Form 235
Vsnt Size � `'
KIND OF LINER / SIZF NONE G%�
Draft Hood ���/ � /� Regularor
Fi Iters Size Number
Chimney Loeation Inside�_Outside � �,
Chimnsy Constwdion e' � . � ' � �_� 4� �
Smoke Bomb
Draft
Wiring _
Test Tag
Door Pressure Lighting Inst.
Date Tested �� ° a � ° � �'
Company Testing "� d' �� ° R' � �-
Name of Taster � � �' ��
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UTNER OFFICES
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MlB/�Kti; ,N. ♦
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BAL�• VJRE MD
B1.00Mi�E�D �:ON�.
9015ff. �DA
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CNAIi�ES•i:N K v.1
CwE�ENNE. Nv.�
CNICAGO. tLL
GLHYEiAND �C�+1(?
GL�NTON. ^� �'
COWMBUS OM10
G�1.�AS. TfixAS
DAVTOhA BEACH F..A
DENVfiR. CJLO
DETRO�T. M��N
6A57,)N. PA
GRAN^ AAV�DS M�CN
GAEE�VSBORU. h �_
HOME INSPECTION C4NSULTANTS
55 NO. LEXINGTON PKWY.
ST. PAUL. MINN. 55104
224-8300
Au�ust 8, 19?6
N'r. Dale iiamm,erstrom �
ti431 E. River Road
Fridley, Minn.
Dear Mr. I?.aamerst�om;
OiMER UFi10E5
MARRISBURG PA
MOUSLON.TE%A$
►+uNrsviu e. wu
KANSAS Cfi� MO
l_AS VEGAS_ NEV
UY�•aGSTIiN h J.
MEMPM/y. TEPIN
MUM�. F�h
MUNTp�At LUEBEC
NEW YOR't N 1
ORLANDO �LA
PIiTSBUFCS.�. PA
PHI�EIELPr11A PA
R�LNt�WNO YA
A�rCKV�LLE CENTER. N� •
FiUHN11MEDE N 1
`i7 LUU�S. Mv
5AN FRAIVC�`iCd. GAi.1F
SEA�*� E. WA>H
1AiLAHAStEF_' Fl,h
WASMiNCi.'^.N. C C
At yotu° request I inspected the home �ou now own at the above address
ori August 5, 19'l6. T:ao t�t�se oi the inspection was �o observe certain
surface s�ructural imperfentior�s that are occurMng or have occurred Lo the
basic structural system of the house. I�st of the problams were noted bJ you
in the house and pointed out to me at the inspection. � '
'1.
�.
;
PiaDHI.�IS
_�
A beilge or ra3s3ng of Lhe roof ab��re the partition bet�een the housg
and the garage.
A rather large crack (1f4 to 3/8 " wide) in the front foundation
Wall near the intersection of the house and �arage.
The entira fovndation rear xa11 of the house 3s tilting ou�ward
at the top.
TME FOREGOtNG REVORT IS FURNISMEG AT YOUR REOUEST IN STRICT CONPIDENCE !Y US AS YOUR AGENT AND EMPL01fEE FOR YOUR EXCLUSNE USE AS AN AID IN DETER-
M{NING TkE PM'ISKAI CONDITION Of THE SUdJEC7 VREMISES. THIS REYORT IS INTENDED TO COVER OtrlV SUCH PORTIQNS Of THE PREMlSES AND TIiE EQUIPMENT THEREIN
AS MAY SE EXAMIHED vISUAIIY; AND WE WARN YOU TNAT AITMOUGM SUCN PREMISES AND/OR EOUIPMENT MAY BE IN GOOD GONDITION WMEN lXAMINEO, THE CONDlTION
MAY CMANGE TNEREARER. FURTMERMORE, THIS REPORT IS NOT i0 8E USED AS A BASIS FOW DETERMINING TME VAIUE Of SUCM PREMISES O8 WHETWfR SAME IS OR IS
NOT TO 6E PURCHASED TMIS REPORT i4 NOT TO 6E CONSTRUfD AS A GUARANiY OR WARIUMY OF TNE PREMISES OA EOUIPMENT THERIN OR OF TMEtR FITNESS fOlt USE_
HOME AND BLlILDING INSPECTION FOR THE HOME OWNER AND 9UYER
. .
•,i ,
L
4. The concrete floor slab at the bettom of the stairs has moved sach
that tbe floor ti�.e has opened up considerabls.
