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Ca.ty of Fridley, Mi.n.n.
BUILDING PERMIT
na�: Ju7� 14, ].965
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N° �198
Oveaer: TRED C�"lPA1VY, TNC. B�� 'THE TRED C�II'ANY
�� �1! ,�7 J�owr9 A�enueBTorth A� 1l�2? T�owly Avenue Nort�h
Minneapolis 11, M3nnesota �inneapolis 11, M3.nnesota
LOCATION OF BUILDING
N� 593 S�t F�IRMONT ST. Part of Lot
� 33 � 34 sio� I Addition or Sub-Division �4�eT� Heigh�s
Corner Lot _ Inaide Lot � Setback 35 � Sideyard 10 �
3ewer IIevation
Fotmdation IIevation
DESCRIPTION OF BUILDING
To be Used as:
oue-Family Res. �t 26.0� �p� 38.67� ��t �. �1,008.08� � 17,000�
Front Depth fTeight 3q. I+'t Cn. Ft.
�►pe of Conatruction I}we17.iIIg �. Cost ��10� 0{30•AO __ To be Completed
New Hou�e OUTSIDE AFPEAR�,NCE OF THI� EUILDIPlG UST BE OF
APP �OVED VAfIANCE WITN OTHER BUILDlNGS IN THIS
�LOC�(.
In consideration of the f�uence to me of a permft to canstruct building described above I agree to do
the proposed work in accordance with the d�scripiion above set� f=�and in�liance,wl'th a'l1 Provisions of
amrlinanoea of the dty of Fiidley. C�( f� _ __
In coa�deration of the payment oP a Pee of $ 21.00 , permit ia hereby graated *o TRFD CO.. I�1C �
to conatruct the buflc�ing or adaition as descrYbed above. This �ermqt fs -granted upon
the eapre� canditioa tbat the to whom ft is granted and hfs agents, empio s and worl�en, in all work
re
dome fn, arauad and upon eai building, or anyp� thereof, shall conform 9n reapecta to the ordinances of
Fridley, Minnesota g lxation, ��nstructt�on, alteration, maintensace, repair and movfng of buildings
wlthiu the dLy limitsn a�this permit may be revoked at any tfaae upon violatton of a�+ of the P�visiona of said
ordinances.
ALI�N G. .T�IVSEN Bu�lains sn�t�r
NOTIC�
71d� p�rmb doa aef eorar tla eensleoeH�, tnstaQaHoe �e� rrtrin9. P��9� 6a 6�attag, sswu or w�tsr. B� wn to a�
du BQildt� I�e /or ap�r� � for �h�a h�ms.
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Vllir�. L.Voi t��ssociates Inc. Office
i�EGISTERED �.ANO SURVEYORS 73�2-42n� Ave.No.
Minneapolis 27, Minn.
Mi�nesota R�ist�ation No. 5522 Phone! Ke.7-6047
for �'REr� e°.
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T hereby certif;� that tiiis is � true and correc� repr�sentati�n
of a survey of t�1e boundaries of Lots 33 � 34, F31ock I, �
F�TV^I��VI�',� HI�.Tc�HTS and of the location of all t,uiluin;rs, if any,
fi.,tiereon, dnd dll visiblP �ncroachments, if �ny, frorn c�r on �aid
lanr�. Tt al ,o sh�ws tr,� location of the stat�;�s as set for �
�ro�ospd h�_aildin�. tis surveyed k�y me this 9t7��. clay of Jurie,
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City of Fridley, Minn.
BUILDING PERMIT
Date: �Oct. 30, 19�7
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�� 9530
pwaer; Arv3d M. Baldwin �� Mi1es Lumber
Addre�s 593 Fairmon.t St. N'. E. Ad�� 4500 Lyndale Ave. North
No. 5 93 ____ street
Lot �3a3�a __ B1ock
Corner Lot — Inside Lot
Sewer IIevation
LOCATION OF BUILDING
Fairmont St. � � Part of Lot
_ I Addition or Sub-Division .� Riverview Heights
Setback —_ Sideyard
�...._ Foundation IIevation
DESCRIPTION OF BUILDING
To be Used as:
Gara gn Front _.._ Z�� nepth 20� He�ght .— ��� �q, �, 448 �� 4400
Front Depth H'eight .� Sq. F't. Cu. F't.
