AF - 41884SUBJECT P
City of Fridley ° 1519 0
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � RE T NO.
� ` .�___ COMMUNITY DEVELOPMENT DIV. �
� � � PROTECTIVE INSPECTION SEC. � � ���
r , ,
� . ,
' � ����ti � CITY HALL FRIDLEV S$432 NUMBER REV. DATE PAGE OF APPROVED BY
�""'"� � ��� 612-571-3450 910-F15
5/ 14/79 � �
JOB ADDRESS 8280 EdSt R1VCi Road N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. �]_� E Riverview Heights SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Beverly Betts 828Q East River Road N. E. 786-1567
3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO.
5ame
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USEOFBUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
$
8 DESCRIBE WORK
Insta.11 neaz windows and ins lation in rch
9 CHANGE OF USE FROM TO
STIPULATIONS
SE,PERATE PERMITS REQUIRED FQ� yy���
HEATING, pL��qg�NG AiVD SI��S.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHOfiIZED 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 1. STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED y�]_� OOO �`. 5O
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 REGULATING CON- $`7� SO
STRUCTION OR THE PERFORMANCE OF CONSTHUCTION.
PLAN CHECKFEE TOTALFEE
y�8.��
` . SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT ionTE� - WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
x " � ���� 1 1'1
SiGNATURE OF OWNER IIF NE UILDERI IDATEI BLDG iNSP �ATE
cz�rY �or- r-iZZ»�cY , � �
`• /�P('L.i C/1TI 01� FOft (i(�S 1 ll(:PlT Il1L LU ) LU Z(dG f'�ftl�1 t TS .
• (f'J�w, -I1�Y�rzn��l��rs, /Ii�viTlo►a�, o� Rci�niris)
. . . .
owctrn: � , � � r.vxr.ui:�z: �_.,,�-�2�, i .
Addr.ess : �� �� �.�' t V� � lZ � Address :
� T��.. tao . 7 � � - /S� �' .
No.: � Street: � .
7�OT: .� l � }3iACY.: � 1 - nDDxTIOPJ : �' � � i �� R V /� �e,� l�e ! �'i �`i- �
COIt1JER L07.': �^ II�SID� LOT: SLTBACY.: SIDLYARDS: + �
Apnlica'r,L attach to L-his iorm 2�ao Certiii.cates of Survey af Loi: and proposed
bu�.].ding locaL-ion dra�m on these Cextificates. •
DESCRT PTI O(d OF BUI LDI S�G
�o l3e Used As: �.
I.QJ � � °
ni�,�Qj�, `0.�,d - ���ont: Depth: . . . Height:
�, Square Feet: Cubic'Feet: �
�I'rant:
Depth : � Iieight :
Squaie �eet: Gilbic Feet: _
0
7'ype of ConstrucL-ion: Estimated Cost: $ _1 �D o�
_.��
To Be Completed: �Q �%%d�7�2T1�J � . Alt. A Al�. B
� 1Pxoposed Drive�aay Width If New Opening Xs Desired $ � $
• (S� 22�VERSE SIDE OF SHLETj
The uazder�igned �iereY�y makes application far a permit for the wor}: herein
specified, agreeing to do a11 �.ork in strict acc��.'dance ��iL-]z the CiL-y of .
Fridle�� Ordinances and rulings of the De��ari:nient oi Buildings, and liereby
declares L•hat all the facts and x'Cpl'CSC1lL'.i1�lUIlS stated in this d�j�1.1Cc3l:1011
�xe true and corrcct. �See reverse si�de far acldiL•ional iniornlat�ion.
DATE: ������%,�, SIGNA�rvr.�:
Stipulatioiis : . �
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- BUII_DI(JG PER��IIT FEr SCHEDULE
SECTION 2. The Inspector of IIuildings shall, before issuing �ermits for the erection
of any building or structure, or for any additian to any existing building or structure,
or for.any al.teration or repairs to any existing building or structure, upon application
therefore, require the payment by the applicant for such permit of fees to tTie amount
herein below set forth and.in �the manner herein provided to-wit:
IdEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CIiECK: 25 percent of building permit fee.
