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AF - 41871,� i'� ;� City of Fridley, Mi.nn. BUILDING PERMIT .: _ �I � - � ' _ • . �" . , � � I � � ` �� ; _•� ' '' -� � ��.: �� / N° '7224 �� CA ` �F��ING No. Street ...,�. Part Loii _�______ Lot �� Addition or Sub-Div9sia� �_� � v j Coraer Lot _ 7s�de Lot Sstbe,ck -�� Sidey�d � �� ►.�,,;a.� \a.� �,;,5i � .� � Foundatlon �F ' � �� F`ront ��. DePth 4�� Height _� Sq. FL �� Cu. FL ��' /�� Depth ITeight ,�,�,,Sq. Ft Cu. Ft �n �� Type of Construct4on ..____ �.3�. Fast .�-��y�°�..` ��To be Completed In consideration oP the issuance to me of a permit to construct building describe above, I agree to do the proposed work fn accordance with the d�scription above set fo �a� � c th all provlsions of ordinancea of the dty oP Frldley. ,..,: � `9, ' In con�deratian oP the payment of a fee of ��_� , permit 3s hereby granted to to construct the buflding or addition as described above. This �errnit is granted upon the express candition that the person to whom it ia graated and hia agente, employees and worlmien, in all work daae fn, around and u�n said building, or anypart thereo� shall conform fn all reapects to the ordfnance� of Frldley, Minnesota regarding lacation, construction, alteration, mafntenaace, repair and moving oP build9nge withiu tl�e dty Iim�its aad thfs permit may be revoked at any time upon violal3on of any oY the Provlslons of eaid orrlinaac�s. ��8 � NOTICE: '11� pemh doa no1 corer f6s eo�rucdoe, leshllatiae �or vdrteg, plambtne, ea hudee, s�wu e� waler. B� sun to aM t6a &rlldie0 ImpKtee to� aparaN p�rmtb for 1k�a f1�nn. �; _ _ City of Fridley, Minn. BUILDING PERMIT � Da�: SEPTEMBER 28, 1966 �1 /�'1 �,,_.,, . ��'a :i �� Builder SAME Addrea� 8200 EAST RIVER ROAD N.E. AddresB — FRIDLEY, MCNNESOTA 55432 ��/ �� No 9p3 � LOCATION OF BUILDING No. � 8200 S�t EAST RTVER ROAD Part of Lot Lot �Z&.$.__ Block F Addition or Sub-Divisian .� ��RVIEW HEIGHTS Corner Lot —__X..._._._ Ina3de Lot Setback —r._ Sideyard Sewer IIevation ____�.. ..._ Foundation IIevation DESCRIPTION OF BUILDING To be Used as: DET. GARAGE �nt �22 �p� 24 H��t 10 �. � 528 �� 5,280 Front Depth I�eight — Sq. F't � Cu. Ft Type of Constructfon � F�t. Cost _._..__•-a�.��.�___..__ To be Completed In consideratfon of the issuance to me of a perrnit to construct the building descrlbed above I agree to do the proposed work in accordance with the descrlptlon above se orth and in compliance with afl proviaione oP ordinancea oP the dty of Fridley. � In ca�nsfderatton of the payment oE a fee of $ 5. 00 ��t ��by �� .LMER BULLEN' to construct the building or addition as descrYbed above. Thia permit ia granted upon the express condition that theperson to whom it is graated and his agents� employees and worl�en, in all work dane in, around and upon said building, or any �art thereof, shall conform in all reapecta to the ordinance� of Fridley, Minnesota regardiig location, conatruction, alteration, maintenance, repair and moving of buildings wltl�in the dty ]ianits aad thia permit may be revoked at any time upon violation oP any of the provisiona of said ordinancea CLAREIQCE BELISLE Suil�]inBIn�ctor NOTIC� Thb psrmh d� not eovsr ths coestracHoe, iestallaNen fe� wtrlee. Plumbte8, gn hsaHeA, sewer or wN�r. B� am w a� tiro Bnildieg lesp�eter fe� aparafr parmNs hr 1h�a IMms. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MI1�IESOTA . � OWNER'S NAME � BUILDER a��" ADDRESS d °� �� '�'''��.•��'� ADDRESS t-�a w LOCATIOAT OL� BUILDING N0. �� STREET ' ��"�-�- _ PART bF` t�OT LOT � � � BLOCR��_ADDITZON OR SIIBDIVISION��-°'�� `�°- ��— �a CORNER LOT I� INSIDE LOT SETBACR SIDE-YARD �_ . �— SEWER LrLFVATION F'OOIVDATIOft ELEVATIOA Applicant attach to this form Two CertificaCes of Survey of Lot snd propoaed building location drawn on these CertiEicates. DESCRIP�.ZON OF BUiLD�G To be ed as; � q o � �� Front °�, � Depth� � Height� ' �' a � Sq. Ft. � � Cu. Ft. , �-- �� Froat Depth Height Sq. Ft. Cu. Ft. i� �� Type of Construction ��-��ee� Estimated Cost f'�'�,� To be completed ��R� � �� 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 Ordinances a�d ruZiags of the Department of Buildings, and hereby declares that all the facts and representations stated in thia application are true and correct. DAT � � � SIGNATIIRE �� / —� � �--- (Schedule of Fee Costs can be found on the Reverse Side). � " J `� , � .. .. , � �1 ( � � 0 � BIIII.DING PERMIT FEE SGIiEDULE . .�. ..� SECT_, IOP 2. The Inspector of Buildings sha7L1, before issuing aay permit for the erect3on of any building or, struc�ure, -:o��-fo�t any ad8ition to an.y esisting building or structura,�or for any alterationa or repairs to any exiseiug building or atructure, upon application Chegefore, require�the paymeat by the applicant for • such permit of f�e�e` to �the. ebn�ount herein below Bet forth and in the manner hereia �rovided to-wit; 2�,1. Fox,any such permit for the erection of eny fire-proof building, oth2� �thacr� a garage, warehouse, factor.yr . or �rain elevato�c, or for the erection of any fire-proof addition, for sim3lar occupancy, to any esistiag building, shall.be at-the�rate of $1.40 'for e�ch ori� tfiousand cubic feet, or fraction thereof, in such cubical conteats. � � 2.2 For any:.such perm�.t for the ers�ction of any fire-prooE garage, warehouse�, factory or grain elevator, or fox the erection.of any fire»pioo# addition, fo� similar oc.aupancy,., to any..exi�ting buildin� shall be at the rate of $1.25 for each one thousand'cubic feet, classified as "fireproof" by Section 502 of the Minneapol�s Buildiag �ode. flOIISES 2.3. For any such permit for.the er�ction of any non-fireproof building, other than a garage, warehouse, factory or grain elevator, or any non�fireproof addition, for s3milar occupaac.y, to any existing bui],ding � permit $1.00 for each one thousand cubic feet. GARAGES 2.4. For�any such permit for the�•erection of aa� non-ffreproof garage, warehouse, factorq or graia elevator, or for the erection of any non-fire-proof addition, for aimilar occupancy, to�any egisting building or for each auch building or addition - ninetq cents ($0.90) for each one thousand cub3c feet or fracCiori thereof, in the cubical content� thereof with the