Type of Constructton Frazute Est. Cost —._..�i.� ..000 _ __ To be Completed _..._
In cans[deration of the isauance to me of a permit to construct the building described above I agree to do
the proposed work in accordance with the description above -farth and in compliance with a.�l provlsions of
ordinances oE the dty of Fridley. � �� L`, 1�✓� ��_
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In consideration of the payment oP a fee of $ �• 00 , permit is hereby granted to._.._. M�les T�umber
to construct the buildfng or addition as described above. Thispe rmit is granted upon
the express condition that theperaon to whom ft fs graated and his agente, employees and workmen, in all work
done in, around and upon said building, or anypart thereof, si►all conform in all respects to the ordinanc� of
Fridley, Minnesota regarding location, conatruct�on, altera.tion, maintenance, repair and moving oY buildiugs
within the dty limits and this permit may be revoked at a�y time u�n violation of any oP the provisiona of eaid
or�inancea
CLARENCE BELISLE g�� ��
NOTICE:
'Ihis psrmh does aot eovsr ths COOiT►OCHOO� ie�hllaHoa fer wiriee, plumbine, en h�aHag, s�r�r er w�1sr. Bs we� to ue
the Bnildiag lesp�etoe for �pant� p�rmhs fer thas hfms.
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E1PgLIGATIOId F�R BiRLI)II� PERMTT
CITY OF FR�v`.;�ii, �SOTA
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OWrIE$ � S NAML �� �aA i�7 1\/� I�� 1L ��,��/ i ��� � B1T7LLLER � ��i=�� �,_,,. �ti� ��� iZ
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ADDRLS6 `���3� �a���;.,��� ` ��'�� � '-'' '�� `�D�;�� _�'`�ec'� ('_yi�a�/��� (-`�,�` i�E.,-
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L4T �'� �,�;� � BLOCK � ADDITION OR S�BDIVTS,�4�i��� �� /���:!LZf -����2��
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SEWER �LEdATION F4UNDATION ELEVATI01�
Applicaat atrach to this. �asm Two ,Certif�.catee of? Susvey of Lot aud prapased
bu.ilding 'I�aCion=tt��w�r"r-�b�i� �6��e �eirC�f�c��ea: ��' : - .
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To �$e 'Osed �' " . .�: �,�. � _ . °= F_ . �ES_�> . . _ a�� -�� ..�. .
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�ype of C�sts�icti�' � `�. �, ' - � - . � . f ��Fstim�itec� CoBC ' ��1���� .
To Be Co�pleted �� �° % ` � � ��i � _
The underaigned�hereby make� agplicattae� for a g�xmit for the work hereiia spe�ifi�d,
agreeing to do ali work in strict. accordeace toith t�e� City of. Fsldley OrdiaancBa�
and ralings oi the Department of Buildiog�, aad heredq declares that s11 the �aces
and repr�esatetiaas afated ia this ap�liaatiou a�e ts�us aad carrect.
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OATB _ ��' ;��� � L�� '��� � � SIGNAI� �L. �`�l`-�-� � � �> > , .-�- :�
�.�wr.�.����''t+i r.u..�r�....��r� . ..�..■ . ..� .
(Schedvle of Fes C�ts e� be fau�1 oa the Hev�ree Sidej.
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SECTION 2. The Insp�ctor of Buildinga ehall, before issuiag permit� for
�'. �'.. ,.��,.=�......-tt�e-�ere�tion °crf •�ny 1�iiil�lin� a�us�e�i-=�r:.€vr: a�ry a�di-�i�n �o any �
existing structure or buildiag, or for any alteraCion or repaire to any
existing buil��Lng or s,�su�tu�e•;�; upo�ts app�,�.cation therefore, require tbe
the payment by the applicant for such permit of fees to the amount herein
. bel+c� s�et ; forth and in Che ma�aner herin prt�vide�d to-wit:
.. . ,� .: ..'• � :: +.�:; � •: ;. , + f,+,.� � . �:,: �.
'�` `IIniform Bv�ildfa� Code; Type 1, 2, '6 `4- ��1.75 �for each orie thousand cub.ic
feet, ;pr;f;�ction thereo�, in,.�such;cubical coqtente; Ty►pe 3 8-5.-� $1.5,Q• for
..� . ... each ane thoue�ai8" ei�bic °feet . " • ., .
. .. . . _ . . .. . . . ; - . � . , , .. ;,., .
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. . ., p....q� . ? . t .,.:+�, . .. „ .-;j te 1..,.,�.. .":.ti . � : . -+ . ,, � , ! F;. „• :a F . ..j.* ,..