DRIVEWAY DEPRE5SION: (Concrete Curb Streets Only)
' Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x$�,5� 75
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with ��
6 inch depth; Driveway width plus 6 feet x$17.85
;11 � � �' ' �l
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from a
point six (G) inches below the floor line of the basement or th� cellar to the
average heights of the upper surface or to the average height of the roof surface
of the main gable of a pitched roof.
For repairs or al.terations to an existing.structure, the fee shall be at the rate
of $3.00 per each five hundred dollars�($500.00) or fraction Yhereof in the cost
oF all proposed work.
In•no case shall the fee charged for any permit as set forth in 5ection 2 be less
than $'7.50 plus $.50 state surcharge. � '
` VERIFICATION OF FOUNDATION
NOTE: Permits �or cons;�ruction will be issued a minimiun 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, sliowing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
_; : � � 'd1
Application for a Certiiicate 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 or occupied until a Certificate of Occupancy has
been i.ssued.
SUBJECT P .
City of Fridley � 15 81 1�'
AT THE TOP OF THE TWINS g U I L D I N G P E R M I �
r
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV. ���
� ; V �'���'�
r � � PROTECTIVE INSPECTION SEC.
1 i �
� /'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�'""� � ��� 612-571-3450 910-F15 7/3/80 / /
JOB ADDRESS 8�80 �st River Road N.E.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oescR. 5-10 Bl. E Riverview Heights SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Beverly J. Betts 8280 East River R�ad N.E. 786-1567
3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO.
Same
4 ARCHITECT OR DESIGNER MAII ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS 21P PHONE LICENSENO.
8 USE OF BUIIDING
Residential
7 CLASS OF WORK
❑ NEW X ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 10' x 10' Deck and install one window
9 CHANGE pF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTHUCTION ZONING S�. 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 VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1�00� �S.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 PERFORMANCE OF CONSTRUCTION. �`%.SO
PLAN CHECK FEE TOTAL FEE
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SIGNATUREOFCONTRACTORORAU OR12EDAGEN7 IDATEI WHEN PROPERLY VALI ATED THIS IS VOUR PERMIT
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SIGN RE OF O N IIF O� R B LD 1 IDATEI BLOG �NSP �T��-
CITY Of FRIDLCY • •
1�(?PLTCIITI4�� FOR RESTDLPl7IAL QUILDIPaG PCRMITS
' (tJe4r, Alter�a�ions, Addil;ions, or (tepairs)
06J(�dER: Q - � '
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ADDRESS: �� ��� : �� � , i `
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ADDRESS: • '
TEL f�d0: ' ,
Construc�ion Location
STFtI�T N0: � � �� STRT:�T: �
LOx: ��`� �C� • BLOCY.: /
l — — a . a r�
ADDITION : �� ������-`� / �'-''e ��� ..
Gorner Lot: � Insiiie. Lot: Sei:back: Sideyards:
Ap,�].icant attach to this form two Certifica�es of Surve�y of lot and '
propos�d building J.ocation dracan on c�rtificates to scale. -
pESCRTPTIO�d OF CONSTRUCTION �
� i/
� _ c�-�Cc'� Front: �Cy � I�pth: � [`� � Height:
• Squa�e. Feets C�ibic Feet: �
Frox:t: Depth: � e �ie�_ght:
Square• Feet: Cubic Feet:
� �� �- �-�n-�'
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, s � e,�-' ._ ; � ����� � ��stimated Cost: $ C7 � ��� �-
Type ot Construction . � ��- ��'j�� � �� � •
. .� �c �,�'�° ; P %Y{' � � �
7b Be Cbm�leted: � ' � �,.,.��
• Alt. A Alt. B
Proposed Driveway Width If Ne�v Opening Is Desired: $� $ .
• �• •. . SEE REVERSE SIDE OF SAEET�,
�'lie undea:signed hereby makes applicaL-ion for a perniit ior the work� herein specified.
agreeing to c� all work in strict accordance wii:h the City of Fridley Ordinances and
xulings o� tlle DeparWent of Buildings, and hereby declares i:hat all the facts and
representations sta,ted in this applicati.on are true and cor . ct.
DATE:.
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Stipulations:
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. BUILUING PCRI�IT �C� �G1if:DUt_E' .