minimum of $4.00. For the purpose of computing fees for buildiag perm3ts, the cubical contente of any building or additioa to a uaiform height throughout by multiplying the grouad area covered from a point�six (6) in�hes below the floor line of the basement or cellar to the average h�ight of the upper surface or to the average height of the roof surface of the main gabl� of a pitched roof. � 2,5. For repaira or alterations to'an �xisting atructure, the�fee ah��l be at the rate of $3:00 per eac�l� Five Hund�ed,�Dollars ($500.00) or f�activn thereof in the cost of a11 proposed work. 2.6, . In no case shall the fee charged for any permit as �aet�forth in Section 2 be less.,than $4.00. STORM REPAIR DAMAGE FEES: , Reaidential; Eatimated Cost of work up to $S�?na^� - ctie�,� Estimated Coat of work ov,e,� ^��, ..�-:� �� ;�;_„ .�p Commercial; Estfmated�at of wor�- ��-. �.�, �'"_�':, ,,�1 -. ;�?_f:� �• Estimated ,sC of krc�'� u,:•::r Y: t;t:� v� -�<i;. . ° t` � 4 e �. �. e�� CIVIL ENGINEER AND SURVEYOR 3828-21YH AVENUESOUTH MINNFAPOLtS, MINNESOTA 88649 PARKWAY 4-2189 ��.�r��°L� f�%I° /f��C��'c/ `�c�7�`,� i, � _.� 'r_. .... ; t'.' i 4 J�) �1, c t � �,d 3 �`-{ �;. -- y ,,.�'"� �`/ m Q� ,.? v �i �. ., :. °..- .....,--" �. Y ,�t f ,r��it�L�' ��:./:°i�r%��VC..h`°, � � f�� . ,,�'� �� , �,. r� �,�,.. � � 1 G�% °�'' , ��' - �� ;� ` �,�� . r � r�� — °I f v �� d � ' _ � + � � L/,�`„�° �, � 1 Q�:; u ,�g` 7 ��=-�:.1 - 1 .; ;%�;ri��`� � � s� y� � l� I i '1 � ,p e ��i � S �'• ! � ,� ✓ ,� w,. � � ` � e � �� ,1� jj ,,7 � t', �_--"� \ � ' �t eJ �f.+ � ...:. �. ,_-,, `�-�„ - r. ',�;- _-"'-� ° . �`'A ��P �I �� = - � ��d � � ��` p� � s �'; � ` � ,u� . e i� � �—� t p '� r,� '�'_ _ A` 1 �� 1� � ( f �v fi � , - � � �.; � �� , � �: � � 6 ✓C1��N'. "`'/ r'� _�� ,. . � , �i � t,� . �� . !~ � �''� , �, � � d.: � - i'�� r �1 � � - �t . � � ' I � � r,�� V t� 9r . ��-L r� d�, � - , � �. �/ i'�`ce.%:,�:��e� C.�'—'�r1,�,��` %y'f1 �•'; r t / j/.d' ' �+ c�'' � ,`�'�� --> 1"?��r'`��.:�%ir'C:�'(,�f t ;'� ,r� � ,, �° ,.:.; _°" �. - ' -� �'�''�, :'Q. i�V :� ' ��t:, b;s; lC_ ��'V.l '` �''L/ �J�1..J ( 'i�Gi'/t�.,i �.li'� 1%�! `/ l ..J � ie o, L' �i' �'r'� �.,,Se! r,,,r'+ a . ._ ��.J s;.. �. ,/ ,'.,, .°'r'�Jl�,lc='y f,.eY4y+'! �%�,%%� .J•'%/�v�t;.�=C.."l j;.i; �'J�_�,' j''"d��r �i �� U�a% � �'i� �%✓i� �/ �'y� �� r I � " , . w f t -t - . +�✓ � � �� SUBJECT P E. I City of Fridley � 19850 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � RECEIP . � ' COMMUNITY DEVELOPMENT DIV. ' `ti: - r � � PROTECTIVE INSPECTION SEC. �p{ �� 1 i � � /"'1 � CITY HALL FRIDLE� 85432 NUMBER REV. DATE PAGE OF APPROVED BV �""'� � �'� 612-571-3450 910-F15 4/25/89 � � JOB ADDRESS g200 East River Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 r 8 F Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gary Johnson 8200 E�ast River Road N,E, 786-2213 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAIL ADDRESS Z�P PHONE LICENSE NO. 8 USE OF BUILDINt3 Residential 7 CLASS OF WORK � NEW ❑ ADDITION � ALTERATION C� REPAIR ❑ MOVE O REMOVE 8 OESCRIBE WORK Reside Dwelling & Garage 9 CHANGEOFUSEFROM TO STIPULATIONS SEPARATE