5. It appeare tt�hat t,he wal� in the agra�e is motr3ng out�rard sucrr, that
the ceiling joists haye pul],ed ayaey from the wal.]..
6. �'he w3ndoxs and doors are out of pinmb and ali.grmnent� such tbat ihe
storm �r3,adoxs and doors da not fit proper],�P resul'�ing 3,n per3.od3,c
pla�tng do�n to- make thetm fit� _ .� -
IXLSWSSI�Bi
In �r jucl��SAi all of the above pr�bl.e�rs are c�u�ed b3r nn�nta� dif�er- .
entia� settlement abou� xhich we do �t have� at►y m�thad ta deir.ernnit�� whsisI���r
it has stopped. The sattling iass occurred bsoause ths eaiire hous� has been
glaced npon poor soil. Due to t,h� fact that t,he gar$�e has greater dead
load caused i�r t]ie� conarete fl,00r slab most of t,he problems ara loca,ted
ia the garage°ars��
A].thongb mar�,y houses and small b�dings are placed upon poor soil,
the foot� and foundatior� are d�sigried accordi�g],Sr,
REC4i�i�+DAT�
Since� in my judgAent, t�►ese problems may c�ntiru� 3,ridefi.nite�y�
I wauld rec�e�d repa�.ng a7,1 of the ma�or defects and consider selling
t,he house. On the ot,her harid if it is your decision to keep the house you
should be prepared to have contintial, maintenance prcblems until all of the
ssttlemnent cesses.
���,s � ' ��'
� , . . • .c.�..�*�^"' �
Chester ' i�an3�g�.E.
Clvil tructru g3nser
xes. xo. 4532
�
�
� �
� �INHF OiFICES
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` ,! i1
.��e�r,v a r
AN�,^OA�GE A�ASKA
ATLANTA.. GA
BAI,TiMORE. MO
BLOOM�IEID. f.C�NN
B01SE.�DA
eosxur+. M�ss
CMARtESTCN. W VA
C►�E►ENNE. wv�
CM�CA!�J ��LL
CIHVELANC C`�+Il:
CL�NTpfv N. Y
COWMBUS. OMIO '
DALLAS.TEYAS
OAYtONA BEACt�. F�A
DHNVEN CJLO
DETRO�T MICM
EASTCN. PA
GRAN-O RAPIDS. MiGM
GREEN58�RO.N C.
HOME INSPECTION CONSULTANTS
�:arch 26, 1977
55 NO. LEXINGTON PKWY.
ST. PAUL. MINN. 55104
224-9300
;ar. Dale Hammerstro�
d931 East River Road
Fri�].ey, bliruzesota 55432
Dear I�ir°. Hammerstrom;
OTMER OiFiCES
MARpISBURQ. PA
MOUSTON.TEXAS
MUNTSVILIE. Ai.A
KANSAS CiT/. h7p
LAS VEGA3. NEV
LIYINGS70P� N J
MEMPMi3. TENh.
M�14M1. iLA
MONTREAL OUEBEC
NF_W �Oi1K N r
ORLANDO FLA.
PIffSBUR�3N. PA
PM�LAOELPN/A. PA.
RICNNIfsND. 1fA
RuGMV1LLE CEN7ER, N Y
RUNN�MflDB. N. J.
5T LOU�S, MO.
SAN RRANCISCO. CAl.li.
SEATT:.E. WwSN
TAtLAMAS$EE. iL/!
WASM/WGTGN. O G
This lettsr is in answer to your letter dated February 4� 197?.
First of aIl let me apologize for the long delay i,n answering yeur
letter. I have been qui,te busy lately in addition to now being a
Review Ewaluator Consultant of houses �or the Truth-in-Sale-oi-Housing
Baard in the Clty of Minneapolis. �
Basically you ask me to answer two
9UE5TIONS
1. What is the estinated cost to repair thesa defects?
�. Naw �izch 3o you feel these defects �.=ould a.ower the value cf L�e
house based upon today!s marketsB
OPII�'ION .