:;1:C`�IO1J 2. 79ie J:n::�acctar. of )3ui1c1iruJr, s:ha).�, befor.e i.�suing 1�c�aniL•:;, �or Lhe err.ci;ian
a� a.ny bui.lcl:i.nc� or :�L•zuct:ure, or. for any �aa�.L�.on L-o any er.i:�L•i.nc� building oz sL•nieL-ure,
. tix fox G,rry altcration or. r.cpair.:. t:o •any cr.�.s;ting }�ui.J.cli.»g or st-r.ucL-urc, u�on ar�pl.�cat�.on
'tlier.efor.c:, rec�uirc thc paymenL• by tlic. a�pl.�_can4. fo1' :;uch J�czmiL of fces to. L•l�e amounL
hcxein I�C�.04! set forth ancl in the mannen c�re�.n prov9.clecl L-o-wiL•: �
171:41 CQNSTP.UC�I�N : 5ingle 1'ami].y Ilomes and Gar.ac�es : S� . OQ/]., 0�0 Ct��].G tec4:. ., �
3'I,T�22 C1I1:CY.: 25 �,�c�rcent- oL• bui.ldzncJ permi.t fee.
llRlVl.l�?nY llE1�RESS20F�: (ConcreLq C�rh StrceCs Only) '� �" �
• AlL•crnaL-e I�: Rcmoval and repZacement; oi concrete curb anci
yutLer only; Driveway widtli plus 6 ieet x Y�5.e 75
-. Alternaie }3: Removal and rep].ac�ment- o� cancrete curb and
• � gufiter and install. a 3 foo� wide aPproach c•ri�h �'
'__ , • G ��ch dept3�; DrivcY�ay width �plus G :Ceet r. $17.85 �
• . . AllDITION/�f„ tNFOR�1liTI0N
Por i:he purPose oi computi.ng iees for bui].ding Pexmits. the cubical. conteni:s of any
builda.ng or addition, is dcL-ermined by rnulta.plyiny Uie ground area covered from a
��a�nt sir. {6) inches below thc floor line of the basement or the cellar to the
average heights of the upper surface or to the averag� height of ihe roof suzface
oi the ;�ain gable of a pitched rooi. �
For.repairs or alterations to an existing strucL-ure, the fee sha31 be a� the rate
of $3.00 �ier each iive hu.ndzed dollars -($500.00) or fraction tliereof in the cost
of a11 pzoposed work. � _ . •
T�i •ne L.a�e shal.l ilie � �G criarged for any pez-mit as set- forth in Section 2 be �.e5s �
�han $7.50 plus $.50 state surcharqe. _ • '
' . . ,��RTFICATID��,F FOU�IDATTON .
NOTE: Permits �or COIIStYl1C{:1011 will be issued a minimiun of 24 hours irom the time
of- appla.cation ta allow for proper review of the prc�posed stx�ucture and of the
const�:uction site.
h Ceiti��cate oi Survel� af the lot, showing the location of the foundation once i�
has been co�istnict.ed will be rec�uired before pr.oceedinq with the frami.ng.
� GkRT I t= I CpTE OF OC[' 11Pl�N('Y ', ',
' I►pplication for a Certificate oi Occupancy shall be made L-en (10) days prior"to the
use or occupancy af any structure: roz which a� building p�rnut ha� been �ssued; and
said structu�e slial�. �io� be used or occupied uiitil a Certi�icate of Occupa�icy has
lbeen S.ssued.
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SPECIAL ASSESSIIltENT
PAYME�IT AGREEMENT
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�� Beverly Betts the owner of the .
following described property 8280 East Ri ver Road
�Lots 5-10, Block E, River View Heights Addition)
Hereby agree to pay in cash $ 141. 90--50 ft. Sewer Lateral
onLotsS&6
to the city of Fridley to cover my proportionate share of
the utility system, or in lieu thereof agree to have the
City levy an assessment.against the property described
above to cover the cost of my proportionate share of
the utility system as provided in Section 2 of Ordinance
No.113, passed by the Council of the City of Fridley on
;
December 11�, 1958.
��
,�`./����
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Tapping Permit No.