PERMITS ARE REDUIRED FOR ELECTRICAL, PLUMBING, HEATINO, TYPE OF CONST. OCCUPANCY OROUP OCCUPANCY LOAD VENTILATING OR AIF CONDITIONING. Vllly�- THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PEFiIOD 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 COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S3 � OOO $1. SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PEiiFORMANCE OF CONSTFiUCTION $S4.00 PIAN CHECKFEE TOTALFEE $55.50 SIGNATUREOFCON7RACTOROFAUTHOR12EDAGENT IDATEI �. � ._ WHEN PROPERLY V IDATED THIS IS YOUR P RMIT � � � �� SiGNATUREOFOWNER�IFOWNEFBUILDER� IDATEI BIDG WSP �' I]FTE NEw [ ] Effective 5/1/88 ADDN [ ] I�1 AND 1�2 1�L7.�t [ ] Building P�ermit Applicatioai Constru+ction Addres��: � a� �� , � � U� �" I`Gt Legal Desctiptian: Loi- %�t�� ' 61uc.k � (�;v4rv� ew �.��hts owner rrame & A�--�: (�a,r�/ N:�e�h�ro�� 8aoo � R��, �� Te.l. # 7d'�- aaf 3 Dontractor: Tt�1. # Addres.s: Attach t�o this application, a C�rtificate of S�vey of the lot, with the prq�osed �uctioaz drawn on it to scale. .�- ��• •.. � s ��, LSVII�IG AREA: Letigth Width Height Sq. Ft. (�R�►GE ARE�i: Length Width i%ight Sq. Ft. DDGR AREA: ip*�h Width Iigt/GY+o�]Tyd Sq. F't. �RS �-Q—S:iie �e,uS( d G1�i.'•�4� — Corner Iat [] Inside L�t [] Ft. Yd Setback Side Yard Setbacks 4j�pe of o�nstxuction: �/' ,' h�, j Estimated Cost: $ 3 000 Approx. Cc�npletion Date: Proposed Driveway Width If New Openi,r�g Is Desired: Ft. $ $ Width + 6' See Back Page OATE: �' 015 ��`� APPLICAI�Fr: C�iM. N Te1. # 7�Q i..n -� a-1 3 �t F� $ �� D state surd�aYge $ /.� SAC Q�arge $ Driveway Escrow $ Park Fee $ sewer rlain �rge S . v �Mr: a ; M .:.�. $ � � �� C1't'Y IISE �II,Y Fee �ule an Rever�.,e Side g.5o/$l,000 valuation $575 per SAC Unit Alt. nA�� Ot Alt. nB" AbOVe . Fee De�tenw�ed bY �xlir�eerin9 �ent Neo�a�Y L] N� N��Y L l � :�1 � � � f �;�I��Y�1j1 � �:ri� _'4;I:r1� IJ ' Zlle (hief Buildi.t�g Official s�all, before ��Q» *!Q pezm,its for the erec.�tion of ariy building or stn�u�e, or for any ar�ditio� to ariy existing �ilcling or stnlcture, or for any altQration or repair to at�y existirg building or stn�re, upon application therefore, require the payment by the applicant for s�h permit of fee.s to the amcvnt herei.ii belvw set forth alxi ii1 the manrwr hereitl prcrvided to-wit: �I'AL VAIIJE $1 t.o $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 � a. $15 (Mini�mm Fee is $15 plus su�c�ge) $15 for first $500 plus $2 for each acLditional $l00 or fraCtiCa'i thet�eof, $o a1'�d ]nCluding $2, 000 $45 for first $2,000 plus $9 for each acklitional $1,000 or fZaCtion theleof, to and ]sicl�ling $25, 000 $252 for first $25,000 plus $6.50 for each additional $1,000 or fractio�n thereof, to and inclwding $50, 000 $414.50 for first $50,000 plus $4.50 for each additional $1,000 or fraction thereof, to and includitzg $100,000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction ther�of, to arid including $500,000 $500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction thereof, to and iricluding $1,000,000 $1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional $1, 000 or fractiorn