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City of Fridley, Minn.
BUILDING PERMIT
.: - -. _,,.- •..:
OWII�l: J��LY��Qx'f�, BU]udCT S�.2T"P
�jd�g ��. Fas R i v_r Road Ad�gg Se.me �
No- 9931
LOCATION OF BUILDING
No. 759 �Street Ea�'� �V�� R__o�d � Part oP Lot -
� --
Corner Lot
Sewer IIevation
Block
Inside Lot X
Addition or Sub-Divls�ton
Setback �_ Sideyard
-- Foundation IIevation
DESCRIPTION OF BUILDING
To be Used as:
Liv Rm & Dia. Rm�t 284 �p� 10' Height ��— Sq. Ft. 280 Cu. FL .�920
Addition �nt Depth � i%ight Sq. F't Cu. F't
Type of Construction -�'x�e Es� Cost _�.,SD.�_ _ To be Completed 60�ayq
In consideration oP the i�usnce to me of a permit to construct the buildiug described above I agree to do
the proposed work in accwrdance with the descript�on above set forth and in compliance with afl provlafons of
ordinances oP the dty oP FrTdley. .� �� /9
�r�^ - - - -- i � . �f�..s. .1_�.re �O
In conafderation of the payanent of a fee of $.�0� , permit is hereby granted to Pat�ica.a L. L�raford
to construct the building or addition as described above. This �ernnit is granted upon
the express condition that theperson to whom it is grented and his agents, employees and workmen� fn a11 work
done fn, around and upon said building, or anypert thereof, shall oonform in ali reapects to the ordtnances oP
Frldley, Minnesota local3on, construction, alteration, maintenance� repair and moviag oP buildiuga
wlthin the dty ]imfts and permit may be revoked at any blme upon violation of any of the provisiona of said
ordiaanc�s. �--- .
J�o� Breher
Official
Bullding
�
� NOTIC�
'flds psrmt! dea aet corsr ths coes�rndioe, hnlalldioe tor �rUina, plumbine, ea haHn�, awu or w�r. B� wn fo sM
f6s Bntldiee le�etor tor aparai� p�rmhs fee th�a Itfms.
_ '
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. _ -.,
APP�I�ATION FOR BUIL�IN� PERMIT
LITY OF FRIDLE�9 MINNESOTA
OWNEC �S NAN� ���- ' � _ BUIILLDEft
ADDRF�S % 5 / 3 �c,..�t � ; �cJ ��z,_.e�AI�DRESS �" � lt-� y,-�-���� C� ,
�� t��-z-, ,..
LCC;ATION OF B�'ILDI�Ti�
1Nlf o "� ;�r � -� t,.711iL' P�1 •�� �i�/i'�-�/Z� �� � ��t`"J�
LO'T �/ BLOCI� 9�DITIOI�T OR SUBDIVISIO�f
COR�,'ER I,C�T I�TSIDE i�OT II SE°I'BA�k �I�E�%ARD
SEWER ELEiTATI01`I TOP OF �'O�TI�'�
Appli�arit arzach ico this �°o�! Tyao �°e�tif idat�s o�° Su�vey of I,ot a:e�LL
p�oposEd. build�..g loca.tio:ez drar�n. or� ch�s� ::e�tiiieate� o
�ES�R��I' i 01V Oa BII?�I,DING
To Be iT��d A�:
r �
L/v. ��• � D'l�.'�,�.r �ont �`� TJ�pth t� He�ght i'�
�:ac� rz��a. ` �.
�quare ieet ,2Fi� Cubic FE�t � 9 � �'
F�°ont DEpth Height
Squ�.re b �e�t :;ubic Feet
Type of Con�tructioxi ��- �'►-�� Estimated C��t .��r�' �T � c
To Be Completed � � � '`a `7 S
The undersigned hereby mak�s application fo� a permit f'or the �vorl�
heyeir�. speci�°i�d, agree�g to do all vaork i�. �trict accord€�.nce w�ith the
�'ity of Fridley Ord.ina..�.ees a,nd ruli.n.gs o�` th� D�partment o�° BuiZding� 9
and hex�eby decla.res that all the �'aets and rep�e�er�tationa statEd �n
this ap�lication a�e tru.e a;x�d co�rect o
�
DgTE `�?�/ / �Co � � 3G�TATURE 6 e.�►,�-,.�u, � .1
(Sch�c3ule o�° Fee Co�ts ca� be iou.tzd. on the Reve�ee Side�)
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BUIIIsIDIl�TG PE�RMIT FEE �CHEDt�IaE
SECTION 2o The In�pector of Buildinga ahall, ��f°ore i�suing per�its
for the Esection of any building o�° structure, ov° ior any add,ation to any
ex��ting �tzucture or buildi:c�g, or ior a.ny �.lteiation or repair� to �.ny
existi.t2g builr3ing or st�uctur� 9 upor� appli:;ation therefo�^��, �equire the
payment by the �.p�licax�.t ior euch �ermit oi fee� to the amoura,t het�ei�.
below �et iorth a.n�. � the ma:�tze� herein provid.ed to��sit:
Unifoxm Building Codeo Type 19 2, & 4 m$1075 ior each o:ne thousa.nd
cubic feet, o?� fraction thereof", ir such cubical c:ontent�a Type 3 8� 5-
$1050 for each one thousand cubi� feeto
For the puspose of computi�.g fees ior build.ing permits9 the �ubical
contents of any building or addition to a u�?iform height th.r°oughout by
multiplyin.g the ground area covered from a poirt six (6) inches below
the iloor line of the basement or the ceilar to the average height of
the upper �urface or to the avexage height o� the roof suriace of the
ma�.n ga.ble of a pitehed roof a
For repairs or alterat� o�.s to an exi�ti:ng str•uctu.z�e, the iee shall be
at the s�ate o�' $3e00 per eacY: iive hundred dollars ($500a00� or
iraction thereoi in thE co�t of al1 p�oposed wo�ko
In no case shall the iee charged f°or any pexmit aa aet �`orth i.� Section
2 be less than $50000
NSSSD Connection Cha:�ges based on location - Area 1 or 20
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� CITY OF FRI�LEY � � y3 � �
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PUBLIC WORKS DEPARTMENT
TAPPING APPLICATION AND PERNIIT
FOR INSTALLATION OF WATER & SEWER SERVICE
I) This form to be completed before a ta.p is made to aay esisting water or
sewer line.