SAC CHARGE -- $425.00
Less 149.50 -- Sewer Bill Credit for 1978-79-
and 80
$275.50 -- To be assessed
GRAND TOTAL--$417.40--TO BE ASSESSED OVER 15 YEARS AT
9% INTEREST
MP3-7T =
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sue�ecr P IT NO.
City of Fridley _ 15 9 2 6
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
; � CEIPT .
� ; L ______ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
� . �
� � ����� � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�'"""� � ��� 612-571-3450 910-F15
9/10/80 / /
JOB ADDRESS
8 8 Eas Ri ver Road
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 6� �� g� g� � 0 E R i ve rv i eu� He i ghts SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Beverl J. Betts, 8280 E. River Rd., Fridley 786-1567
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO.
same
4 ARCHITECTORDESIGNER MAILADDRESS , ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDINC3
R s'd i
7 CLASS OF WORK
� NEW O ADDITION 0 ALTERATION O REPAIR � MOVE ❑ REMOVE
8 DESCR�BE WOHK
Detached ara e cement stab for ara e and drivewa wood frame
8 CHANGE QF USE FROM TO
STIPULATIONS
Slab to be installed this year, garage to be built later
Provide hard surface dirveway
Garage can not ever be attached to the house
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, wood ra @
VENTILATING OR AIR CONDITIONING. 5
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORAECT. 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 4 264. O�F 2• � 3
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OFi CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFOFIMANCE OF CONSTRUCTION. � . 6
PLAN CHECK FEE TOTAL FEE
- $21.4g
SIGNATUREOFCONTRACTORORA OR12EDAGE T IDATEI, a-. . WH PROPE LY AT D IS IS YOUR PERM(I'T§
/ � �� . ' � ��S.JM
SIGNATUREOFOWNERII W ER ILOERI 10 1 G iNSP �pTE
CITY OF FRIDLEY
, AR['LICA7IOid FOf� RESIDE.(dTI/ti_ BUILDIf1G PERI'�ITTS
(tJct��, Al�terations, Itclditions, or Repairs)
� UWPdER: QUI LDER . �� �� .
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ADORESS: DDRCSS: -
-r�� �o: ��.�— ��j�� TEL �d0: �
STI2EE7.' NO : t� � � �
S�'REET:
Consl:ruction Location '
I,07': .�7 ?�� 9�� BLOCK: � ADAITION: `�i �1��1�/
1
Cornex Lot: �� Insic7.e Lot: Setback: Sideyards:
Applicant attach to this form twa Cextificates of Survey of lot and
propose3 building location drawn on certificates to scale. �
��1 ��,�� � DESCRIPTIO�J OF C�P��STRUCTION • �
y���� I�'ront: �� Depth: o�� Height: l�
Squa�e. Feet: �8� Qtbic Feet: '�c��Z
�'ront:
Depth: H eight:
Square• Feet: � Cubic Feet:
Uv 1�/�"� �,K��ill�'eG�� ,/-�
Type of Construction: �timai.ed Cost: $v "i�'� � C)
. �� '
7b Be O�r,�pleted: ���� .
_ � Alt. A Alt. B
Proposed Arive��ay Width If New Opening Is Desired: $� $
SE� i�VERSE SIDE OF SHEET
xlie undersigned hereby make� application for a permit tcr the war3: hex'ei.n specified,
agreei.ng to do .all work iri s-�ric't accordance with the City of �'ridley Ordinances and
ruling� of i:he Departntent of Buildings, and hexeby declares that all the facts and
representations stated zn this applicatian are true and coYrect.
D11TE: �� J D SIGN?1TUF�;
5tipulations:
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��u�J1 k��. Y-�-�� c0 ��r� �F�C� ��� E��Q��yyL
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- • �SUILDIIJG f'�(ZMIT FCt= SCiICDU�E�� .