thereof �I�Y �I�T ffiC�i0�1 (C�crete CZirb Streets On1Y) Alternate "A" ; Remwal and replaoemnt of curb and gutter only - Drivera�ay width plus 6 feet tilnes $13.50. Alternate "B": Re�oval and replao0oent of curb ar�d gutter and install a 3 foot wide approac� with 6 inc� depth - Driveway width plus 6 feet times $15.75. ' :�i' ■" V� •; • ' "�?11 I� • •) Permits for c�or�structio� will be issued a a�*+��m+ of 24 hours fraan the time of a�lication to allow for prc�per review of tiie pro� structure arid of the constructi� site. A Certificate of Suzvey of the lot, showing the locatiari of the faur�dation on� it has it has been ooristYUC�ted will be required before proceeding with the framirig. _. ,... April 21, 2004 ANOKA COUNTY ATTORNEY ROBERT M.A. JOHNSON Govemment Center • 2100 Third Avenue • Anoka, MN 55303-2265 attorney @ co .anoka.mn.us Administration Fxpedited Process Criminal Division �ctim-�tness Services Juvenile Division Civil Division (763) 323-5550 (763) 323-5586 (763) 323-5559 Investigation Division Family Law Division (763) 323-5570 Fax (763) 422-7524 Fax (763) 323-5769 Fax (763) 323-5586 (763) 323-5550 (763) 323-5651 Fax (763) 422-7589 Fax Debra Skogen, City Clerk City of Fridley 6431 University Avenue NE Fridley, MN 55432 RE: 8200 East River Road, Fridley, MN Dear Ms. Skogen: Enclosed please find a notice signed by homeowner Kevin Partlow, Anoka County and ACCAP, Inc. regarding Mr. Partlow's acknowledgment of the Fridley's City Code Chapter 205, which applies to his property at 8200 East River Road, Fridley, MN. This notice is being sent to you pursuant to Fridley Resolution No. 09-2002. If you have any questions, please contact me at (763) 323-5666. Sincerely, ��, G. �� Anthony C. P I mbo Assistant Anoka County Attorney ACP:kmm Enclosure cc: Karen Skepper, CDBG JoAnn Wright, ACCAP Affirmative Action / Equal Opportunity Employer � RECEIVED APR - � �� I, Kevin Partlow, the purchaser of the property at 8200 East River Road, Cit��ley, have reviewed the Fridley City Code Chapter 205, as it applies to "LOT REQUIREMENTS AND SETBACKS." I understand that the property at this address does not currently meet City code with regard to setback. � � Kevin Partlow G1�—.�^ � � Date NOTARY State of Minne�ota _ � County of i�.i- , � �} Subscribed and sworn to me this by _ .; a BEATRICE AKUA MENSAH ' �� JOtary Public Min�esota � My Commrssion Expires Januery 31, 2008 STATE OF MINNESOTA day of r � 20�, COUNTY OF ANOKA, Minnesota _ � . � _��i=.�� ) ss COUNTY OF ANOKA ) On the /�L day of ��.Jt,� , 2004, �Qr�h �k��p�r° personally appeared before me and subscribed below as Director of Communit Developmen of Anoka, MN on behalf of the County. t.m�A��iRO� �, - --,� �enN+r�.•�+�e� � � "� �� ,.. MYCaM/.l�V.1.11� Notary P lic STATE OF MINNESOTA ) ) ss COUNTY OF ANOKA On the � day of , 2004, ��y"ir,�(d �� (��Q.�% a eared before me and s scribed below as Executive Director of Anoka County PP Community Action Program, Inc., a Minnesota nonprofit co oration on behalf of the corporation. . . � � ..:� D ��L��d�' �.. LORI JO MANZOLINE - NOTARY PUBLIC-MINNESOTA My Canmission Expires Jan. 31, 200i r � .... ■ �� Anoka County C� Program, In�- x ��./! 