For the purpose of co�puting �3es fc�r bui,lding ,peacmi�s, , Ci►e cuh.ic��l '; ,• ,
conteats of any buildiag or additiaa to a uniform�helght�thsoughout by
multiplyiag the ground,area aovered,fram a�oinC aix (6) ioches belaw the floo:
liae of tbe base�at or"t6e'cella�`Ctl @he average height of the upper eurface
or to the avesa�e height of Che roof �urface of the main �abie of.a :
pitched =oof. _� � �
' • ° �� �i�or repairs �dr alter•atiotss- to•�att existiiig��'str�ure,..:the •fee-:�hall. ize .aC the
raCe of $3.00�;per each five hundred doll�ra ($500.00) or frection thereof
. _ . �tu� the cdst �ol�a�l ��roposed -wo=k. .._. . .
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. ...� �°. . .. , Ia'no 'ces� ehal�-�iis tee-�he�ged- €or•eaq germiC-as .set �rth..in,:S�ctien: 2 be
Less tban,$5,00.
, . . ._ . . � . � . . . .: .. _ -.. .... ..�.,,..... °
NSSSD CQeaectian Charges baeed oa ��atian- Area 1 or 2.
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City of Fridley
� 4T TIQ; TOP O� TII� TwIN4
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� �t � MOT�CTIVR IINI�CTptj OtK,
i I�_� i CITr MA1.L FAIOI�: �M:{
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ob Aaaress
593 Ne E. Fairmont Ave.
John Hu�hes
Contractor
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Kind of Building
Frame
Comp etion Date.
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PLUMBI�r, PERf�IT APPLICATI���
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Ad ress
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ReS,/ViPLS.6 Af11i�6�.
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lo.00
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Plumbin Fixture Rates: N0. RATE TOTAL
Number Fix tures 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
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Elec. Water Heater x $2.00
I� Gas Fittin Fees:
lst 3 Fixtur s
, e x $2.00
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' Additional Fix tures __ X $ .75
I
iGas Range-199,000 BTU x,55.00
� Repairs � Alterationa
. Install Grill See
Description. Code 5•� I
� State Surchar�e �,� ,;._, ,. - , , .,; ,� ,-,,,,. .50
iTOTAL FEE $ 5.5�
!The undersigned hereby makes application for a permit
for �he work herein apecified� agreeing to do all work .
in atrict accordance with the City Ordinancea and rulin
of the Depaxtment of Bui7.dinge, and hereby declare that
a1l�the facte and representatione stated in this
appl icatio� '�°°°re"�'�nd.�or��:t t .
:� �.�' ��°'� � d,=_ ' =- -
m�i�?;$ �'�.;n � �°
�'S ignature Date ,
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8431 UIJIVERSITY
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AVENUE N.E.� PRIDLEY� tA1NNESUTA 5.5432
� TGLEPHONE .( 612)5T1•3450
OBSTRUCT'IO�vT :
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Pra��erty O��n.er-:;ddres� �
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SuBJECT
City of Fridley
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
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� • COMMUNITY DEVELOPMENT DIV.
' LL �����'�
r � � pROTECTIVE INSPECTION SEC.
� � i�"� � CITY HALL FRIDLEV 85432 NUMBER REy.
�•"'� � �'� 612-571-3450 9t0-F15
JOB ADDRESS 593 Fairmont Street NE
1 LEGAL LOT NO. BLOCK TRACT OF; ADDITION
oESCR. 33,34 I Riverview Heights
2 PROPERTY OWNER MAIL ADDRESS
Bob/Mardell HadleX 593 Faa.rmont St NE
3 CONTRACTOR MAIL ADDRESS
CalvaYy Constructi,on 10160 Linnet Ave NW, Coon
A ARCHITECT OR DESIGNEH MAIL ADDRESS
5 ENGINEER MAIL
DATE I pAGE Of
10/6/92 / /
21593
IP .
APPR� � D �
SEE ATTACHED
SHEET
780�8515
ZIP PHONE UCENSE NO.
ids, MN 757-7905 7136
ZIP PHONE LICENSE NO.
ZIP PHONE LICENSE NO.
8 USE OF BUILDINCi
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION � REPAIR O MOVE � REMO
8 DESCRIBE WOHK
Rexoo� Dyaelling (16 Sc�uares� 2nd Layex
9 CHAN(iE qF USE FROM
STIPULATIONS
TO
Roo�%nc� can be the 2nd layer hut not the 3rd,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTFiUCTION
AUTHORI2ED 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.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEFiEIN 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 REGUTATING CON-
STRUCTION OR THE PERfORMANCE OF CONSTRUCTION.