SIiC'rI01•� 2. '1'h� 7n�.,��ectar. of l3►iilc?ing�. t:hril.�, bcforc i. �.ui�iy pcnniL-� f-or the crect-i.on
of: any build:inc7 or :;�:Z'liC1:UZL'� oi: far a�i�� �dcli.i:ar,n t•o ai►y.er.i:;L-i»c� Ltiildinc� oz structuxe,
. ci�_ i:oa- r�ny a�.L-�.�:ation or xcl�airs L-o •any c�:i.:.L-i.ng }�uS.]_ci�,�ig or st-�-ucturc, upon ap��l�catioi�
'L•hcr�:tor.c, xequare t}i� Paymeni: by tlie ap�,�].icant: for. such ��er.m3.L- o� fees to the arnonnt
hcr4in bel.na� sct for.t}i and in tlie manncn c�rein j�l"OV.1.C1CC� �:O-L•1].i_: •
l.Ei�I COIJSII:UC`PIOIJ: Sing].e 1 amiJ.y Ilomes and Ga�-ac�es : $4. 00/1, 000 cuk,ic tee�. .
PLTsiJ CI11.Ci;: 25 percer�L- Of bu3.ldiluJ }�ermii: iee.
UKI:VES�IA1' ll�PP1:SSIQi•I: (Concr�te Curb Strects Only) �'
� Alt-crnat:e n: Rcmoval and replaccment oL- concrete curb and
qutL-er only; llriveway c•�idth plus 6 feet x�:�,5.75
Alternate B: Rr�noval and replacement of concrete curb and
. ' guL-ter and install a 3 fooL ��ide approach a�ith
' _- 6 i.nch depL-h; Driveway a�idth �plus G i'eet x$7.7.85
• . �DAITION/�l, It�FOR��1AT1ort
�or the purl�se oi computing �ees for_ building permits, the cubi.cal. coni�ents of any
building or addition, is dctermined by rnuliip].ying ihe ground area covered irom a
p�int� sa.r. (G) inches below the f].00r J.ine of the basemen� or the cellar to the
av�erage he�qhts of the rzpper surface or L-o the average height of t.he roof surf:ace
of �ie mai.n c�abl.e of a pitched root. �.
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 rer. each fivc hundred doJ.lars �� ($500.00) or fraction ihereof in �he cost
oi all pro,�ased worY.. , , '
In •no aase sha].l the fee charged for any permit as set iorth a.n 5ectian 2 be less •
than.$7.50 plus $.50 state surcharge. •
V�RTFICATIO�! OF F(1U1�(DATIOIJ
' NOTE: Perniits �or constxucL-ion �aill kie issued a minimu.-n c,i 24- hours from the time
oi application to aJ.low for proper reviec,� of ihe pro�sed structure and of the
construction site.
A Certificate�of Survey of the lot, showing the location of the foundation once it
�has been coiistnicted �.*il.l be required before pr.oceeding with the fr�ming.
_ CEj�T I F I CATE OF OCGUPAf�Cti'
' hp�Iication for a Certificate of Occ�ipancy shall be made ten (ZO) days prior t�o the
use or occuz?3ncy o�' any struc�ture for z�hich � builcling permit has heen �.ssued; and
s�-i.id structure shall iiat be used oi: occupi.ed uiitil a Cer-L-i�ficate oi Occupancy has
been xssued.
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CITY OF FRIDL6Y, �l�i _
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��ss � Lnc�,L n�o�t: ��� �� ��� � �� � �o � ��
0�/oo�'itp,Cr �: �'"r� � ��`�'
OONS1'RDCTION L1ATE: ADDITIONS: 7--��0 �-�� �`�-/o -�� r' a� ��
CERTIFICATE OF OOCUPANCY: ISSZIF�: YES AD nATE
A. ZCIJIlJG ACTIQiJ: ORDII�N(� N0:
B. SPDCIAL OSE PERMIT(S): $
C. I0T SPLIT(S): $
D. VACATION ( S) :# ORDII�,NCE N0:
E. RICE CREER WATII2SfiID DISTRICT APPRWID: YFS # I�A # AATE
F. VARIANC�S
APPEAI� 00�'Il�IISSIOIJ: APPRWID DISAPPRWID L1ATE 1�A.
CITY CO�UNCIL: APPRWF� DISAPPRWF� �ATE 1�A.
G. F�ASIIHII�ITS:
Bikeway/walkway
Street right-of�aay
utility
Drainage
Al.ley
Other (Specify)
H. LICENSE(S) (List):
� a• �
� �.