1. I aould judge that to repair all of the defects properly would cost
in �ze nei�hborhood of �5,000.00 to �10,000.00. Insofar as your concern
re�ardir,o tt:e horizontal sidin�, my estimate is based agon the removal
of a11 the aif �cted horizontal siding and windows and repZacing thc�
THE FOREG0ING REYORT IS FURNISNED AT YOUR REQUEST IN STRICT CONFIDfNCE 6Y US AS YOUR AGENi AND EMPLOYEE FOR YOUR EItCLUSIVE USE AS AN AtD IN DETER
MINING TNE PN�SICAI CONDITION OF THE SUSJECT PREMISES. THIS REPORT IS INTENDED TO COVER ONIY SUCM PORTIONS OF THE PREMISES AND THE EOUIPMENT THEREtN
AS MAY BE EXAMINE[l VISUAItY; AND WE WARN YOU THA7 ALTHOUGN $UCH PREMISES AND/OR EOUIPMENT MAY BE IN GOOD CONDITIOlM WHEN EXAIWt�IfD, THE CONDITION
MAY CHANGE TMEREAFTER. FURTNERMORE, THIS REPORT IS NOT TO BE USED AS A pA515 FOR DETERMINING TME VAIUE OF SUtM PREMISES OR WHETHER SAMf IS OR IS
NOT TO BE PURCHASED TMIS REPORT IS NOT TO SE CONSTRUEb AS A GUARANTY Oft WARMNTY OF TNE PREMISES OR EQUIPMENT TkERIN OR OF THEIR flLiVE55 FOR USE.
MOME AND BUII,DING 1N5PECTION FOR TNE HOME OWNER ANO BUYER
.., .
P '•
including a new paint job on the entire houss. I do not now if I
told you or not, but the footings, foundations and S].gDS could be
raised by a method known as "mud jacking." This would take care of
the problem for the prasent. There is no way to be sure tha,t settle_
ment hss ceased.
2. I aould judge tha� the pxresent problems r�ould lower the valve of
the haus� by �'Ipoppp�00 if the house was bought by a scrc�.pul,aus b,u�er.�
�' �ourse, sc�e bqy�rs would be infatuated i+►ith the hous�, t3a� t�igia�
borhood, the loca�Gion aud complete�r overl.eok any irregular9,ties iaa
the structu,re of the haus�o T�iey may even affer you more than y��n
think you cavld ge� in a normal, mm�°ket.
If you have at�rfnrther questions, �lease do not hesitate to
oontact me.
C�4j tOL
0
Yours very iruly,
� �
��f �� �
�-• G'?"'rtoSGC.Y-�G4� .
Chester,.J;,�3efricz �' ,,E. Reg. �w�832
/ � b:
��
6
�
l�oo•� .le.cdin� fo �undec�r .- /%4 .inch �ap 6e#ween dooa a,u! P�ame.
^�If.f lcand iui�dora ove�.loo�<�e� aundech -//� inch gap be�e�t Lvuaelc �i;ql►t
co�en�. and mi,i,da.� r,fi�anee.
�'�e�ck in uxe.L,L 6� doo�c .Leoding �inio 9a�cag�ee
�'�ack in �Cowmle,t,ion �. .Ge�. •si.d�. o� ga�ag,e doo�. - �L !/4 �rch.
�ou�da.tion be.#�ee�c 6eue�n� and �oam cu�de� � ti,lt,ing ou#u�d. S#,a.ra,�
p�.Lle.d arua� �aom r�,�a.LL //4 incly parn�liny, bvrhe.L�d 0% .incfi. auxe� �m �..
Soa.tleecvst co��e�. ol h�cl�R and .L�vtng �coo�+ee -�oau //2 inc% ocef o� .Leve.!
B�se,�ent �.[oo�, u#, �oot o� •�irun� �ett.Ge�ol !//2 i.nch. Lcue�,e, clrack,
�oin.f be�een b4xh �vund.a�,i.on �»,d maen hvu��. in �teo.�e., !�v ///2 inch c�ac.h.
BaAe�e�uE m<ndaca, ove�loo�hing .oeax �poad oat o�C LeveL' ��8 � raitli.i►c u.idt�
o,l each u,irrdo�.
�'�ac1�a �n ba�n.t .Gaund�.� �.00� �.loon. a,rd w�a,LL //4 ,i�cche.�.
C�ach�, in 6�e�en.t ba#lue�o� �.LaoR and +r�.lo .
�'wacJrs a,e hu.�e�et be.d�wwx �.Low� I/4 �ch.
l�o.se�„e�e.t 11ooK. 4et�.led cv►►�i�Lenab.l,e. in lec.Llu�ct�g a�a .Le.arf�c�. i.i+t.o .La�n,d�� noo►�.
Law�,z 6riLy,e in �ool abov+e pvic.ti�,ioR be#iuee�c #l�e l+octi.e and gnnccg,�, .
l?ea�c wa,l,L �o�rda�.i.nR v� hvu.le �il#,ing o�t�rrxucl a,t #lre fop.