Lot It�Block Addition �v �L A`'o Sv R� ��
Address � �1 �/� /� a (Z, � ,
�Yl /fl �/I�! 6 .CJ/JC A/'��d� _
CHARGES TO �BE PAID �EFORE TAP IS MADE — WHERE
ASSESSMENT HAS NOT BEEN LEVIID AGAINST PROPERTY
II) Water & sewer connection permit must be registered before this Tapping
Permit can be issued.
City supplies all material and labor for 1" or under water tap. Con-
tractor supplies all material and labor for water tap over 1", and all
sewer taps.
WATER TAP:
CO<5ui�(
Materials Used: $ � � � � ��
Street Patch: x . $
TOTAL: $ � �, � U
Street Patch: x . $
III) If this property has not paid a full Lateral Charge for its share of the
water and sewer system, additional chazges will be placed against it.
This will be in addition to the normal connection and tapping permits,
meter deposits, etc.
Water �/ �
ASSESSNiENTS TO BE LEVIED: Lateral: $`�T �.- D�
Sewer La.teral: $
�/ ��/// TOTAL ASSESSMENT: $ � • � �
l��.e-et.z.! �1�KY�(,'�Q.. � , `�
Clerks Signature �
Supt. of Public Works
M/P 3/76 White P.W. Canary Finence Pink Prop. Owner Goldenrod Plumber
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53-81�-S-915. 51
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Number Fixtures x $2.00 �_
Future Fixtures __ X $1.50
New Fixture-Old Open. x $1.50
Catch Bastn 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 Fitting Fees:
lst 3 Fixtures x $2.00
Additional Fi.xturea __ X $ .75
Gas Range-199,000 BTU x ,55.00
Repairs � Alterations
See
Description: Inst�ll D�ver Code 00
State Surchar�e
i�d�s:� `'!��' �aa��ha�g� �,6+�i;:�— • 5U
TOTAL FEE $ 5.50
The undersigned hereby anakes application for a pernai�
for �he work herein specified, agreeing to do all work
in atrict accordance w ith the Citp Ordinances and rulin
of the Department af Buildinge, and hereby declare that
�11'the facte and repxesentationa etated in thie
application are true and correct.
�-`r°+�-- _ _ � �
b41 G
�-13-�c./
Date
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City of Fridley
� aT Tke ToP o► rN[ rwiMY
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f ��-� i pTr MALL FIUOI.R: iM�
�.._..Jl.� �.� �-sso-s+so
ob Addxesa
7513 East River noad
Contractor
Kind of Building
on liate
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BJIN�BI
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53-8u-s-9i5.5i
Richard H. Keller
AAINNE��SCO
Frame
5-10-71�
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PLUMBI�Vr, PERf1IT APPLI�ATI��►�
1
s
naress
%3z fJ1AFcC�uE�� TF AV
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Res.
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one
, io.00
Plumbing Fixture Rates: N0. RATE TOTAL
Number Fix tures x $2.00 �_
Future Fixtures x $1.50
New Fixture-Old Open. x $1.50
Catch Basfn x $3.25
Water Heater-99,000 BTU x $3.00
Ground Run Old Bldg, x$3.25
E1ec. Water Heater x $2.00
Gas Fitting Fees:
lst 3 Fixtures x $2.00
Additional Fixtures '�_
__ x $ .75
Gas Range-199,000 BTU x $5.00
Re[�airs & Alterationa
See I
Description; Install Grill �ode 5.00
State Surchart�e �-i , ,s ,-,�"v, ���r������ p���, .50
I TOTAL FEE $ 5�50
I
!The undereigned hereby makea application for a pemnit
fvr the work herein s�ecified� agreeing to do all work .
in atrict accordance w ith the City Ordiaances and rulin
of the Department of �uildinga, and hereby declare that
a11'the facts and repxesentationa atated in this
application are true and carre t.
�� ; �a���,.,..�.,..
-o� _� e� � `� � � ��,.
'Signature i'�•: _ `J . - �' , Date ,
:
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.
SUBJECT PERMI
City of Fridley . 12634
, ` AT THE TOP OF THE TWINS g U I L D I N G P E R M I T RECEIPT .
r
� ; y _.�_ COMMUNITY DEVELOPMENT DIV.
r � PROTECTIVE INSPECTION SEC. ��� �
1 �' i
i-_-_ j �'��,,, CITY HALL FRIDLEY SS43Z NUMBER REV. DATE PAGE OF APPROVED BY
L J\ si2-ssasaso s�o-F�5 7/16/74 / /,
JOB ADDRESS 7513 East River Road
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1]. == A.S. �%% SHEET
2 PROPERTYOWNER MAILADDRESS 21P PHONE
Richard Kellon 7513 East River Road
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Milton L. Johnson Comn an 2513 Central Avenue.1�T.E.
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Aluminum sidin trim & utters
9 CHANGEOFUSEFROM TO
STIPULATIONS
SEPERaiE PE�}I�tTS fiEQU1�EQ F � �
�HEATING, PL�IMBING ANQ SIG�(�, �� �1R1N�,
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OP CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
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 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 yqLUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. $2 i OOO'�
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1. OO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY O ER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PE{A�F MANCE OF CONSTRUCTION. � ��.2. OO
PLAN CHECKFEE TOTALFEE
.`� �� 7 y $i3. o0
SIGNATUREOFCq TRA ORORAUTHORI2EDAGENT (OATEI W N PROP R V A D THIS IS YOUR PERMIT
I
- i i�
SIGNATUREOFOWNER(IFOWNERBUILDEFI IDATEI G INSP pA7E
AP.pLICATION FOR RESIDENTIAL, ALTERATION,
OR AllllTTION BUILDING PERMIT
. CITY OF FRIDLEY, MINNESOTA �
,
OWNER' S N1�� : ��� C-d'6 ��,�-ag ��; � C_a°a'e� BUILDER: � i � Tcr„6 - � ,� � 4 /=/ ,� ��.� ��
ADDRESS : `� �/ � � �Fs p �,���� V l o r�--� ADDRESS : , ,^7 � �° � /v �� � L�
NO•. 7�I � STREET• �'�s: �eJ� ��� —
LOT: BLOCK: ADDITION:
CORNER LOTs INSIDE LOT: SETBACK: SIDEYAR.D;
Applicant attach to this form �ao Certificates of Surv_ev of Lot and proposed
building location drawn on these Certificates.