Date of Renewal:
I. STIPUI,ATIONS (List) :�p,� g�QpIg� DATE �O1+�LETID
R�C'D
J. MISCF�.T�ArTFlOOS:
sue�ecr PER . � �
City of Fridley 0 18607 �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� � REC .
� • COMMUNITY DEVELOPMENT DIV.
� ; V � � �
r � PFOTECTIVE INSPECTION SEC. � ��
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1 i �
� /'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OP APPROVEO BY
�----� • •`� 612-571-3450 910-F15 8/20/86 / / '
JOB ADDRESS 82g0 East Ri.ver Road N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 5-10 E Riverview Heights SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Beverly Betts 8280 East River Road N.E.
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
TnTestern Construction Co. 5353 Wayzata Blvd, Mpls 55416 546-3385
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Resi:denti:al
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WOHK
Construct a�XX%� 22' x 32' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Garage must not be connected �Go dwelling unless frost footings
are installed under garage. Old garage must be removed 30 days
after new one is coanpleted. Provide a hard surface driveway.
II�ARNi�G
Before digg��ig caN f'oca! ��il�fies
'iELEPHONE . EL�CT�'fC �� ����
REQUtRED BY l�.�i
SEPARATE PERMITS ARE REDUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTII.ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WOFK 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 CORREC7. ALL PROVISIONS OF �AWS yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $8, 245 $4. �-2
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OF CANCEt THE pERMiT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. y5`%4. SO
PLAN CHECK FEE TOTAL FEE
$78.62
SIGNATUREOFCONTR C ORORAUTHORI GENT __ IDATEI � .� WHEN PROPERLY VALIDATEDQ THIS IS VOUR PERMIT
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SiG aTU E OF O^ ER WNEA r[ A� iDAT � B�DG iNSP pp7E
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NEW [ �
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Construction Addr�
Legal Description
City of Fridley Effeetive 4/1/86
�R-1 AND R-2
Building Permit Application
Owner Name & Address: Tel. �
� � S i c� �� d�� ���rti� � i • ��� . � � i `� � C � �'i.t � �. c� .� cr � .��� � el . # �� � � � �r �
Contractor: ��� ,- �
Address:
LIVING AREA:
GARAGE AREA:
DECR AREA:
OTHER:
z
Attach to this application, a Certificate of Survey of the
lot, With the proposed construction draxn on it to scale.
DES�RIPTIOH OF IMPROYEMENT
���` �_��
Length i�idth Height Sq. Ft.
Length Width Height � Sq. Ft. G 7Z.
Length Width Hgt/Ground Sq. Ft. __
�
Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setback
�
Type of Construction: Estimated Cost: $�� Z y •
Approx. Completion Date:
Alt. A Alt B
Proposed DriveWay Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: APPLICANT: Tel. 4
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
SeWer Main Charge
TOTAL
CITY OSE ONLY
� _/r .� gee Schedule on Reverse Side
$ 2�x of Building Permit Fee
$ �� � �/ $.5���1 * 000 Valuation
$ �475 per SAC Unit
$ Fee Determined by Engineering
� Agreement Necessary [ ] Not Necessary [ ]
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BDII.DIKG PERMIT FEE SCAEDIILE
The Chief Building Official shall, before issuing permits for the erection of any
building or structure� or for any addition to any existing building or structure, or
for any alteration or repair to any existing building or structure, upon applicatio n
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 Valuation
�1.00 to �500.00
Fees
$10.00 (Minimum Fee is �15.00)
5501.00 to $2,000.00 $10.00 for the first a500 plus �1.50 for each
additional �100 or fraction thereof, to and including
52,000.
$2,001.00 to $25,000.00 $32•50 for the first �2,000 plus $6.00 for each
additional $1,000 or fraction thereof, to and
including �25�000.
�
$25,001.00 to $50,000.00 �170.50 fo he first �25,� plus $4.50 for each
additiona��1 , 000 or frac'�ion thereof, to and
including �50�000.
$50�001.00 to $100,000.00 $283.00 for the first �50,000 plus $3.00 for each
additional $1�000 or fraction thereof, to and
including �100,000.
�100,001.00 and up
�433•00 for the first �100,000 plus $2.50 for each
additional �1�000 or fraction thereof.
