AF - 42071�
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City of Fridley, Minn.
BUILDING PERMIT
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N° 694�
Date: _..�..._w.l....l._._ �"(F"a ...�.. _..___._.___._..._......._.__.__
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Owner: �.�� . . _ _._..: ...A.._._.__ Buflder _. �..,.::: -_^___�:�z�:.._�._ ............._....__.._...___.._._.
Address
Address
LOC T ON F B ILDING
No. �....4----,/••�........ Street ....._� ....._._ .... ._.�r._•...._._.-a�la•�•••.e.•• ................. Part Lot ... ..._ .___.._._. .. _._._.._...____
j � / �� /�� �
Lot .��...f� ...._ Block _.__..._._......__..!_- •-•--------. Addition or Sub-Divis�n, - ��•�%�T`-•'-•--��••••�..._.._��
Corner Lot _.__.._......._....__ Inside Lot •----_..----�!�'�....---. Setback ...�.��........._...._ _ Sideyard ----..... �..___�,r....._.._.__.__.____
Sewer Elevation .....�_�I.� .I� p _. . � Elevation ---•--...� :�.. � �..iz � .�___..___..___.._._._..r.
..�... _......._..._.__.__...._....�...._........._._ . _. _
rtoP c* F��f/n/G
� DESCRIPTION OF BUILDING
To Used : �
, ', �
_ ......_ .._ Front � _ _..._.. DeP�► �.`�...,,w iIieight ...�.. Sq. F� �,�.__
t -� /i . .
._. .... .. ... ...._. Fro _�_.�1.....__ Depth �......,� I�eight _l._'.��_- Sq. Ft. �.d-�.�_..
Type of nstruction ......._.__ . ......_..._... Es� Q�t� .._.;L..�.�...�_...._tl....._........ To be Completed _.
Cu. Ft`.�1.�1.�,0
Cu. F� 1t•.- ��
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
th� proposed work in accordance with the description above set and in liance all provisions of
�
ordinances of the city of Fridley.
- - � �� •---
In ca�sideration of the payment of a fee of $� �_......._.., permit is hereby granted to__.__....._ _
._.__,........_.._._____..._.:..__..___._.._ to construct the building or addition as described above. This permit is granted upon
the eacpress condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked a t ar�y time upon vio]�tion of any of the provisians of said
ordinances. ,� f 1
Buiiding' Inspector
NOTICE:
'[l�is puadt do�s aot eowr ttw ionstruefioe, MsfallNion for wir6��. P��Y. Yu I��atiny, »w�r er wabu H� wn to sM
�h� BviWfnB Intp�ero� fer ap�rah p�rmfts for th�a N�tns.
A.PPLICATION FOR BUILDING PERMIT
GITY OF FR�DL�i, MINNE50TA
OWNEI�' S NAMR BUII.DER
ADDRESS � C ADDRESS
LOCATION OF BUILDING
No. ��- �, Street Part of Lot
Lot � f�' Block � Addition or Subdivision �Ch�_
/ (
Corner Lot Inside Lot�Setback � S Side Yard S '� l�
SEWLR ELEVATION FOUNDATION ELEVATION
Applicant attach to thia form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
To be used as:
Type of Coastruction
To be Completed
DESCRIPTION OF BUILDING
Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Pt. Cu. Ft.
Estimated Cost � � ��"�
� ��`
The undersigned hereby makes application for a permit for the work herein specifiad,
agreeing to do all work in strict accordance with the Citq of Fridley Ordinances an3
ruiings of the Department of Buildings, and hereby declares that all the facts and
representations stated in this applicatifln ar true and correct.
BATF � C �b �` S IGNATLtRE � � �"
TT /
(Sct,edule of Fee Costs caa be found on the Reverse Side).
.. . . ,.
, , _.�,- • •
r:+ � - .