To Be Used As:
DESCRIPTION OF BUILDING
Front•� Depth• Height:
Square Feet: Cubic Feet:
Front• Depth• Height•
Square Feet; Cubic Feet:
� L IJ`l�� .� ;lo �.v � , i /� i s�j ,�
Type of Construction: �° �� u� T�-`s Estimated Cost:_$ �, �s--� -�
To Be Completed: % - ��- � ,
�
The undersi.gned hexeby ma.kes app�.icatinn for a permit for the work herein
specified, agreeing to do all work in stzict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hexeby
declares that all the facts and representations stated i.n this application
are true and correct.
, .
DATE: � - / � - , Y� SIGNATIJRE • '� �(-c.�J- � �`°��
(See Reverse Side For Additional Information.) �
/,�. � � .
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BUILDING PERI�iIT FEE SCHEDULE
SECTION 2. Th.e Inspector of Buildings shall, before issuing permits for the
erection of any. building ox structure, or for any addition to any existing
building or stxucture, or for any alteration or repaixs to any existing
building or structure, upon application therefoxe, requixe 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:
UNI,FORM BUILDING COD�: Type 1, Z& 4-$2.15 for each one thousand cubic
feet, ox fraction thereof, in such cubical contents. Type 3& 5-$1.85 for •
each one thousand cubic fee�. �
ADDITIONAL INFOR�7ATION
For the purpose of computing fees for building pe7cmits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point six (6) inches below the flaox line of the basement
�ox the cellar to the average heights of the upper surface or to the 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 per each five hundred dollars ($500.00) or fraction thereof in
the cost of a11 proposed taoxk. �
In no case sha11 the fee charged fox any permit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE: Permits for construction will be issued a minimum of 24 hours from the
time of application, to allo� for proper review of the proposed stxuctuxe and
of the construction site.
d.
A Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceeding with the framing.
CERTIFICATE OI' OCCUPANCY
Application for a Certif3.cate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for which a building permit has been
issued; and said structure shall not be used ox occupied until a Certificate
�f Occupancy has been issued.
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.
City of Fridley
r OT TMR TOP 0� fl1E TMrINY
� ��-L ------; COMwUro1T� DEV[L.O�MENT OIV.
_ � � MtoTCCr�vit ws�tcTro►� onr.
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i......�.� �.J N7{-b�0-aN0
JOD Aaar@88
ner
Contractor
Rind of Bui
Com�e[ion
?57-3 East Rieer Road
Richard H. °eller
�IH�EGi�5�0
ng
Frame
e
3-7-75
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i�A�[CT
PLUMB I�r, PERf1 I T APPL I CAT I�7�J
ss
s ��3 MARqUETTE AVENU�hone
e
Res.
�` � �I�jB
�sLimacea c;ost -
. 10.00
Plumbin Fixture Rates:
N0. - . —RATE TOTAL
Number Fixtures x $2.00 �_
Future Fixtures x $1.50
New Fixture-Old Open. x $1.50
-�.._
Catch Basin 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 Fees:
lat 3 Fixturea ; "`� �'� X �=;QO °'
.� n ' -� n , '�--_.
Additional Fixtures � `�� �������'����j�
Gas Range-199,000 BTU 1 x$5.00 5.� �
Repairs � Alterationa
^ See I
Deacription; Code
State Surcharge ����� ���v� ����harge .��� __
xo�w �E $ 5.50
L'he undereigned hereby makes application for a permit
Eor the work herein �pecified� agreeing to do all work
L�n strict accorda,nce w ith the City prdinances and rulin
>i the Department of �ui�.dinge, and hereby declare that
�7.�.�the facte and representations etated in thie
tpplica��6�'.�s,`� Ap�����'�-
.
'Signature Date
.
M
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$TAT�:OF MINN►$(ITA Uf.YAMIMCNT04 HCALTN
7l'A�ION UY wiLL
a�"� WATE11 WELL qECORO
Anoka M,..�psp�„„�,.n,.,�
uNyNa� TewoYq tW{eN�m1w SRtr�wNe. Irrlw.a J. PROPCI
Fri dl e 30 5 24 E 2 N6J�` S�` S�J
ei...a �w.enw rrm r�almn.s�be. u. siMat MW..o na c7�s or a.a
7513 E. River Rd. _____.
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lDRMATION LO(i Lb1.OR NA�I�Nk�
Sand
Clay
{iard Pan
Clay Sand
tJater Sand
�dater Level 40' in 19�9
Vlell was removed
B ro�m
Gray
Gray
B rotan
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�D. RCYAHRB. tL6VAT[ON. BOUNC6 O! DATA. �ta.
Well Log Taken From:
Bob's Producw
7800 E. River Rd.
Fridley, f��J 55432
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M/NNRSOTA UNlQUE r'ELL 11/O, �
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ONiNE AME
, es L. Schl e�r �
7512 E. Riv ' d. �/ �(��'
Fridley, 55432 �
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1. CASIf/G NEICHT� Alow NOLL DtAM
25 �oaK. ��,.�., 5 �
71314tl�. fOWdded =R�� R.
/ �
50 '°"14 "0 12' �..�.* Y2�73 —
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s.� en.... a.e n.
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v. STATIC WATl6 LEVEI,
Dry � o� �.M� 9-21-87�
10. VUMPINGLk'wE1.NW�laudnd�ee) Not Pumped
11. �rts ta� O�d�t PCa.
f1. Ma hn. pomp6i{ �,p,..