Sa�a.�,e �tu�ivn se.tf.ce..c�. dvu�rur�ed �ieom �,aie��e �P,cooR I.�av.inQ �a�e 9�P.
n
e
SUBJECT •
City of Fridley 2 2 6 2 5
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
f
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
' `� - aa� �
1 � � PROTECTIVE INSPECTION SEC.
1 = �
� �"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE GAGE OF APPROVED BV
����"� � �'' 612-571-3450 s�aF�S 6/20/9 � �
J08 ADDRESS 6931 East River Rd NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. (} 4 Ostman�s 3 Addition SHEET
2 PROPERTY OWNEfi MAIL ADORES$ ZIP PHONE
Dale Hammerstrom 6931 East River Rd NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE IICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PMONE LICENSE NO.
8 USE OF BUILDIN(i
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
X
B DESCRIBE WORK
Construct a 248 SF Deck
9 CHANOEOFUSEFROM TO
STIPULATIONS
See notations on plan.
WARHIH6
Before digging call for
all atility locations
REQUIRED BY
LAW
TYPEOFCONST. OCCUPANCY(iROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REDUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERAAIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONINO SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WOFiK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. � NO. OWLG. 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 TVPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEHEIN OR NOT. THE GRANTING OF A PERMIT �ZsO21 �I.OI
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEfiMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- ' @
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �pS�F.00 Fire SC �L.OL
P�AN CHECK FEE TOTAL FEE
$57.03
SIGNATUREOFCONTRACTORORAUTMORIZEDAGENT IDATEI yy EHLY IDATED THIS IS YOUR PERMInT
�_ Y�
SiGNATUREOFOWNERiIFOWNERBU1LDEfi� IDATEi BLOG INS IATE
NEW
ADDN
ALTER
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Construction Address:
[.egal Descriptic�n:
Owner Name & Address:
ContraCtor:
CITY OF FRIDLEY
SIAIGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Applicadon
3/,N�'
Effective 1 / 1 /94
�+��i7
Tel. 1# 2 SS ��'/.�
MN LICENSE #
Adciress: S'� �I �;' Tel. #
Attach to this appiication, a Certificate of Survey of the
lot, with the proposed conshtiction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length R/idth Height Sq. Ft.
Length Width HgtlGround � Sq. Ft. �
4x/
Comer Lot j] Inside Lot [] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $ � � � I , � � _
Approx. Completion Date:
(Cost on BackJ
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: APPLICANT: Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$��, o o Fee Schedule on Reverse Side
$ � ��� .�1 of Permit Valuation (1/lOth%)
$ � , � $.SO/$i,000 Valua.tion
$ $800 per SAC Unit
$ $5.00 (State Liceased Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Coaservation Plan Review
$ Fee Determined by Engineering
$ Agreemem Necessary ( ) Not Necessary [ )
� �����
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BUILDING PERMIT FEE SCHEDUI.E
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 stntcture, or for any alteration or repair to any existing
building or sttucture, upon application therefore, require the payment by the applicant for such permit
of fces to the amount herein below seX forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$SOi to $2,000
$2,001 to $25,000
$7_5;001 to $50,000 �
$SO,t?Ql to $100,000
$100,001 to $500,000
$500,001 t,o $1,000,000
$1,00(3,001 and up
FEES
$15 (Minimum Fee is $15 plus surcharge)
$15 for first $500 plus $2 for eaci� additional $100 or
fraction thereof, to and including $2,000 �
$45 for fust $2,000 plus $9 for each additional $1;000
or fraction thereof, to and including $25,000
$252 for fust� $25,000 pl�s $(_50 for each addifional $1;OOQ
or fraction thereof, tn. and including $50,000
$414.50 for first .$50,000 plus $4.50 for each additional
$1,Q00 or fraction thereof, to aad including $100,000
$639.50 for first �$i00,000 plus $3.50 for each additional� -
$1,Oa0 or fraction thereof, to and including -$500,000 .
$2039.50 for the first $500,000 plus $3 for each additian,al
$1,000 or fractio3n thereof, to and including $1,000,000
$3539.50 for the fust $1,000,000 plus $2 for each additional
$1,000 or fraction �thereof •
DRIVEWAY DEPRESSION ESCR011V
(Concrete G�u�b Sireets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times
$13_50.
Alternate "B": Removal and repiacement of curb and gutter aad install a 3 foot wide.
approach with 6 inch depth - Driveway width plus 6 feet times $15_75.