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PERMtT for Power ants and Heat�ng, Cool-
ing� Ventilation� Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION C�� W4RK
No. of / Heating Plants �'�" to be nstal —altered—repaired
Make � , Size � � 3 � ;
Oil fired : Coal fired ; Gas fcred�_; Gas Authorization
Rem.arks
Approved
Final Inspc-ction
GF. s�
19____
Inspector
�� � �����
Pernut N° 4 4 2 8
Fee $ "�� �Z'
Of�ice of the tnspector of Buiidings
City of Fridiey
City of Fridley, Minrz. , 19.(,�..
Owner�� '--� �-�- aa� '-""'�-'�
Location �'� � �� �"' '� L � '
Kind of Buildin
How Occupied d
Work to be Commenced `�- � � ,19 �S
To be Completed '�" � ,19 � 9
Estimated Cost, $ � �� • �—�
Building Permit No.
Perrnission is kereby granted to to install—erect—use the »zaterial and devices described in the
aboue statement. This permit is granted upon the express condition t i the person to whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the operation of the devices herein mentioned shall conforrn in all respects to the ordinances of the City of Fridley
relating to or governing tlxe work to be done and tke operation of the devices herein named, and to the spec' ations set forth in the approved application far this
permit on file in the ofj°ice of the Inspector of Buildings. , �,.y �
�-' `�. , Inspector of Buildings
4e sM »-6� v
HOUSE HEATIN^ EST RECORD
ADDRESS d+ +� ����V S 1�`� ���i �� � APT. FLOOR CITY SUBURB t"—
OCCUPANT �C� � � � r"►f OWNER
HEAT LO55 DATE WTG, NST. ^AS CO. METER BADGE # �` ��� f
SOLD BY � y+�� '�-' � iNSTALLED BY
Eleetrical Work By Gas Line By ���� Yi � r'y' � "
TYPE OF iiEAT GA FA �HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE � � � 'F'`� �'+–� MAKE OF BURNER
Model �/ � Z- d �/ Model
Sxial `Y �� 3 b ! Max. BTU Rcting
INPUT ( V�� d��' MAKE OF FURNACE
Model
CONTROLS :r
THERMOST/�T �� Heaf Plug ,y � Vent Size �
Valve C�'i'"�'�''�' a� KIND OF LINER ���� SIZE�NONE
Limit �Z-� <<�.. F�'� �J+ Draft Hood ���-� �i fti�- Regularor
Limit Setting t� 6� � Filters Size ���'t'�' Number
Fan Setting a� M� 1� � Chimnay Location Inside x Outside
Pilot Type '�-� �+�-�'--t � • Chimney Construction � : U'J � V `c' y� �"
Pilot Moke �''�'�-- �
Pilot Model Smoke Bomb Wiring
s
Pilot Timing � a"'y`�' ' Draft Test Tag �
L.W. Cut Off l�� Door Pressure Lighting Inat. L
Prossure •� y� Pereent CO2 �� Date Tested `3 � t 5%�/ %6
Input CFH r!�'�' � Pereent 02 �i �� Company Testing S'�-a ti*- e�� �`ci �`
Stack Temp. 7�� Percent CO � �—��� Name of Tester �—�`���-t-,.�,
Form 235
N"�18526
Building Job Report
ADDRESS��j% �L� ST
OWNER �U S S� ,� C��P �'yJ YH F"`�`
BUILDER �'N��/= /� ��.0 /�%L� J�
DATE 1��--� -7 t PERMIT NO.
DESCRIPTION �� �����jy� �,� G�'� C'O i�S� � .�L�
��; T���/,ri5 - f i�C � n�L fl�s J'l�� i' � D�P�i JI�
��� R���``%� �� � INSPECTION RECORD �� s �C� �
DATE REPORT
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SUBJECT .