11. WELLHEAUCOMPLETION In Basement
10 P�ttw �LayM. mmN�e[un+ mnetl
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�a areu. anovrena
OY.. �ne
�o�.��•.� :o�„�. ,0 0 Bags
Pulled Point
awm m.w�� ne. b R. Co. 7d.
`�.��°*��`��`a'" �"� Ci ty Sewer
Ma
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1�. PUMi
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❑ r�a �u,e.a
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LeapA of dteo Ob� � W7Rbf bya.
IUtM.I ef droy pp�
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Is. WATE0.N'ELLCONT0.ACTOR4�FATIi{CATid�
71W .r�O m dr�sd �aAs wf l� W IW nP� Y trs te
�.�„�.,.�.�p..��.
E.H. RENNEt� S� SONS, INC. 71015
llnnn OotwmNw L1nrr Ns
15688 Jarvis St. NW, ELK RIVER
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9 9- 24- 87
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M�.a.ipd �a.,.r..tatt..
Kev n Hoppe 9-23-87
���
�.
sue�ecr PERMIT
City of Fridley �. 4 3 5
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
� � COMMUNITY DEVELOPMENT DIV.
� �.: ------, ����
r � � PROTECTIVE INSPECTION SEC.
1 ` i
� /'�'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�"""� � �'� 612-571-3450 910-F15 �/8/92 � �
JOB ADDRESS �513 East River R�.d NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 11 REV. Auditor's Sllb. #%% SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mark/Susan Cutler 7513 East Ri.ver Road NE 571-5270
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 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDiTION ❑ ALTERATION � REPAIR O MOVE O REMOVE
6 DESCRIBE WORK
Reroof Dwelling (12 �qua.xes) Tear�o��
9 CHANGEOFUSEFROM TO
STIPULATIONS
Unde�laX�rtent must cozQply �ra.th. State Suildi:ng Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATIN(i,
VENTILATING OR AIR CONDITIONING.
THIS PEHMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. fT.
AUTHORI2ED 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 OFFSTHEET PARKING
I HEREBY CERTIFV THAT I HAVE READ ANO EXAMINED THIS APPLICATION STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUFTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $��6 $. �O
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON- $19tQO Fire SC yfi.64
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
$20.14
SIGNATU E OF CONTRACT R AU Ofi12ED AGENT DATEI H P RLY VA � ID ED THIS IS YOUR PERMIT
�� � � � � {� II � � �
GNATURE O� OWNE �i OWNER BUILDER� i AP i BLDG �NSP �p7E
\,��
NEW [ ]
ADDN [ ]
ALTER [ ]
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective 3/ 1/g2
Construction Address: �% J I 3�_ 1e /U� ]e, � 1'J ,
Legal Description: j� .� � v. /,����%, �� � c�� r/ � s n ��� 1
Owner Name & Address: ��k-,� SU s�, „� �,r,�?C.C--/2 Tel. � 5 � �' SZ,O
Contractor: � �. �- � MN LICENSE # �,� ,
Address: ��( Y� ��� A B O U� Tet. #��
Aitach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
� DESCRIPTION OF IMPRO�MENT
LIVING AREA: Length Width Height
GARAGS AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
OTHER:
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [] Inside Lot [] Ft. Yd �Sexback Side Yard SBtbacks
6
Ty� of Construction: Estimat� Cost: $ ��
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Ne�ed: Ft. + b Ft = Ft x$ _$
DATE: �% i 9� APPLICANT: Tei. #��/-5�- ��
Permit Fee $ 1 . C� �
Fire 5urcharge $ �
State Surcharge S • �1
SAC Cbarge $
License Surcharge $
Driveway Escrow $
Park Fee $
Sewer Main Charge $
TOTAL $ �� � �
STIPULATIONS:
_ � ����
Fee Schedule on Reverse Side
.001 of Permit Valuadon (i/lOth%)
$.50/$1,000 Valuation
$7(� per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. °B" Above
Fee Determined by Engineering
Agreement Necessary j] Not Necessary [)
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 bnilding or structure, or for auy alteration or repair to any existing
building or structure, upon application therefore, require the payment by the applica.nt for such �rmit
of fees to the amount herein below set forth and in the manner herein provid� to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,�
$2,001 to $25,�
$25,001 to $50,000
$50,�1 to $100,�
$IIXT,�l to $5�,(T00
$500,001 to $1,000,�
$1,(10U,001 and up
FEES
$1 S(Minimum Fe� is $15 plus surcharge)
$15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1,000
or fraction ther�f, to and including $25,000
$252 for first $25,000 plus �.50 for each additional $1,000
or fraction thereof, to and including $50,�0
$414.50 for first $50,000 plus $4.50 for each addidonal
$1,000 or fraction thereof, to and including $100,000
$639.50 for first $1�,�0 plus $3.50 for each additional
$1,(�l0 or fraction thereof, to and including $5�,000
$2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,(�0,000
$3539.50 for the first �1,�,0� plus $2 for each additional
$1,000 or fraction �thereof
DRIVL�WAY DEPRESSION ESCROW
(Concrete G�rb S1re�ts Only)
Alternate "A" : Removal and replacement of curb and gutxer only - D�iveway width plus 6 feet times
$13.50.
Alternate "B" : Removal and repL�cement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75 .
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of applica.tion to allow
for proper review of the propos� structure and of the conshuction site.
A Certificate of Survey of the lot, showing the location of the foundation once it b.as it has been
constructed will be required before proceeding with the framing.
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Hois�r�i�a�se x��rss ar� a�i�
sue�eti • PERMIT NO.
c�ty of F��a��� 3 2 0� 9
AT TME TOP OF THE TWINS � u I L D 1 N� P E R M I T
r
; � RECEIPT NO
COMMUNITY DEVEIQPM�NT DIV. r�j?2 360�
i ♦V ��'��'� .
f � � PROTECTIVE INSPECTION SEC. �
1 . . @�
� _ �"'1 � CITY MALL FRIDLE� SS132 NUMBER AEV DATfl vAGE OF Ap ROV
�""'� � �'' 612-571-3450 910-F15 7/31/O1 � �
,
JOB ADDRESS �513 EAst River Road
t LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACNEO
DESCR. lj REv. Auditor's Subdivision ��77 SMEET
2 PROPERTV OWNER MAII ADORES$ ZIP PMONE
Cutler, 7513 East River Road, Fridley, MN 55432 763-571-5270
3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO
Tacheny Roofing, 49 S Owasso Blvd W, Little Canada, MN 55117 651-484-1466 7596
4 ARCHITECT OFi DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
S ENGINEER k1A1L AODiiE$S 21P PMONE IICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION C� REPAIR O MOVE • O REMOVE
8 DESCRIBE WORK
Re-roof (tear-off) 14 sq.