9 2004 NTY A7?ORNEY ,_,_, _� "_„_,r ,w, _�, , , ,� , " , From; 176371,21835 Pa�e�?J2 `� Date: 9h 0/2008 3:35:10 PM �` , � , , BUildirig BUILDINGr P�mitNo.: �SA��ns . RESIDENTIAL AFFLICATIQN R�y� B 763-572-3604 �y �F F1tLDLEY D��'� sn� nnn�s az� �as �r.rcu�rr is: TEPTAIVT �* , :�i�_r�; � Yovxr�►n.�,urn�s K�iepa� lb_�v__@_Pxceti roofin� iprr�.�►e� �r� Pav+lav,l �200 tasi ifii �tv f� ci 5543? RiVt\ 11�A{.rA Vi( Nq�; tx[e 1 Kooh n SUBMIT A COPY OF sTATB IiCBN�N Z 01 li Z Z$ F.7� DATS YOUR STATE LTCENSE a��: � 8 08 I 13' /s Avc crrsrA►ar,�� h sTareM�ir SS 3� � W1TH APPLICATtbN pgp� "'j �p 3-'712 - 0'7 S'7 F�►x �� . fa�,i:�� t i 't. �� , �.� . r r- r: u� r O DRAIN TR.i'i 04'ff�i DBSCRIDEWORKBEIl+ra�NE: Ye-roo�- hauSe �t ar S�B OF IlVJPROVEN.�VT LBN(�TH WIDTH _ FIEiC�ST _ . Ft sQuARBS�_� ;�. ,�. •�. � �► :, �.�.��► -,��: � ir t. ■ ,. w i��n ci i ■ •+ r, otrous�a�o�c� O ATfACF�D GARACi$ 1� D�TwC� GASAaE �t O'Mm O P� � . tN 87IISTI4t[i OP�S DYC� ONo LOCATION oF WtI�IDdWs OR FORNSW OPSlV1N(�8 DESCRIDE 3IZ8 OF OP8l1[Nd CHANti84 dt T1fPE OP 61RNAO�V TO HB II�TSTALL� I8iJ11d9ER QP W11�OW3 �� as� H�n oN v�u.vA�oN, n�czunn�G z� c+os�r o� ' (UBING TH� 183��,T B.0 FEE SCBFDIILEi PermitFeo Plen Review Fire S�scbarge is,�� SAC Chargo f �u� Cut Eacrow Erosion Control Park F�o 9awar D�lain Chazge $ � �. $ � � 9�." I. 8� Ftoa mRn 2. Prop�d�oacPleo 3. Li�of��ttrk mambc� to b�o t�d FORId�9Y CONSTRUCTIOIV INCLUDINCi DEC[{�, A�7DITION9 FORCf�S�TM-�= 1. Site P1�o/SurveY ei�win8 fl� e�ing amnwris 2. Tao � oY�plme 3. Eoetgy C�lmlattaas See Ha�c Page for Fee 5chadu2e 65°ib of Buildiag Po:mit Foe .QOl timea t�e total job valuetiau .4�OS s Petmit Velue�tion 1V�aimum �.50 SS.IX? (State Lic�eed Rasidm�ial Corrtsactora) $1675 par SAC Uait (Plens to MWCC for d�a�on) $+6@� iix$"Zl -$� $450 Coasarvation Plsr� R�view Pae Dateminad by Eagineeriag Agroomeat nea�emY i� Natt NecersearY � 3 --- TFiIB IS AN APPLTCATIOAT FdA A P�RI►4iZ' NdT VALiD fJNP1L FROCEBSED I iieroby epply for � building p� �d T�owledge tl�t I�es mforn►eti+�n sbove is aamplete sad aoouiate; ti�t th� wa�k wiIl be m, c�formar�ce wrth the ond�anaea and codes of tbe City of Fridley end w�th the Mama�ota ConsWction Codes; that I und�rs�d �i8 �e nat a phrmit lnrt oaty ea epplice�iaa for a pecmit Bntd wo k ia t�nt to etart vQith�t a pe�mit; that tha work w,�l ba, in �ccrordamse wi�h the appravod plao �u tbe aess of all work wbich requ'vas review d oval of pIans. ' s�c�,� QF „�,,IC�r �rrr � M� t he 11 c Gi h e n n�s 9 �► e�a8 � From: City of Fridley To: 651-203-0554 Page: 4/5 Date: 7/26/200612:02:13 PM � 1� .�(� Building BUILDING Permit No.:�� Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY D '�!'�Y 1--�� DATE�� _ YOUR E-MAIL ADDRESS STfE ADDRESS �SZ��C�S-� �1�1�-,.