� City of Fridley � 1220"1
�
AT THE TOP OF THE TWINS g U I L D I N C P E R M I T
; � R E 1�10'�
� �L _ COMMUiJITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. //
1 . � «� (O
�` � /"�\ � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF ��� APAROVED BY
`•"'� � ,�� 612-560-3450
910-F15 6 29 73 / /
10B ADDRESS 2$1 Ely Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oescR. 5, 6 14 Spring Brook Park s"EET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Russel Schlemmer 281 Ely Street N.E. .
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Miles Lumber Company 4500 Lyndale Avenue
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUiLDING
Residential
7 CLASS OF WORK
�7 NEW O ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct 26' x 22' Garage (2nd Garage a prav d by Council May 21, 197
9 CHANGE OF USE FROM TO
STIPULATIONS provide a hard surface driveway. Planning Commission stipulations
that are a`ttached.
o �p� �11R1���
� REQu���
�P�RA-�� PERM� �G ANp SIGNS.
S P�v�11B
KEp,�1NG�
TYPE OF CONST. OCCUPANCY GROUP OCCUPANGY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOCl FTaiAe
THIS PERMIT BECOMES NULL AP1D VOID IF WORK OR CONSTRUCTiON ZONING SQ. 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 PARK�NG
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO 8E 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 y�L�591.16 1.29
DOES NOT PR TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROYISION F ANY THER STATE OR LOCAL LAW REGULATING CON-
STRUCTI OR ERFORMANC OF CO CTION. � yfi1.�..00
\/ t PLAN CHECK FEE TOTAL FEE
X ` 12.29
Si u E PCO iRACT ORA T EonGE T (DATEI WHEN R VAIIDATED THIS I�OUR PERMIT ��
- � ��
SiGNATURE OF OWNER UF OWNER BUILDERI IDATEI BLDG. IN DAT
% •� ' '
�(�, ✓�-Q2�� �.� ��2�Jue e� �� ��n . ���-n� . s 9 - �.3
.
,(.��,t�l� � �.� � c�..��:�� �J � - �c-e., �� �. ��c�c�c._C�
�.,�zJ c�. `���Gl.l� a �, � 9'�3 -
���� , HAPLICATION FOR RESIDENTIAL ALTERATION
� ,
OR ADDITION BUILDING PERMIT
, CITY OF FRIDLEY, MINNESOTA
OWN�R'S NAME: BUILDER° �
ADDXtESS : � t� f ADDRESS •
NO:�, � STREET:
LOT: � 1c. BLOCK: � �� ADDITION:
CORI�ER LOT: INSIDE LOT: SETBACK: SIDEYARD;
Appl;icant attach Co this form �ao Certificates of Survey of Lot and proposed
builiding location drawn on these Certificates. �
�ESCRIPTION OF BUILDING
To B Uaed As;
� Front• �
� Depth • 2 Z- / Height • � �
Squaxe Feet: J�' Cubic Feet:
' Front: DePth' Height• ,
Square Feet; Cubic Feets
Type'of Construction: WC)O Q�/�%%1 Estimated Cost;_,� �,S g/,/�
To $e! Completed; _ � %}��� I �
Tha ujndersigned hereby makes applicativn for a permit for the work herein
sgecilfied, agxeeing to do all work in sttict accordance with tt�ye City of
Fridl�y Ordinances and rulings of the Depar�cnent of Build�ngs, and hereby
decla'pres that all the facts and representat�ons stated in this application
are t�CUe and correct,
, .
DATE:''�� . � � � SIGNATURE•
(See �tevexse Side Far Additional Znforaiation. )
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� e � � ►�ArTING
•.:Y�1�l�i:.. '�� � .. . fAi1M SU�l1r[�S
� LAIVD SI:RVEVOR '
CaT♦ �OTS �� LA�CSMO�C �
'D�rG4�"�^'C ���� ih�+ �� � .' . � REG�S7FplO Uh:;Eli LAWS OF STATE Of MtNNESOTA � .aOrG��
� i . .�.rEr.SF.^. •• U�CI���.CFa O� C:T� Oi M�N�:[�op:'S .