9 CHAN(iE OF USE FROM TO
STIPULATIONS �
Underlayment must comply with State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAI, PLUMBiNG. HEATING, TYPE OF CONST OCCUPANCV GROUP OCCUPANCY LOAD
VENTI�ATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULI ANO VOID IF WORK OR CONSTRUCTION ZpNING SO. FT CU FT.
AUTHOR12ED IS NOT COMMENCEO V�!ITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANQONED FOR A PERIOD Of /20 DAY$ AT "
ANY TIME AF7ER WORK IS COMMENCED. ` NO DWLG. UNITS OFfSTREET PARKING
I MEREBY CERTIFV THAT I HAVE READ AND EXAMIN�O THIS APPLICATION S7ALLS GAiiAGES
AND KNOW TME SAME TO BE TAUE AND CORRECT. ALL PROVISIONS OF LAW$ yp�UATION SUR7AX
AND ORDINANCES GOVERNING TMIS TVPE OF WORK WILL 8E CpMP�IED @
WITM WHETMER SPECIFIED MEpE1N OR NOT. THE GRANTING OF A PERMIT W 1 f 432 . OO ��. 72
OOES N07 PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL TME pERMIT fEE SAC CMARGE
PROVISIONS Of ANY OTHER STATE OR IOCAL LAW REGUlA71NG CON- @
STRUCTION OR TME PERfOflMANCE OF CONSTRUCTION y�S�F.�� F,ire .5�.' �1.43
� P�AN CNECK FE� TOTAI FEE
�_ �--._r�._ , � - - �,, � �,-, 1�.�,�, l�'� ► �� l� License $5.00 $61.15
S�GN4TUAE OF CON'AACTOA OA AUTMOA�ZED OGEN1 iO�TE� WN PqOPEpLY VALIDATED TMIS IS YOUR PEAMIT
` - C
s i �- >
S�GNGTUAEO�OWNEp���OWNEpBWLDEp� �O�fE� G �NS q�TE
NEVV [ ]
ADDN []
ALTER [ )
Effective 1/1/2001
CITY OF FRIDLEY (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: � � ' � E�=�c�-r �-� a �. c� �A o��, � �
Legal Description: �� � �� ��-� ��� � 4-� � �,� �
Owner Name 8� Address: C� �--1 � � Tel. # � � � -- '� � � - �z� ��
Contractor. y v=«�"'�� N��� \'�,�,� ��, ��{�, MN LICENSE #��`�-� �
Address: �1�� '� �, +� t;�, n�� C �,�..� v � i �• 1 ,�..l� Tel. # C�, c � d - �c `���-} � 1 � � "�
Ca�'�'� C��«d.�- , %'� S�L, '1
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LNING AREA: Length Width Height Sq. Ft
GARAGE AREA:
DECK AREA:
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
OTHER:
�� .3 �. �
Construction Type: Estimated Cost: $�' ,��� 0 I'� �:'Jc, ,,
�,
Driveway Curl� Cut Width Needed: Ft + 6 Ft = Ft x$ _$
� �-
DATE: � � � / � � APPLICANT:1���--�.-v-.r._u � s��J �-�.���--a,� �� Tel. # �a � � - 1 �� ��'d;
' -�,
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ U Fee Schedule on Reverse Side
Fire Surcharge $ � 3 .001 of Permit Valuation (1/10th%)
State Surcharge $ • �a $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ $1150 per SAC Unit
$ 5� o� $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 [ ]
$ iQ.�J
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 e�sting 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 tawit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to _$50,0�
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$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 $1,000
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,�
$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 $500,000
$3,233.75 for the first $500,000 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
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Altemate "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 foundaxion once it has it has been constructed w�ll
be required before proceeding with the framing. New Houses Onlv
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ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
57Z-36U4 l+'AX:
: 7513 E RIVER RD NE
: 103024110013
: AUD SUB NO 077 (REV)
: LOT 11 BLOCK
: HEATING
PROPERTY TYPE : RESIDENTIAL
CON5TRUCTION TYPE : ADDITION/ALTERATION
571-1Z7f7
---�_ �
�.
PERMIT O.: 2004-01223 �
,
DATE ISSUED: 07/30/2004
VALUATION : $ 2,500.00
NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERNIISSION FROM
ADJOINING PROPERTY OWNER. COMBUSTION AIK SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A.
INSTALL AN AIlZ CONDITIONER.
# A/C iJNITS 1 VALUE OF APPL OR WORK 0
#FURNACES
# GAS RANGES
APPLICANT
BONFES PLUMBING & HEATING
505 RANDOLPH AVE
ST PAUL, MN 55102
OWNER
CUTLER MARK E& SUSAN J
7513 E RIVER RD NE
FRIDLEY, MN 55432
0 # GAS DRYERS
0 VALUE (FOR MINIMUM CALC)
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or constntction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and lmow the same to be true and correct. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating con�truction or the performance of constru�ti 1.
Ap�fi� , Date
: � � � �/�I i�1;r►�� � .
HEATING PERMIT MIl�TIMUM FEE
FURNACE SHELL/DUCT WORK
GAS RANGE FEE
GAS DRYER FEE
AIR CONDITIONING FEE
I�ATING REPAIltS/ALTERATIONS
STATE SURCHARGE, MECH FLAT
TOTAL
PAID WIT'H CHECK # 3678
0
2500
0.00
0.00
0.00
0.00
25.00
0.00
0.50
25.50
ADDRESS
PIN
LEGAL DESC
PERNIIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
s�z-36u4 r��:
: 7513 E RNER RD NE
: 103024110013
: AUD SUB NO 077 (RE�
: LOT 11 BLOCK
: BUII,DING
: RESIDENTIAL
: ADDITION/ALTERATION
s�i-ia��
PERMIT O.: 200401337
DATE ISSUED: 08/16/2004
VALUATION : $ 15,722.00
NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS.
PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOM5 AND ON ALL LEVELS OF TI� DWELLING PER R317 OF TI�
2000 INTERNATIONAL RESIDENTIAL CODE. CONSTRUCT A 28' X 6' FRONT PORCH; REPLACE 16 WINDOWS WITHIN
EXISTING OPENII�TGS.
STATE LICENSED CONTRACTOR 1
APPLICANT
TWIN CITY HOME REMODELING (20385210
6527 CENTRAL AVENUE
FRIDLEY, MN 55432-
(763) 572-2577
OWNER
CUTLER MARK E& SUSAN J
7513 E RIVER RD NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes nu11 and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and l�ow the same to be true and conect. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a pemut does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Anuli� Date � �
Bldg Insp.
SEPARATE PERNIITS
BUII.,DING PERMIT FEE
PLAN CHECK FEE
FIlZE SURCHARGE
STATE SURCHARGE, VALUE
LICENSE SURCHARGE
TOTAL
PAID WITH CHECK # 22601
0
FOR WORK OTI�R THAN DESCRIBED ABOVE.
265.25
72.31
15.72
7.86
5.00
366.14
NEW
ADDN '
AL7ER �
�Ly� `����� 3�� �
[ ] CITY OF FRIDLEY
[] 6431 University Ave NE, Fridley, MN 55432
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
�
� ����
Effective 4/1/2004
(763) 572-36 4 Bld Insp
(763) 57 -12 7 �
l� �'
�
r
Legal Description:
Owner Name 8� Address: f�l�� C��-I-e� Te� #� ,�"°7 /- S`'2 � o
Contractor. � c� �� ��DELING MN LICENSE #
VG.
Address: ��ie ee�� ��,��� Tel. # . L�NQ
, Ph.7G3- - 77
"�,� � Uc. �����,#�i this application, a Certificate of Survey of the 6521 Old Central Ave.
, '�he proposed construction drawn on � to scale. F�iley� MN 55432
. PIt.7�-572-2577
DESCRIPTION OF IMPROVEMENT �.,_ � �. �385210
LMNG AREA: Length Width Height Sq. Ft
GARAGE ARE�A: ,c Length Width Height Sq. Ft
DECK AREA: �� Length :Z �� Width C� Hgt/Ground L��� Sq. Ft Alo �
OTHER: � "� �X � �°l•�%G S4 of . �' ��I �' -�o� ��
I� U.�.� �..'�.:G� -�,r : s�� cav�� wS S� o � I j��o��� ��
Construction Type: �ite� �o � Estimated Cost: $ Z e o o� 3 3�l�
Driveway Curb Cut Width Needed: Ft + t= t x$ _�
DATE: ?� � � —a `I APPLICANT: �'v Te�# � � 2 - Z.S� � ?
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for car� number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
CITY USE ONLY -
Q� ��� 0 O[ �
�
$ -7� , .
$ / .
$ -
$
$ ���
$
$
$
$
Fee Schedule on Reverse Side
65% of Permit Fee u�s�� �� ��1 �� `��1�� �-� °
.001 of Permit Valuation (1/10th%) �°2 �2c� °`�l�
$.50/$1,000 Valuation
$1350 per SAC Unit
$5.00 (State Licensed Residential Contra�tors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ �C4� < I� STIPULATIONS:
BUII,DING PERMIT FEE SCHEDULE _
The Cluef Building Official sha.11, before issuing permits for the erection of any building or structure, or for a�y
addition to any existing building or structure, or for any alteration or repa.ir 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:
$1
TOTAL VALUE
to $500
$501 to $2,Of�
$2,�1 to ' $2�,000
$25,001 to $50,000
$50,001 to $100,0�
$100,001 to $5�,0�
$500,001 to $1,000,000
$1,0�,001 and up
FEES
$23.50
$23.50 for first $5� plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,� plus $14. QO for each additional$1, 000
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,� plus $7.OfJ for each additional
$1,0� or fraction thereof, to and includi.ng $1�,0�
$993.75 for first $1�,000 plus $5.60 for each additional
$1,�0 or fraction thereof, to and including $500,0(?0
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,0� or fraction thereof, to and including $1,�,000
$5,608.75 for the first $1,000,�0 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 constntction will be issued a minimum of 24 hours from the time of applica.tion to allow for proper
review of the proposed structure and of the construction site.
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the existing founda.tion will be required before
proceeding with the framing. New Houses Onlv
JUL 30, 2004 17 :46 Dati Mo�[tel
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TWIN CITY HOME REMODELIN6 • 6527 CENTRAL AVENUE •�FRIDLEY, MN 55432 • 763-572-2577 / FAX: 763-572-2578
ADDRESS
PIN
LEGAL DESC
PERNIIT TYPE
PROPERTY TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
�63) 572-3604 FAX: (763) 571-1287
: 7513 E RIVER RD NE
: 103024110013
: AUD SUB NO 077 (RE�
: LOT 11 BLOCK
: BUII..DING
: RESIDENTIAL
CONSTRUCTION TYPE : RESIDING
VALUATION : $ 13,578.00
�� �
PERMIT O.: 2004-01923 ',
�
DATE ISSUED: 10/19/2004
NOTE: PER R703, 2000 INTERNATIONAL RESIDENTIAL CODE, REQUIRES THAT A WEATI�R RESISTIVE BARRIER BE
PLACED OVER EXTERIOR SHEATHING TO PROTECT THE INTERIOR WALL COVERING. EXCEPTIONS FOR THIS
PROVISION WOULD BE IF SHEATHING IS AN APPROVED WEATHERPROOF PANEL OR WI�N TII� SIDING IS AN
APPROVED WEATI�R BARRIER VINYL SIDING IS NOT A WEATI�RPROOF COVERING UNLESS THE
MANUFACTURER STATES THIS IN TI�IR APPLICATION GUIDELINES. CALL FOR INSPECTION OF WRAP BEFORE
COVERING OR TAKE PICTURES, RESIDE HOUSE.