� �AGI ' ��Z TM3 APPLICANT IS: ❑ OWNER �ONTRACTOR PROPERTY OWNER/ NAME:��l1(1 � 4Ca ��t.11 �z�1f � a TEN'�1�TT ADDRESS: �al/i'L� CITY �yj(�f��Pt� STATE ZIP ��Z PHONE• �LD� 1F5�4 —�S��S1 CONTRACTOR NAME: 1�-�.0 U�`rlCle'A�� eaar �as�1Cc� __ SUBMIT A COPY OF STATE LICENSE #�L'7�—P�� EXP DATE ��` I� YOUR STATE LICENSE �D�� CITY�„N�v�1� STATE ZIP�� WITH APPLICATION pHONE CFrI �f �0�� FAX PROPERTY TYPE � SINC3LE FAMILY/NEW CONSTRUCTION s�ZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIE $�Rl�'IIT TY.PE � �DITION 0 CiARAC3FJSHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF 0 DRAIN TILE ❑ DECK ❑ SIDING ❑ OTi�R ❑ SWIMMING POOL TYPE OF WORK: ��W ❑ ADDTfION � ��f i ❑ MAINTENANCF/REPAIR ❑ REMODELING � � DESCRIBE WORK BEING DONE: � (�ftrr� I� V��o'LC�LLl�� /iG�l/1/J�.� SIZE OF IlvIPROVEMENT LENGTH WIDTH HEIGHT S. Ft. Oit OFI1�1G ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE aASEMENT REMQDELING SUBMIT: GARAGES ❑ ATTACf�D GARAGE 1. Existing Floor Plan PROPOSID SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan PROPOSID HEIGHT: 3. List of sW cw�l membecs to be used gIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum 0 Trim 1. Site Plan/Survey showing the existing swcwres ❑ Other ❑ Fascia and proposed project. �� 2. 'ltvo sets of consGucdon plans IN EXISTING OPENINGS� es ONo LOCAT ON F WINDOWS 3. Energy Calculations OR FOR NEW OPENING3=DESCRIBE SIZE OF �� /W�m �� OPEATING CHANGES & TYPE OF WINDOW TO BE INSTALLED � S% ER OF WINDOWS ALL FEES ARE BASED ON ALUATION. INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) AL JOB VALUATION $—�i ��C�C7 . C.�� OCCUPANC Permit Fea _ __ _ _ Plan Review Fire Surcharga Surcharga Licensa Surcharge SAC Charge Curb Ciit Escrow Erosion Control Park Fee Sewer Main Charge Total Due _� __ _ S�s Back Pa e£ r e Sc le _ __ ___ _ $ 65% of Building Permit Fae $ .001 times the total job valuation $ .0005 x Parmit Valuation Minimum $.50 $ $5.00 (Stata Licensad Rasidential Contractora) $ $1550 per SAC Unit (Plans to MWCC for detarmination) $ ft+6ft= ftx$21 =$ $ $450 Conservation Plan Review $ Fea Determined by Engineering $ Agreemant necassary ( ) Non Necassary ( ) $ Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCES5ED I heraby apply for a building parmit and I acknowledge that tha information above is complate and accurate; that the work will ba in conformanca with tha ordinances and codes of the City of Fridley and wikh tha Minnasota Conslruction Codes; that I understarid this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in tha casa of all work whic raquues review and approval of plans, SIGNATURE OF APPLICANT F� PRINT NAME r � DATE � D �y�/ � �. B. H. BRADLEY CIVIL_OVOC[VFl�R AND SURVENOR 8828-?ATH AYt'IVUESOUTH dIIPIIN[�APOLIB. MR�II�IEBOTA 69G08 PARKWAY 4-2189 �J,,: � �_ . ) �' � �_ `°� �`� � � rl �ur��+ fc�t = /��t�r�rr� ��°��.�' ��G° �e,re��,��v�, r'`�''. � ,�� ,� r,�� ,, � � � �� _ ,�� d . � � i� � n �� ' 3� � �', �1 . X �" , .�`�''.. �' �'�- : " - ' �, �,_ � - � �� J�i�i'f� '�-t'�? � r ti � � il r� r r � � � � L � � � .t�� 4' ��. � �+ /' � w • ��/jpy��`j6�� `�� _ - �- - I 7�F/'V. ', �'.+� y t > , � �' ��.f f f' � � �� ,� � �-� L.. �� ' � i �� '� -f�a �� 1� � � �� ti ��`. � � � � � c� � . .��i�re�;� ��-�o�� ' ��i�' ��` c�' �.��e ��'�c��',�a,��'��,�`� �,��►�►�� '�,��a� �' �i+��-�r�,wAo'�e�%�h�,.�,' r��aa�c�� `��.�J, ��, �'� ��,��'' ,�� .�`��,� �''��"� ��✓�j�� __ �- - r-1, ,� r _