; � 3300 �rNDALE AV'E 50 MINNEAPOL15 8 MItvN
� � TAYLOR 4•0370
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• I id+urbcpoc's �Certtfuatc �
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RUSSELL SCHLENffKER SP ��73-02
I SC�,�C, 1" :'��' Blocks 5& 6, B1. 14, Spring
� '' : . Brook Park Addition, to
, _�� J� _. � 1 consCruct a second detached
garage.
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'' ` I hereb�� cartif�r thc-.t th� �r.r.exe�i is a true
' _ a�d cerrect :.Za� o£ a s�;s�veJ o£:
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CITY OF FRIDLEY
��,�.NA3ING COMMISSION MEETING MAY 9, 1973
CALL, TO ORDER:
n
PAGE 1
Chairman Fitzpatrick call�d �h� m���in� to ordex ai :10 P.M.
ROLL CALL:
Members Present: Fitzpatrick, Harri.s, Lindbl ,�lair, Arigans
Members Absent: None
Others Present: Darrel Clark, Community velopment Administrator
.�PPROVE PLANNING CONAMISSION MINUTES: APRIL �, 1973
MOTION by Drigans, seconded by B1air that the P1arining Commission
min�rt�s of Aprai 1t3, I973 be approved as written. Upon a voice vote, a11
voting aye, the motion.carried unanimo 1y.
RBCEIVE PLATS F, SUBDIVISIONS-
AFRII, 18, 1973
UTILITTES SUBCOI�IITTEE MINUTES:
MOTION by Harris, secondPd y Lindblad, that the Planrting Commission
xece.ive the Plats & Subdivisio -Streets & Utilittes Subcommit�ee minutes
of Apri1 18, 1973. Upon a vo'ce vote, aZ1 voting aye, the mot�on carr�ed
ur.animousl y .
F.ECEIVE BOARD OF APPEALS I
NUTES: APRIL 24, 1973
MOTION by 81air, s conded by Driqans, that the Planning Commission
.r�eeive the Board of peals minutes of Apri1 24, 1973. Upon a voice
��e�te, a1Z voting aye the motion carried unanimously.
° Mr. Drigans lled Chairman Fitzpatrick�s attention to page 26 in
the agenda and t statement by Mr, Crowder that he recommended that the
Planni.ng Commzs ion look into these areas of allowing or not allowing zero
setbacks. Ch rman Fitzpatrick said we will add this as the last item on
our agenda a discuss it at that time.
RECEIVE B
1973 �
DING STANDARDS-DESIGN CONTROL SUBCOAM4ITTEE MINUTES: APRIL 26
TION by Lindblad, seconded by Harris, t�iat the Planning Comm.ission
rece' e the Bu,�lding Standards-Design Control Subcotrtm�ttee minutes of
Apr' 26, I973. Upon a voice vote, a11 voting a,ye, the motion carried
�an �i�nously. � �
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GONTINUED: PUBLIC HEARING: REOUEST FOR A SPFr.rar.>>SF PFR1dTT_ SP #�;_n�
ing Brook Park, pex City Code, Section 45.051, 2 A.
Public Hearing open:
.
Pl.anning Commission Meeting - May 9, 1973 Page 2
Mr. Russell Schlemmer was present.
Chaixman Fitz�atrick asked the petitioner if he had any s�Gatement
to make at this time.
° Mr. Schlemmer said his original proposal was to have the garage
45 feet behind the house and 5 feet from the propexty line. Because the
Ga�nmission had asked him to see if he could bring the garage closer to the
ho�ase, he said he would be willing to move the garage 10 feet and have
it 36 feet behind the house, but to eliminate too sharp a turn, he would
have to go to the minimum requirement of a 3 foot side yaxd setback.
Mr, Fitzpatrick said he was a5ked to c�n��,de�' mavit�� the ���'���
d�s°�ctl.y behind the house and have the garage d4or& qpen t� tho We$t inst�ad
�f the South.
