AF - 42056SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
f
� .
� �
• COMMUNITY DEVELOPMENT DIV.
� j \: ------�
r � � PROTECTIVE INSPECTION SEC.
1 �
� � �"'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE
`���'�i .�.J
612-571-3450 910-F15
JOB ADDRESS 262 Ely Street N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
�ESCa. 37,38 11 Spring Brook Park
2 PROPERTY OWNER MAIL ADDRESS
Howard Walters 262 Ely 5treet N.E. 784-6785
3 CONTRACTOR MAI� ADDRESS
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAfL ADDRESS
PAGE OF
/ /
PERMI
I 17587
CEIPT NO
1 ����
APPROVED BV �
SEE ATTACHED
SHEET
ZIP PHONE
ZIP PHONE LICENSE NO.
ZIP PHONE LICENSE NO.
21P PHONE LICENSE NO.
6 USE OF BUIIDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 �ESCRIBE WORK
Construct a 22' x 22` Detached Garaae
9 CHANGE QF USE FROM
STIPULATIONS
TO
Provide a hard sur�ace driveway,
WARNl�G
Before digging �atl locai utilities �EPERAi'E PERMEi'S RE�E�t��f� �f�R WIRIN�
iELEPMONE-ELECTRIC-6ASEtc. ;-IFATI�i�;. P�UMBtN� At1I� SIGNS+
REQUlRED BY LA1A/
TYPE OF CON57.
SEPARATE PEFMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION zONING
AUTHORIZED IS NOT COMMENCED WITH�N 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
t HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO TNIS APPLICATION �-
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $5, 425
WITH WHETHER SPECIf1ED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING cor,- $56. r'JO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
RE OF CONTRACT O D A IDATEI y�/HE�
►
�2 '
�E OF OWNERII NE UIL ERI IDATEI� � BLDG i
OCCUPANCY GROUP OCCUPANCY LOAD
SQ.FT. CU.FT.
OFFSTREE? PARKING
STALLS GARAGES
SURTAX
�S`2.%2
ITOTALFEE
$59.22
Y V�rC1pATED THIS IS YOUR PERMIT
na
NEFi [ ]
ADDN. L �
pLTER. L �
Construction Address:
Legal Description:_
Owner Name & Address:
Contraetor:
Address:
LIYING AREA:
GARAGE AREA:
DECR AHEA:
OTHER:
City of Fridley
�R-1 AND R-2�
Building Permit Application
�
Effeetive �1/1/84
� Tel . #� � � 7 S
Attach to this applieation, a Certificate of Survey of the
lot, with the proposed construction draWn on it to scale.
DESCRIPTIOp OF IMPROYSMENT
Length Width Height
Length �_ Nidth ZZ Height
Length Width Hgt/Ground
Tel. #
Sq. Ft.
Sq. Ft. �_
Sq. Ft. �_
Corner Lot [� Inside Lot [] Ft. Yd. Setbaek Side Yard Setback
Type of Construction: _�/��� � ��-�"e Estimated Cost: $ �� vS� "
Approx. Completion Date: /� r '
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: See Baek Page for Explanation
DATE•
� � a �APPLICANT: � Tel. #
CITY IISE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
S�Wer Main Charge
TOTAL
STIPULATiONS:
,
� ��p.sd Fee Sehedule on Reverse Side
$ ""�' 25� of Building Permit Fee
$ ��� Z. $.50/$1,000 Valuation
� a425 per SAC Unit
� Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
� �°�,22
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City of Fridley ��3� 36
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AT THE TOP Of TME TWINS g � I L D 1 N G P E R M I T
„
. � �3 g�
� • COMMUNITY DEVEIOPMENT DIV.
r� � v � PROTECTIVE INSPECTION SEC.