VERIFICATION OF FOUNDATION
Permits for conslruction 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 const�uction site.
A Certificate of Survey of the lot, showing the loca6on of the foundation once it has it has been
constructed wil! be required before proceeding with the firaming_
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RIGHT OF ENTRY AGREEMENT
r r; o�%y C`'o �
T�IIS AGREEMENT, is made and entered this (� day of �� �� , 1995 by and
between Dale A Hammerstrom and Janice A. Hammerstrom, hereinafter refened to as the "Grantor",
and the County of Anoka, a palitical subdivision of the State of Minnesota, hereinafter refened to as the
"County".
WITNESSETH:
WHEREAS, The County is in the process of constructing Anoka County Highway Project
No.S.P. 02-b01-36, which includes improvements to East River Road in the city of Fridiey; and
WHEREAS, the Grantor(s) is the owner of property which adjoins the construction limits of said
County project; and
WHEREAS, the County desires to enter upon the Grantor's property for the purpose of
conducting certain work therean, which work is identified and describ�? in Exhibit A,, which is attache�
hereto and incorporated herein; and
WHEREAS, the Grantor(s) agrees to grant permission to the County to enter ugon t�iie property
io perform said work.
NOW, THEREFORE, it is mutually agreed between the parties as follows:
1. The Grantor(s) hereby grants to the County the right to enter upon hisfher property for
the purpose of performing the work identified and described in Exhibit A.
2. The County shall perform said work in a timely manner and return the Grantor's property
to its original condition, except for the changes described in Exhibit A.
s
t �
IN WITNESS WHEREOF the parties hereto have set their hands on the dates so indicated.
COUNTY OF ANOKA
By: �
Name: .� � �' l�� v; �
Title: �roJ��.� ��i'�u ; Sa ✓
Dated: �/ ��-�'�
GRANTOR
� �_.,� �.� ��t�►�� .,._ ��.1 _�
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By: `.. �- ,s.� 9
;
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N ��,�dda�
Dated: ��/ �j ��
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EXHIBIT A
�
I. Address:
• ��. .u�'.1►.■ ��L/
Project No: ��' �D �— 3 (p
Description of Required Work Area:
II.
Work Statement
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SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
�
i �
� �y __���_ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
� . �
i----� ��"' �'� CITY HALL FRIDLE� SS432 NUMBER
� 612-571-3450 910-F15
JOB ADDRESS
6931 Eas R e
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. (F 4 Ostman'
2 PROPERTYOWNER MAILADDRESS
� Dale Hammerstrom
3 CONTRACTOR MAIL AODRESS
Richard Hastin�s 6331 Riverview Ter NE �
d ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAILADDRESS
8 USE OF BUILDING
Residential
7 CLASS OF WORK
REV OATE PAGE OF
R/��/aR / /
27432
_./
RECEIPT NO.
����
AVPROVED BV
SEE ATTACHED
SHEET
ZIP PHONE
ZIP PNONE LICENSE NO.
574-9966 4051
21P PHONE' LICENSE NO.
ZIP PHONE LICENSE NO.
O NEW ❑ ADDtTION O ALTERATION � REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
8 CHAN(iE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, � irc vr wna�.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NUIL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 80 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
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS ypLUAT10N
AND ORDINANCES CaOVEFNING THIS TYPE OF WORK WI�L BE COMPLIED
WITFI WHETHEH SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OH CANCEL THE pERMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFOHMANCE OF CONSTRUCTION $5h _ 7S
� '� � � �? �
� SIGNAiURE Oi CONiPACTOR O UTMOpIZED AGENT IDATEI
i �
STALLS
OCCUPANCYLOA
CU. FT.
ET PARKING
IGARAGES
1C CHARGE
'i SC 1.75
) A FEE
THIS IS �RM 7
1 �
DATE
N� " [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION ��3� `� E�
. a ��
ConstructionAddress: � �3/ .�,�s� �� ���� Z d
Legal Description:
Owner Name & Address: �,� �.� ,z-�,�,c,�� � � .� � � 4 �'t Tel. �#
Contractor: � � �,I�, �. �p - ,�,�.� �'� > ti � � MN LICENSE � � � � /
Address: � 3 3/ ►� �,� � b�z i� t 1= � '%s�= Z Tel. �# S' 7�f - t��'G
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
LIVING AREA: Length Width Height
GARAGE �AREA: � Length Width Height
DECB AREA: Length Width Hgt/Ground
'i : v �
• �I �J /
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: /�� � � �� �-- i� s�� c� � Estimated Cost: $ � `% � � �
� (Fee Schedul e on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � �-� � . �' � �
g � APPLICANT. �,�� �.� Tel. � 5 ' � - l' ���
Permit Fee
Fire Surcharge
State Surcharge
$ .� �- 7S°�
$ /, �
$ � ��7
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
SAC Charge $ .$1000 per SAC Unit
License Surcharge �$ � D C, $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above �
Erosion Control $ $450.� Conservadon Plan Review
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ Fee Determined by Engineering �
$ Agreement Necessary [ ] Not Necessary [ ]
$��
�
BUII.DING PERMIT FEE SCHEDULE
. �.