Mr. 5chlemmsx said he couldn't locate the gara�e th�re because it
wauld interfere with the back entrance to his house. ,
Chairrnan Fitzpatrick explained to the new members of the Planning
Commission why this item had been continued. Mr. Fitzpatrick said there
had been objections from the neighbors because the yards were deep in this
neighborhood and they liked the open space,
Mr. Clark said there was a question by a neighbor whether Mr. Sch�emmer
had enough room for a driveway as there was only eleven feet between his house
and the pxopexty line.
Mr. Fitzpatrick said�the reason for this petition was because Mr.
Schlemmer owns several xecreational vehicles and two cars and needs �
this second garage because he just has a single attached garage at the
present time,
Mr, pigans asked how wide the driveway would be and if it would be
biacktop or concxete. Mr. Schlemmer said it would be a nine or ten foot
concxete driveway.
Chaixman Fitzpatrick asked if anyone else wished to be heard.
Mr. Mykola Moroz, 289 �ly Street, said he had a selfish objection,
but he said this driveway would be 6 feet from his driveway and then in
another 25 feet would be.hir. Schlemmer's present driveway, and he thought
it would make the front yards look like they were all concrete. He felt
this would detract from the value of his home.
Mr. Clark said he was not speaking for or against this request, but
although both the neighbor's on each side of Mr. Schlemmer's home have
attached garages, there are detached garages in this block that are back
on the lot.
Mr. Drigans asked Mr. Clark if he had checked the property fox any
, dxainage p�oblems. Mr. Clark said he had, and there wouldn't be any problem,
' The dxiveway would j��ve to have a crown so that drainage could go both ways,
but this had to be done on most long driveways. �
�
Planning Commission Meeting - May 9, 1973 Page 3
Mr, Drigans asked Mr. Schlemmer if the gxade would be the same for
this drivsway as the adjacent property owner's. Mr. 5chlemmer said it would.
Mx. Blair asked where the gas service was lacated. Mr. Schlemmer said
it was located on the side of the house along the proposed d�iveway, but he
would call the gas company and have the gas servic� mc�v�d.
MOTION by Harris, seconded by B1air, that th� F'Ianning Cetr��B�,�Ar�
c1os� the Fublic Flearinq on the request .�Qr a Sp�c�a1 Usre Perm�t, SP #73-Q�,
b� Russel.i Schlermner. U,pon a troie� vot�, all vating aye, the motiori carri�d
unan�m4us1�.
' Mr. Arigans said that as all the driveways will be concrete, he didn't
feeL this was unappealing. .
Mr. Fitzpatrick said there were
of an open area also, Mx. Clark said
garages East of this area. Mr, Blair
10 feet, this would help some.
objections made to the obstruction
there were at least two detached
said�if the garage was moved forward
Mr. Harris said he would prefex that Mr. Schlemmex maintain a five
foot side yard setback, even if this meansthe garage is 45 £eet behind the
house. He said he thought there should be stipulations that the drainage
plans be worked out with the City, a turn around must be provided for safety
on the driveway, and the garage should match the exterior of the house. Mr.
Schlemmex said he intended to do all these things. Mx. Harris said he still
thought they should still be stipulated so there were no questions. Mr. Harris
continued that he didn't think we would be setting any precedence as there
were other detached gaxages in the area�if we approve this request. This
is a means of keepin� recreational vehicles from standing around in the yaxd.
MOTION by Dxigans, seconded by Harris, that the Planning Commission
recommend to Council approval of the request for a Special Use Permit,
SP #73-02, by Russell Schlemmer, to construct a detached second qarage on
Lots 5 and 6, BZock 14, Spring Brook Park Addition, per City Code, Section
45.051, 2 A, with the following stipulations:
1.
z.
3.
4.
5.
A proper drainage plan be worked ou� with the City.
rnhe esthetics of the qaxage conform to the house.