, ,
l-.•-�,��"' �'� CITY HAIL FRIOIE� 55132 NUMBER pEV O�iE P�GE Of •OVROVED 9r
L 612-571-3450 9�0-Ft5 3/17/00 / /
JOB ADDRESS 262 Ely Street NE
t IEGAI �OT NO. BLOCK TqACT OR AODITION SEE ATTACHED
oesea. 37,38 11 Spring Brook Park s►+eer
2 PROPERTY OWNER MAIL ADDRESS 21D PHONE
Howard Walters 262 Ely Street NE 209-7423
3 CONTRACTOR MAIL ADORESS 21P PHONE IICENSE NO
SMA Inc 10650 Co Rd 81 STE 217, Maple Grove MN 55369 315-8900 20042927
� ARCHITECT OR DESIGNER MAI� ADDRESS ZIP PHONE IICENSE NO.
5 ENGINEER MAIL ADDfiESS ZIP PHONE UCENSE NO
6 USE Of BUILOING
Residential
7 CLASS OF WORK
O NEW O ADOITION O ALTERATION C�7 REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (20 Sq) 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the 3rd.
TYPEOFCONST OCCUPANCVGROUP OCCUPANCV�OAO
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PIUMBING, MEATING.
VENTILATING Oii AIR CONOITIONING
TMIS PERMIT BECOMES NULL ANO VQIO IF WORK OR CONSTFUCTION 20NING SO. FT CU FT
AUTHORIZED IS NOT COMMENCED NJITHIN 60 DAYS. Op IF CONSTRUCTION
OR WOFiK IS SUSPENDED OR ABANDONEO FOF A PERIOD OF 120 OAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO DWLG. UN17S OiFSTpEE? PARKING
I HEREBY CERTIFV THAT 1 HAVE fiEAD ANO EXAMINED THIS APP�ICATION 1 STA�LS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VA�UATION SURTAX
ANO ORDINANCES GOVERNING THIS TVPE Of WORK Wlll BE COMPLIEO
WITH WHETHER SPECIFIEO MEREIN OFi NOT. THE GRANTING OF A PERMIT �1,313 $.6E1
DOES NOT PRESUME TO GIV AUTMOtiITV TO VIOLATE OR CANCEL THE pEqM1T FEE SAC CHARGE
PROVISIONS OF Y O HE STATE OR LOCA� LAW REGULATING CON- @
STRUC O�THE PE MANCE OF CONSTRUCTION $5�.95 � F re .SC. y�1.31
PLAN CMECK FEE T TA� FEE
� �7 d� Licen C $5. $57.92
S�G 0 p f 'FACTOQOAAUTNOQ�2ED�GENT ID�TEi
MEN P O V VALI AT D THIS I VOUR PERMIT
� -/� -�
S�GN4TUqE O� OWNEp��� OwHEQ Bu�IDEp� �DATE� BLD IN$� ' �l�.�E
NEW [ J Effective 1/1/2000
ADDN [] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION � � i� � �
�� �� �r � � �
Construction Address: � � Z- L/ , � �,�/
Legal Description:
Owner Name & Address: ��c�.,--� ���,Q�� Tel. # Z� 9— 7�iZ3
Contractor:
LIVING AREA
GARAGE AREA:
DECK AREA:
OTHER:
MN LICENSE# Z�O�F29Z7
C'� g t S-� 21 �1 �,,�Z�7J� Tel. #�/S -$ tCX �
-��,� /
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width _
Length ��t�
lf�e�'���
Height Sq. Ft.
Hgt/Ground Sq. Ft
�,�� C.� ��
-..._
Construction Type: Q�,.��� Estimated Cost: $���� /�`✓
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _�
DATE: 3� i—D � APPLICANT: Jc�n. P�S¢�i v+•�•.v� Tel. #!-0� !
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$ �d - gs Fee Schedule on Reverse Side
$ � �/ .001 of Permit Valuation (1/10th%)
$ - �o� $.50/$1,000 Valuation
$ $1100 per SAC Unit
$ S C�O $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$
$
$
�_=, = =!,
�, -�= __.:=
i
� �
$450.00 Conservation Plan Review
.Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]