DRIVEiiAY DEPRESSION ESCROIi
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus
6 feet times $13.50
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach xith 6 inch depth - Drive�ay xidth plus 6 feet times $15.75
VERIFICATION OF FOIINDATION
Permits for construction uill 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 been c:onstructed will be required before proceeding with the framing.
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� /�'� , s � � o _ °� • � � �f `"� � Minnesota Well and Boring
we�� oR eoaiNG �oCanoN MINNESOTA DEPARI'MENT OF HEALTH Sealing No. H 5� g��
co���Y Name WELL AND BORING SEALING RECORD Mi��esoca u�iq�e No.
�N�� Minnesota Statutes. Chapter f031 or W-series No.
lLeave blank it not knowN
Township Name Township No. Range No. Section No. Fraction (sm. � Ig.) Date Sealed Approximate Date Well
FRIDLEY 30 24 3 NFn„SW„ Nir� AUGU ;� 3, 1994 °rBonngConstructed �9�,s
Numerical Sireet Address or Fire Number and City of Well or Boring Location
82$0 EAST ItIVER �Q�] Depth Before Sealing 4� ft. Original Depth —� R.
Show exact location of well or boring Sketch map of well or boring ' Stalic Water Level Accurate
in seclion grid with'X- location. showing property lines,
N roads. an�buildings. ❑ Approximate
_� � � �_ � � �_�1C � �� a.�
,--;--,---, •r
Single Aquifer ❑ Multiaquifer fl. below above land surface
i i i
- � - - L - -�- CASING TYPE
W i i i i E
� � � � � A lAl
i i i i A� �' 7 �Steel ❑ Plastic ❑ Tile ❑ Olher
'�. mile —
_I I I I_ � �
I 1 I I
S � Screen from �� ro �� ft. Open Hole from to ft.
� � mj�e � ��� OBSTRUCTION/DEBRIS/FILL
❑ Obstruction ❑ Debris ❑ Fill
PROPERTY OWNER'S NAME
CITY �F FRTDI.FY .
Type of debris/obstruction
Mailing Address'rf difterent than property address indicated above.
ObstructioNDebri�ll removed? ❑ Yes ❑ No
(FI=i.i�. �dNZVERS�i� AVF'iI�iII''o P��P
FRIDLET, MN 55432
Removed ❑ Not Present ❑ Other
CASING
GEOLOGICAL MATERIAL COIOR HARDNESS OF �OM TO
FORMA770N
Diameter Depth Set in oversize hole7 Mnular space indially grouted?
It not known, indicate estimated fortnation log from nearby well or boring.
��D tjr�N 1� � in. trom —{�— to � ft. ❑ Yes �No ❑ Yes ❑ No ❑ Unknown
CLAY BItOWi+T 201 �.0 �n. from to ft. ❑ Yes ❑ No ❑ v� ❑ No ❑ u��,o�,R,
CLAY $L(1$ 1�.� �.6� �n. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown
METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE:
H�'iR� p� �R�W� 160184 �Q No Mnular Space Exisis
JORDON IRQ� R� �, $q, �, 9� ��^nular space grouted with tremie pipe
❑ Casing Perforation/Hemoval
JORDON GRAY 19S 14
in. from to k. ❑ Perforated ❑ Remwed
in. from to ft. ❑ Perforated ❑ Removed
Type of peAorator
❑ Other
GHOUTING MATERIAL
GroutingmateriaiPORTJ.�AND r,am 46 to SUR�' e. �� 1 �95
from to ft. yards bags
REMARKS. SOURCE OF DATA, DIFFlCULTIES IN SEALING ��`
GEOLOGY FRON a 81 Si g. RI�i' A�� . from to ft.
yards bags
WATER LI�;iIEL iN ABOVE WELL a 19 '
DAT� WATER L�V�L TAKEN: 9-23-49 from to ft. yards bags
UNSEALED WELLS AND BORINGS
Other unsealed we�l or boring on property'? ❑ Yes �No
AUG0 3'�9�t LICENSED OR REGISTERED CONTRACTOR CERTIFlCATION
This well or boring was sealed in exordance vrith Minnesota Rules, Chapter 4725. Tha infortnation contained in this report is
true to the best of my knowledge.