Provide a proper turn-around in the driveway.
Maintain 5 foot side yard setback as specified on the plot
plan, the garaqe to be set back a maximum of 45 feet behind
the house.
The driveway to be at the same grade as the adjoining neighbor's.
UPON A VOICE VOTE, a11 voting aye, the motion carried unanimously.
CONTINUED: VACATION REQUEST, SAV
p easement on 67th Avenue N.E
Fridley et N.E. to add 30 feet
Lot 1, Block , c Grove Addition
bui�dable s�X�.
#73-OS, GILBERT MENKVELD: Vacate
. between Anoka Street N.E, and
to the North/South dimension of
to Fridley Park, making it a
Mr. Craig Willey and Mr. James �Ve�lspn, oxney, were present.
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BUILDER I�� ( i "C � `� �— � ~ ? � S � `� :
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DESCRIPTION 6 A � . �� �.
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DATE' REPORT � ,�. S �
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OWNER — REP.C�j U � INSPECTOR
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SUBJECT - � •
City of Fridley ' 216 9 6
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
� � O.
� � COMMUNITY DEVELOPMENT DIV.
� � 13Cv i
� `�: -----
r � � PROTECTIVE INSPEC710N SEC.
� �
� � /�'�1 � CITY HALL FRIOLEY 55432 NUMBER REV. DATE PAGE Of APPROVED BV
�""'�� ��� 612-571-3450 910-F15 12/14/92 / /
JOB ADDRESS 2 gl Ely Street NE
t LEGAL �OT NO. BLOCK TFACT OR ADDITION SEE ATTACHEO
DESCR. S,6 14 Spring Bxook Park s►+eeT
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Jim/Maria Benson 281 Ely Street NE 786-3796
3 CON7RACTOR MAIL ADDRESS ZIP PHONE IICENSE NO.
Minnesota Exteriors 295 Hwy 55, PO Box 68, Hamel, MN 478-6001 2877
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII, ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Q REPAIR O MOVE O REMOVE
8 DESCR�BE WOFiK
Reside Dwellin�
9 CHANGEpFUSEFROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY �OAD
SEPARATE PEFMI7S ARE FiEQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NUIL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONE� FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEfiEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND COFiRECT. ALL PROV�SIONS OF IAWS VALUATION SUFiTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIfIED HEREIN OR NOT. THE GRANTING OF A PERMIT $15,169 $7.SS
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVI IONS OF ANY OTHER STATE OF LOCAL LAW REGULATING CON-
S RU I N O T� PER.ORM NCE OF CONSTFUCTION. $171.Q0 Fire SC $ZS.1%
j PLAN CHECKFEE TOTALFEE
�' / License SC $5.00 $198.75
si Natu EOFCONTRACTOROAAUTHOAIZEDAGENT �� Ei HEN PFOP Y A DAT THIS IS VOUR PERMIT
� � /� /� �
S�GNATUREOFOWnIERiiFOWNERBUiLOERi iDATE� DG �NSP ��4TE
I�l [ ] Effective 1/1/91
ADIN [ ] R-1 AND R-2
AL'Igt� Build.ing Permit Applicatioci
Cbnstruc.�tian Address:
I,agal Desc.�iptiori:
�
�
r �
Owner Name & Addres.s: � Cl�' `� 'I�el. # " � 7 9 �
aoaztractor: /�% �Z� ��/Ll��/J Tel. # 5�'�' � � �
,—�,
Aa�are�: � S S�.S� ..� . �
Attac3i to this application, a Dertificate of Slitvey of the
lat, with the proQo�ed oazstructioci drawn on it to scale.
LIVII�IG ARF�: I�gth
(�R�GE AREA: I�th
DD(.'R AREA: Ier�gth
O�:
vi: a• • •i- � �• •.� • a� i:�
Width
Width
Width
iieic�t � Sq. Ft.
H�ei.c,�1t Sq. Ft.