STATE LICENSED CONTRACTOR 1
APPLICANT
TACHENY ROOFING & SIDING INC 7596
2980 RICE ST
LITTLE CANADA, MN 55113-
OWNER
CUTLER MARK E& SUSAN J
7513 E RIVER RD NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null a.nd void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and laiow the �ame to be true and correct. All
provisions of laws and ordinances governing this type of worl�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of constntction.
Avnlicaat` � Date � 1
: � : � . j�j�.0 l � , r��
BUII.,DING PERMIT FEE
FIltE SURCHARGE
STATE SURCHARGE, VALUE
LICENSE SURCHARGE
TOTAL
PAID WITH CHECK # 15857
SEPARATE PERMITS REQUIKED FOR WORK OTI�R THAN DESCRIBED ABOVE.
237.25
13.58
6.79
5.00
262.62
NEW [ ]
ADDN []
ALTER [ j
Construction Address: 6 � � �
Legal Description:
Owner Name 8� Ad ress: ��
Contractor: �� C ��
°�v�r� . __ ra
LNING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
CITY OF FRIDLEY
6431 Universiiy Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�1►��� (��
�Lf�� �l
����� f ` (� )! �c� _�
e
Effective 1 /1 /2002
(763) 572-3604 Bldg insp
R��O��,
Tel. # %� �.�"�� ,����
�� ' � MN LICENSE#���► �
��/ � Tel. # 6
Attach to this application, a Certificate of Survey of the
lot, with the proposed consttvction drawn on it to scale.
DESCRIPTION OF IMPROVEAAENT
Length Wdth Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width HgUGround Sq. Ft
YP �_l°P � � �� 1 @ 1 ��
Construction T e: o� Estimated Cost: $ ���� �
Driveway Curb Cut wdth Needed: Ft. + 6 Ft = D Ft x$ _$
T
� �DATE: APPLICANT: Te1.
Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
CITY USE ONLY -
$� �i�r �"� Fee Schedule on Reverse Side
$ I� e�b� .001 of PermitValuation (1/10th%)
$ �� , � �,� $.5�0/$1,000 Valuation
$ $1200 per SAC Unit
$ �d �!'�� $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 [ �
F .�
$
STIPULATIONS:�
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing pernuts 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 pravided to-wit:
TOTAL VALUE
$1 to $5�
$501 to $2,000
FEES -
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
------ -
- - ----- -
-- - -
��,DO1--t6 ��;6�-- $69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $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
$391.25 for first $25,000 plus $10.10 for each addition�l $1,000
or fracdon thereof, to and including $50,000
$643.75 for first $50,0� 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 $500,000
$3,233.75 for the first $500,000 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 $3.1� for each additional
$1,000 or fraction thereof
- --- _ —
DRIVEWAY DEPRESSION ESCROW
(Concrete C�rb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 fe�t times $1 S. 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
�iii�d�ig
Inspections
763-572-3604
763-502-4977 FAX
DA� �� z� -.� 9
SITE ADDRESS l J !
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
DESCRIBE WORK BEING DC
SIZE OF IIVIPROVEMENT
ROOFING
NUIV�ER OF SQUARES _
GARAGES
PROPOSID SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
O Aluminum
❑ Other
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR �MAIL ADDRESS
O OWNER �ONTRACTOR
NAME: /„ B� � , C.
annRFCC• i S J 3 �L'�
�
Permit No.;� � ° Q'%�,
Received By:
Date Rec'd: �� �'.�
NAME• � nN� �.. . ..�...� ..�...��M..--• -----
ADDRESS: _ CI1'Y STATE ZIP
PHONE
STATE LICENSE
�SINGLE FAMILY/NEW COT7S'I'AU�TTO�T
❑ TV✓O FANIILY/NEW CONSTRUCTIO
O ADDITION ��� �
� BASEMENT FINISH TL��F
❑ DECK ❑ SIDING
_ FAX
�
EXP DATE
SILE
STORIES
❑ WINDOWS
❑ DRAIN TILE
� OTHER
O NEW HOME CONSTRUCTION 0 ADDI170N
C] MAINTINANCE/REPAIR ❑ REMODELING
:: Jv� �oZ. X �o s
LINGTH WIDTH HEIGHT S
❑ HOUSE ONLY gASEMENT REMODBLING SUBM[T:
_ O HOUSE & GARAGE �� �%„` �� �. Existing Floor Plan
O ATTACHED GARAGE `J� z. Proposed floor plan
O DETACHED GARAGE 3. List of strucdual members W be u�d
OSoffit
0 Trim
❑ Fascia
wnvnows
IN EXISTING OPENINGS OYes �No IACATION OF WINDOWS
OR FOR DJEW OPENINGS-DESCRIBE SIZE OF
OPENIIJG CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF V
ALL FEES ARE BASED ON VALUA7
d/ _ (USING
TOTAL JOB VALUATION
Permit Fee
Plan Review
Fire Surcharge
Surchazge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Chazge
Total Due
FOR NEW CONSTRUCITON INCLUDING DECKS,
ADDITiONS. & PORCHES SUBMIT:
I. Site PlanlSim+ey showing the existing strucriues
and proposed proje�ct.
2. Two sets of consk�uction plans
3. Energy Calculations
INCLUDING TAE COST OF LABOR AND MATERIALS:
1997 UBC FEE SCHEDULE)
`�2ie �l� Or'�C:C"i1PANC'V TYPF.
$ �-� �>�� See Back Page for Fee Schedule
$ �e'd S,� f 65°fo of Building Permit Fee
$ ��, �?}( .001 times the total job valuation
$ A ( , � � .0005 x Permit Valuation Minimum $.50
$ �; � $5.00 (State Licensed Residential Contractors)
$ ��- $1825 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$21=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ ,� ,/ Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I eclmowledge that th information above is complete and ecourate; that tha work will be in conformance with the ordinences and codes
of the City of Fridley and with the Minnesota Co ction odes; U�at I understand this is not a pertnit but only an application for a permit and work is not to stert without a
permit on site; that the wotk will be in accor ' the �,ro�v in the case of ell work which require eview and a proval o/f� lans.