`� � ` �,�
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� SI NATURE OF CON i RACTOR O AUTMOR12E0 " NT IOATEI
�DA7E�
OCCUPANCV GROUP OCCUPANCVLOAD
SQ. FT. CU. FT.
VLG. UNITS
�' STALLS
$848
IRMIT FEE
$23.00
.AN CHECK FEE
License SC $5.00
WjIEN P�OP Y �A
� �� `� �
ET PARKING
$.5C1
4C CHARGE
Fire SC $.85
�TAL FEE
$29.35
THIS IS YOUR PERMf
� /� ���
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ADDN [ ]
AI..TER [ ]
CITY OF FRIDLEY
SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2
Building Permit AppliCation
Construction Address: 5'�%.3 f G� �r�v� � s�%V �
Legal Description:
Owner Name & Address:
Contractor: 1'Y C1S � ; �,cc
c� P
i� G���_ e
Effective 3/1J92
Tel. # '7�0 -�'�/S
i � MN LICENSE #
Address: ��1� % C� ��� v� � P� vlll� vP �� � 0� c� S Tei. #% S 7% 905�
Attach to this application, a Cemificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRiPTION UF IMPROVEMENT
LIVING AREA: Ix�gth Wicith Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: �P �'D� � �� S �. �. C,�_�_ � � Z-C u � �
Corner Lot [] Inside Lot [) Ft. Yd SeXback _
Type of Constructi.on: j� 5 p�c ��
Approx. Completion Date:
Side Yard Setbacks
Estimated Cost: $ �`��
jCost on Back)
Driveway Curb Cut Width Ne�ed: Ft. + b Ft = Ft x$ _$
DATE: /C� —,�-%02 APPLICANT: � Tel. #
Permit F� $ . � � - �` C�
Fire Surcharge $ � c��
State Surcharge � � � �'
SAC Charge $
License Surcharge $ � - c �
Driveway Escrow S
Park Fee $
Sewer Main Charge $
TOTAL
STIPULATIONS:
$ �����
CITY USE ONLY
F� Sch�ule on Reverse Side
.001 of Permit Valuation (i/lOth%)
$.50/$1,000 Valuation
$700 per SAC Unit
$5.� (State Licensed Residential Contractors�
Alt. "A" or Alt. "B" Above
Fee Determine�tl by Engineering
Agreement Necessary [ 1 Not Necessary [)
0
BUII.DIN(i 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 building or structare, or for any alteration or repair to any existing
building or strucbire, 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 provid� to-wit
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,�
$25,001 to $50,000
$50,001. to $100,�
$1�,001 to $500,000
$500,001 'ta $1,000,�
$I,OIX?,001 and up
FEES
$15 (Minimum F� 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 fra.ction ther�f, to and including $25,000
$252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to and including $50,000
$414.50 for first 550,0�? plus $4.50 for each additional
$1,000 or fraction thereof, to and including $100,000
$639.50 for first $1�,000 plus $3.50 for each additional
$1,�0 or fraction thereof, to and including $500,(100
$2039.50 for the first $5�,�0 plus $3 for each additional
$1,(l00 or fraction thereof, to and including $1,(�10,000
$3539.SU for the first $1,�,000 plus $2 for each additional
$1,000 or frdction �thereof -
DRIYEWAY DEPRESSION ESCROW
(Concrete C�rb Stre�ts Only)
Alternate "A" : Removal aad replacemem 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 with 6 inch depth - Driveway width plus 6 f�t 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 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 pr�eeding with the framing.
°�
City of Fridley
TO: William W. Burns, City Manager
FROM: John G. F1ora,�Public Works Director
Jon Hv �ukaas, Assistant Public Works Director
�TfN
DATE: July 2, 1998
SUBJECT: 593 Eairmont Retaining Wall
PW98-144
Following up on the complaint regarding hill erosion on her property by Mazdell Hadley, we have reviewed
the reta.ining wall along Broad Avenue at 593 Fairmont Street. The wall is a dry rumble retaining wall
approximately 5 feet within the Broad Avenue right-of-way. The wall was originally constructed prior to
the mid 1960 construction of paved streets in the azea. The wa11 has a 1 to 3 foot height. The ground
continues to rise above the wall at a 1:1 to 2:1 slope.
There is some minimal erosion occurring. This is not unusual for a lull of this type. Dry rumble retaining
walls have spaces and gaps in between the rocks to allow water to flow through without building up
pressure. The water flowing through the wall has cazried some sedi.ment through over the last 40 years, but
it does not appear to have affected the integrity of the retaining wall.