Iigt/�o�]r�d Sq. Ft.
Cbrner L�t [] Inside I�t �] Ft. Setback Side Yard Setbacks
�pe of ooa�struction: „���� , ry� �.stimatea oost: S /S, /� 9 - �-a
Approx. �letion Date:
Pro�osed Driveway Width If New Opening Is Desired- r,t. $ S
' Width + 6' See Back Page
I3ATE: � � % Z � APPLSC�,I�Tr: Z�el. # �0`' �
P�erntit Fee $ � � I- 0 �
Fire S�large $ 1 � � / ?
State S�lrcharge $ `% - �a
SkC Q�ge $
Driveway EscY�aa $
r-s-��. � L..-�Cf�� � SC $ �- . OC�
Sewex Main Ct�arge $
To�r�r., S ,
� �� , ���
���:
CIi'Y USE Q�B,Y
Fee Sci�edule aci Reverse Sic3e
.00l x Permit vaivati� (1/loth $)
$.50/$1,000 Valuation
�550 per ��,C Unit
Alt. "A" or Alt. "B" Abwe
Fee Determinea by �ngineer�rig
� ���Y I l � N�rY [ J
�.'
3ux�ding
:nspections
163-572-3604
iITE ADDI�E,SS w � � / /
'ii1$ APFLICAIJ'T I5:
pRO�'ERTX O'WNE�,i/
TENAN�'
CONTRACTO�t
SUBMIT A COPY OF
YpUit STATE L�C�NSE
WITH APPLICA'i"ION
��tOPE�tTY '�X��:
pl?it1vIIT '�'XPE
T'YPE OF �'ORiC:
CITY OF FRIDLEY
�'i V �.Ti��r
ktESYUENTYAL A►�'PY.YCA��IO1�T
CI'�'Y O� FR�AL�yY
YOUR E-MAIL AADRESS
D bWNER �(C'ONXitAC'I'OR
��rmit rto..
Received By:
Date �Zec'd:
ADDRFSS: ��_ CI7'Y SFH7� ZIP
PHONE:
S7ATE LICENSE � � DATE ��,/�i y r��fa
.nnflrec. =if_fJ/ /11 �M/11�?/!�� /�/d�, /i�. CT3'I'✓�" �IL.�Lj(%�%�
• .I�`Ci ��ir7LZ/iry5
❑ BAS£MEN7 �fIISH �OOF
p p�qC O SIDiNt3
II SWIIvIlv7
DESCRIBE WORK BEIl�CG
SIZE OF �ROVEMENT
squ�ES � �
GARA-CES
PitOP�OSfiU SIZ�:�
PR0�4SED i�iGHT=
.�G
p viny�
❑ Alutnirnim
f� Other,,,_�
wYtvnows
FN EXISTX�1Cr OPENII�GS OYes ❑No
OR FOR TI£W OPFsN�IQS-DESCRI�E STZE OF
OP�NWG C�ANGES &
'I'YF� pF W[NDOW TO BE_ AdSTAI.iED
ARE
V.
�'ermit Fee
Plaz� �eview
Surcharg�
Fue Surchazge
License Sweharge
SAC Charge
Cvrb Cut Escrow
Erosion Gontrot
Park Fee
Sewer Maiva Gharge
�
�
❑ HOUSE 8t GAZtAG�
� A'FTACIiEA GARAGE
D DE'[RC�IED GARACsE
0
p �y��pws
Q �itAna �
� OTEIF�t
`��1�/
��� � �.�
��
8A^sEMENT R.ENLODEL�ING SUBMtT'
1_ &xistin8 F1oo7 Pitm
7. Pfapo�d $oor piain
3. List o� swcII�ral n�embers to ba t�ec1
FOR NEW CO�NS�RUCTIQN INCLUDING �ECKS,
OSoffit � �
II Trim !. Siu i'�an�y showing thc aristi P struetuees
B Fascia and pr°p°scd prWcd.