SIGNATURE OF APPLICANT ��/ PRINT NAME ��N%�l � �I/ /� /f9 w! DATE�
APPROVED BY DATE
' / � � 1,�.1.,±�.,
1���, �_� 12135 �-�: Pa � 1 of 3
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��� Take this s��e# to the-Build�ing M�t�ri�al� co��:#�r to purchas� your ma#e a s, �
YoW have ����c t� d a�ara e w� t�: �
. 9
�� Wide X�� �eep X 8' High
Gable room �in attic roof wl 10112 pifch trusses
2x4 Wal1 Framing Material
� 12" gablel12" ea�e overhangs
� �a' OSB Wall Sheathing
�� Typar Housewrap
,� �F�' OSB Roof Sheathing
314" T&G OSB RIA Floor Sheathing
R' D bl 4" L S'd'
The options you have selected are:
2' O.C. 15 lB Roof Felt
2 Rows Granular Ice & Water Ba�ier
� 3 ��' JL}�.�s� ��
%�
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, , . .L°'i�k�Li�.�`4_� tFF� IlEL WW� ���Ir
Cypress Vinyl ustic ou e ap i ing ���� ���� ��� :�:�� �����������
30 yr. Oakridge, Onyx Black Shingles' '�� ��' 4
O.C, Vents�re Ridge Vent �� � �
White Aluminum Soffit & Fascia
White Premiurn Roof Edge
White Unyl Ove��ead Door Jamb
Frant Uiew
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Illustration May Not Depict All Options Selectetl
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s�e restrict�ons, all final plans antl matenal lisfs musf be verified wifh your local zoningoffice, arch�ect andlot builder for buildi�g design antl cotle compliance. Menards is a sua;. zr of
construction matenals and does not assume liability for design; engineenng or fhe completeness of any.material lists providetl. Undergrountl electrical, phone a�d gas lines sho�:��: be
locatetl a►�tl marked before your builtling plans are finalizetl. Remember fo use safety equipment includmg dust masks and sight and hean�g protecfioo dunng construction t� ��: ::;; �
a positive builtling ezpenence.
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-- Hel�ful Hints for Room In Attic a�r�.:� e Construction �
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� 10112 pitch truss; room size varies wit b�ild�ng width estimated. �
� Trus�es can not be cut or modifed. �
� Increased loading for the floor is includ d in�the room area only.
� Trusses are not built with eave overha gs, eave overhangs need to be hand framed
N Dormers as well as other stair�designs are possible. To receive a cus#om estimate,
see a Building Materials team member for details.
Menards provitletl material e,.�!imates are intended as a general construction aitl and havebee� calculated using typical construction methotls. Because of the witle vanable in codes a�tl
site restrictions, all final pla�s and material lists must be ve�fetl with your local zooi�goffice, arch�ect apolor builderfor building design and�cotle complia�ce; Menards is a supplier of
construcrion materials antl does not assume liability for tlesign, engineenng or the complefeness of any material lists provided. Undergrountl elecfrical, phone antl gas li�es sho�!d be
locate� antl marked before yoar building plans are finalizetl. Remember to use safety equipment including dust masks and sight antl hearing proteclio� tlunng construction io ensure
a positive building ezperience.
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CITY OF FRIDLEY
6431 University Ave NE
Fridley MN 55432
(763)572-3604 FAX (763)571-1287
MOVING [ EMO
] PERMIT APPLI(:A'1'lUN
�, '��� �� �Q �5 6
�" (
Job Address: `%�i 3 ���� �' �'e� � �
Legal Description:
Owner & Address: �./2 C�v /�� Tel. # S�7/�527�
Contractor : /��`•� � � r,--� �.P/+t e � �` � � e. Tel . #7 %� -� S 7 `�
Address: �i/d �'r�- �►� i�w� %�� rj'�� State License # 2��'� �9��
���z � DESCRIPTION OF BIJII.DING
HOUSE: Length Width Height Sq. Ft.
GARP,GE:Length 2� Width •f � Height Sq. Ft. �
OTHER: Length Width Height Sq. Ft.
Estimated Cost $��,d�9 Approx. Completion Date
Cu. Ft.
Cu. Ft.
Cu. Ft.
rnr•T• GOPHER STATE ONE AT 651-454-0002 FOR IITILITY LOCATIONS. CALL ALL
IITILITIES FOR DISCONNECTS BEFORE WRECItING MOVING STRIICTURE.
Moving Route:
APPROVAL(S) REQIIIRED PRIOR TO ISSUANCE:
1�CA: NOTIFICATION OF INTS�iT TO PERFORM A DEMOLITION O YES O NO
0 Water Bill Paid: Yes[.] or Collect[$
❑
Bldg Official Conditions
❑
Engineering Conditions
❑
Fire Marshal Conditions
]Signature
The undersigned hereby makes application for a permit to wreck/move the building descn�d above, agreeing W do all work in strict
accordance with the City Ordinances and rulings of the Building Division, and the State Code which requires any water well on the
property to be sealed by a State licensed water well driller, and hereby declares that all facts and representations stated in this application
are true and conect.
ALL DEMOLITON DEBRIS, INCLUDING FOUND�ION &�. SHALL BE REMOVED FROM SITE.
� �� ,� G ��G��,,�G�/D't��-._-
Date Signature
_- _ -- -_ -
Muvin .
Principle building into Fridley . . . . $3�.�
Accessory building into Fridley ...$ 42.00
Through or witUin the City ......$ 20.�
Move a building out of City ......$ 20.�
� �i
Wrec '
For e,ach 1,(�0 cubic feet or fraction. .....$1.25
For structures which would be impractical to
cube, the fee shall be based on the total cost
of wrecking at the rate of $6.� for each $5�.00
or fraction.
PERMIT FEE: MINIMLTM $20.� Ot�ce Use Only: SAC-D form completed
Effective 4/21/09