The Chief Building O�cial shall, before issuing germits for the erection of any building or structure, or for
any addirion 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 $S00
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000 .
$50,(}O1 to $100,000
$100,001 to $500,000
$SOO,W1 to $1,000,0{?0
$1,000,401 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 $2�,�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 $1�,U00
$887.25 for first $100,000 plus $5.00 for each addirional
$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 or fraction thereof
DRNEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Altemate "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.
0
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, THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION W1LL BE RETURNED '
• �i �� • ► / ► / ► • ► ► • : � ► � • ii � 1 • ► ! : � 1 � ►
Wh@n ela _in9 an eYistinA f�rance, the undersigned hereby verifies that the
��°�nting has been examined and is free from rust, deterioration, obstructions, •
�d is securely supported and firestopped where required. Yes (� No ()-
��e venting system is piastic/PVC and meets all current codes and manufacturer
�eafications including sizing, length, number of elbows and termination. Yes (`k No ()
The undersigned aiso verifies that the replacement unit is a Gsted assembly
and meets the current codes and manufacturers specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The p� ' ��� ��-�+�+�si�ed-and irtstalted fio meet i�t� currerrtcodes
and manufacturer's speafications.
When �2quired to ine+all a new cemh�e±ien air�,it wi11 be sized and installed
to meet the current codes and manufaeturers speafications.
When in�Q a n w v_r,t�r,o� Pr,,, the undersigned hereby verifies that
it is a Gsted assembly and meets the current codes and manufacturers
speafications. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances.
Is the common vent and vent connectors sized and installed correctly after
an appiiance has been removed from the common vent and vented
separately as per cuRent codes.
Yes � No ( )
..
Yes � No (
Yes (� No ( )
Yes (� No ( )
Yes�No ( )
�nliance Tv�n�and S' a/ _emmen V_n and V _enn _cter Ir�fermafien
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appfiance #3 Type BTU Input Fan Assisted or Nat
Total AppGances Total Btu Input _ � _ _
Common Vent Type
Vent Height Diameter inches
AppGance #1 Vent Connector Neight ft ��hgth ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
� - 1�► �:- ..-
-- � - - - -
Center Potnt Energy MGCO
13562 Central Ave NE
HEATING CO: �ot�a, MN 553�4 � �
Signed By: � Date : � �' a� �
e
Cerr�erPoint�
Energy
Minnegasco
ADDRESS UC�?7� �l�aST Z���'� �B�
OCCUPANT�L�� lqti1a61rtL°
HEAT LOSS Yes � DATE HTG. INST. —1 21�03
SOLD BY s o
Electrical Work Bv__ C�� w dt� � 14�41QWUS Cp
TYPE OF HEAT FA �. SPACE HTR.
GAS DESIGN
MAKE � ��
Model � �5-01� 4� �.
Serial �� D ��Z �00 �O 1 �
NPUT ��� f30�
IlA 1.. ea�^��
CONTROLS
Pressure ?� � Percent CO2 �
nput CFH Percent OZ �� �
Stack Temp. � Percent CO � 1'° ' r'�"
HOUSE HEA�TING iEST RECORD
APT. FLOOR CITY T" rl(!l
OWNER � rr
INSTALLED BY ent int E er Mi ne sco
Gas Line By �,v� � 0�� " w� y d�nwy,a5 ( p
UNIT HTR. OTHER
CONVERSION
Vent Size �
KIND OF LINER SIZE
NONE �
Draft Hood �u+ V L ti'� Regulator
Filters Size I `IGZ � Number
Chimney Location Insid Outside
Chimney Construction G ���5
wirin9
k
Test Tag _ k
Lighting Inst.
Date Tested � " �- —
Company Te ' ter o' t Ener Minne asco
Name of Tester --C �"