� '� �r �. ` -,
� � � � Confp�lerB�ess Name Licrense or Regisfrafion No.
�� /'�p
� • �-,:.. . c'Y_-' •fiL__ _ VO°�.��94t .
tNonzed Represe ative Signature ' Date
n�ro�-rarr� -- Fi�e w� � H�oP�Rrv C� 9 q q JOH WAG ER /ICE�Tl� HOFPL
E'r1PF_RS—VHELLOWNERrpPY H �7 1J. NameniPersonSealingWelloiBoring
HE-01434-01
SUBJECT �RiM'FT�O-�---"-
City of Fridley � � g
r AT THE TOP OF THE TWINS ,, g � I L D I N G P E R M I T
� � R IPT NO.
� • COMMUNITY DEVELOPMENT DIV.
� � –___��_,
� L � PROTECTIVE INSPECTION SEC.
� �
i = �
� /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE Of APPROVED BY
�""'�"� �'� 612-571-3450 910-F15 8/ 16 / 94 � �
JOB ADDRESS $280 East River Rd NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. S—IO E Riverview Heights SHEET
2 PROPERTYOWNER MAILADDRESS 21P PHONE
Fridley HRA 6431 University Ave NE 571-3450
3 C ACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Veit and Co Inc. 14000 Veit Pl, Ro ers MN 55374 -
4 A ITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILOING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE
X
8 DESCRIBE WOFiK
Wreck House (892 sf)
9 CHAN(iE OF USE FROM TO
STIPULATIONS
Per City contract. SAC credit to be City wide.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATIN(i, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. fT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OH ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER�WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE HEAD AND EXAMINED THIS APPLICATION 1 STALLS GAHAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT N A
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
ST OR THE FORMANCE OF CONSTRUCTION. NO F22 N A
g PLAN CHECK FEE TOTAL FEE
`�''� 9 -o-
SI NATURE OF CO ACTOR OR AUTHORIZED AGENT ( EI pqOP Rl� THIS IS YOU � ERMIT
e
SIGNATUREO:OWNER�IFOWNERBUILDERi IDATEI BLOG iN �/•TE
�i�i �i � '���.��
�'L)�R.�aidC'a � � �� �RE�KIN^v �✓� �PPLt�f�`€'Ii?�
3ob Address : �Z �J �- �+r��' � l
Legal Dascription: `ofS � �_ `'D�S� �O ,p�,l�r � , G�2r� �P�v �erSGr,�S
G;�ze�- � Address: ��IC��,c� ���- T�1. �`
COil �:� :.: �
Address:
5s 37�
DESCRIPTION OF BUII.DING
m e 1. � �Z$ —Z24/Z
�Living
Area: Length Width Height Sq. F't. ��^ Cu. Ft.
Garage
Area : Length � ei . --��u . �`-Ft : —
Other: Length _�� th ei q. . .
Estimated Cost $ Approx. Completion Date `� ��
�G'i� ���ol/ fi�l �.ecf- ��EC� �'�, �i-2�' �l� l �s7 C llre�v�
UTII.ITIES TO BE NOTIFIED ��
City Water%Sewer Mpls. Gas Company Northern States Power
571�3450 (� 372-4720 [�j� 566-9120 [�
Water Bill Paid: Yes [� or Collect [$ ] Initials
Moving Route:
U S West
663-6000 [ ��
- $-15-q �
The undersigned hereby makes application for a permit to wreck/move the building de�cribed above, agreeing
ta 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 declar�s that all facts and regresentations in this lication are true and correct.
� /z 9 � 2�3� � �,•�1-�ro'
Date Signature
Nt�vim�: Principle Building into Fridley ... $ 80.00
Aor,es..�ory Building into Fridley ... $ 20.00 �[;nim�m Fee: $15.00
�rottgh, within or out of City ...$ 15.00
Wrecicing: For each 1, 000 cubic feet or fractioal ..$ 1. 25 __
Fbr �es which would be im�acti.cal, to cube, the fee shall be ba.5ed aai
the total oost of wrecking at the rate of $6.00 for e�ach $500.00 or fractian.
P�IIT FF.�:
,`t4��.�� : Y � :�5