2. Trvo scts t�£consauc�on plans
3. Ent�y Caicvlations
LOCATION OF WINDOWS
C���
ON V'ALUAT�ON, YNCLLi�1�iG THE CVS"�,' t7r
(USING T� 1997 U.B.0 FEE SC�bULE)
►TiON $ �'�" 31 q 3� OCCUPi4�NC�
Y.ABOZt AiND
-$--- - �' See Back Page for �'ee Sci�edu�e
$ • 65% of Buildiag Penaait �ee
$ (j (.0405) times the total job valnation — Mi.�ixaum �•50
$ , .001 x Pecmit Valt�atian (1/10%)
$ S`_� $5.00 (State Licensed Residential Ca�atractors)
$ $1450 per SAC Unit (Pians to M'WCC for detenmination�
$ ft+68= ft�$20=$
$ $450 Gonsavation Plan Review
$ �'ee Dete�nined by Erngineering
� Ageement mecessary ( ) Nan Necessary ( )
� , Make cbecks payable tfl: Citv of �'iridley _ Atta�
TIiIS TS AN AP�LICA�O� FpR A PERMXT-NOT VALIEI I7I�'TI1- PROCE55�
Z hereby appfy �ur a buiIdiz►g p�rinit and I aalrnowledge tt4at the information above zs co�mplete and accu�ate; that the work will be in
conforma�r.� with the ordiwances and c4des of the City of Fridley a�ad with the N�axunesota Cons�uc�°I' Codes; that i u�derstand this is not a
per►x�it but only an applieation fox a p�rmit and woric is not to start without a�ermit; that tbie work will be in accordanee with the approved
plat� in t�e caso of atl wotk whicl ires review arad approvai of plans_ C ���1 a�
SlGNA71JitE �F APPLICANT � PRiNT TIAN�£�� -"t' � UA1E
Engineering
Department
763-572-3551
763-571-1287 fax
APPLICATION DATE:
THIS APPLICANT IS:
PROPERTY OWNER:
JOB ADDRESS:
LOAD LIMIT
MUDIFICATION APPLICATION
C,ITY OF FRIDLEY
EFFECTIVE 1/1/2010
' 3� ' f� YOUR E-MAIL ADDRESS:
❑ HAULER ❑ PROPERTY OWNER
R�S J3p,•� �'� �
v
MATERIAL TO BE HAULED: C`i) � C ��-2
DATES TO BE HAULED (UP TO 3 DAYS): ���) — G O �T� �'/- Z— � O
,
Permit No.: � �l � � ��
Received By;
Da�'
THIS PERMIT IS ISSUED TO ALLOW AN INCREASE OF AXLE WEIGHT FROM FOUR (4) TONS PER
AXEL TO FIVE (5) TONS PER AXEL OVER THE FOLLOWING DESIGNATED ROUTE:
��-s; f�,U-.�2 ��r� N �� � w r�2 i� f�slf�� 1--
� 1 �., 1_
NOTICE: This permit is valid only for vehicles enroute to construction address during the hours of 8:00 am to
5:00 pm. See Resolution #01-2004 and State Statute Section 169.87
PERMIT MUST BE IN VEHICLE WHILE IIAULING ON ESTABLISHED ROUTE.
NUMBER OF LOADS
$25 per load
PERMIT FEE $ ��
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a load limit modification permit and I acknowledge that the information above is complete and accurate; that the
work will be in conformance with the ordinances and codes of the City of Fridley. I understand this is not a permit but only an
application for a permit and hauling on restncte ads is not to start without a permit.
SIGNATURE OF APPLICAN �'�� �-^d � �-'"'`��V` ,�-�� - �
PRINT NAME DATE
__
___.._
APPROVED BY --- � " � Z "7� S S / DATE �/30 /�
COPIES GNEN TO: ❑ POLICE �� ENGINEERING
City of Fridley
Engineering Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3551
FAX: 763-571-1287
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