The hill above the wall is heavily vegetated with brush and small trees. This vegetation contributes to the
stability of the hill as much or more than the wall at the base.
Any reconstruction of the retaining wall would necessitate the removal of all vegetation and excavation of
the hill in order to lay in geofabric tie backs. This excavation could endanger the structure on top of the hill.
An optional solution would be to reslope the hill beginning at the back of the curb on Broad to the top of
the hill by using fill obtained the next time a project is done in the area This would also require re-
vegetating the slope.
As the stability of the slope does not appeaz to be critical at this time, recommend we wait until there is a
project in the area before changing existing conditions.
JHH/JGF:cz
_
_
CITYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UIYNERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287
July 14, 1998
Ms. Mardell Hadley
593 Fairmont Street NE
Fridley MN 55432
Subject: Retaining Wal� - 593 Fairm�nt
Dear Ms. Hadley:
PW98-129
In response to your concerns of hill erosion� we have revlewed the retalnlr�g wall along the Broad
Avenue slde of your property. The wall is a dry rumble retalning wall approximately 5 feet within the
Broad Avenue rlght-of-way. The wall was originally constructed prior to the mid 1960 constructIon
of paved streets• in the area. The wall has a] to 3 foot height The ground continues to rlse above
the wall at a 1: ] to 2:1 slope.
There is some mtnimal erosion occurrIng. Thls is not unusual for a hlll of thls type. Dry rumble
retaining walls have spaces and gaps in between the rocks to allow water to flow through w3thout
building up pressure. The water flowing through the wall has carried some sedlment through over the
last 40 years, but it does not appear to have affected the Integrity of the retaIning wall.
The h[Il above the wall is heavtly vegetated wlth brush and small trees. This vegetation contrtbutes
to the stabilYty of the htll as much or more than the wall at the base
Any reconstruction of the retaIning wall would necessitate the removal of all vegetatlon and
excavation of the hIll in order to lay in geofabric tie backs. This excavation could endanger the
structure on top of the hlll.
An optlonal solutIon would be to reslope the hlll beginning at the back of the curb on Broad to the top
of the hill by using fill obtatned the next time a project is done in the area. Thls would aiso require re-
vegetating the slope.
As the stability of the slope does not appear to be crlttcal at this time� we r�ommend waiting until
there is a project in the area before changing existing conditions.
Sincerely,
`��
� o--- � ��
Jon H. Haukaas
Assistant Public Works Director
JHH:cz
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�� �j�-
� � sue��tt RMIT NO\
c�ty of Fridle�► 3 2 6 4 7"�
AT THE TOP OF TME TW�NS g u I L D I N G P E R M I T
r
� ` RECEIPT NO.
� • COMMUMITY OEVELOPMENT DIV. � ���
j � v �� PROTECTIVE INSPECTION SEC.
i . ,
� � �"'1 � CITY MALL FiiIOLE� SS:3Z NUMBEN REV DATE pAGE O� APPROVED B1I
�""�' �'� 612-571-34bQ 910-F15 5/30/02 / /
108 ADDFiESS 593 Fairmont Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADOITION SEE ATTACMED
DESCR. 33,34 I Riverview Heights SMEET
2 PROPERTY OWNER
MAIL ADDR�S$ ZIP PHONE
RObert/Mardell Hadley 593 Fairmont Street NE 763-780-8515
� CONTRACTOF MAIL ADORESS . ZIP PMONE LICENSE NO
Same
a ARCHITECT OR DESIGNER MAII AOORESS ZIP PMONE LICENSE NO-
5 ENGINEER IMAIL ADDRESS 21P PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WOpK
O NEW ❑ ADDITION O ALTERATION � AEPAIR ❑ MOVE O REMOVE
B DESCRIBE WOHK
Reroof House & Garage (20 Sq) Tear-off
9 CHANf3E Of USE FIiOM TO
STIPULATIONS
Underlayment must comply with the State Bu�Tding Code.
" TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE FE�UIREO FOF ELECTHICAL, PLUMBING, NEATINCa,
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NUIL AND VOID IF WQRK OR CONSTRUGTIOM zONING SQ. FT CU FT
AUTMORIZEO IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTpUCTION
OR WORK IS SUSPENDED OR ABANQONEO FOR A PERIOD OF 120 OAYS A7 �
ANY TIME AFTER WORK IS COMMENCED. " NO DWIG. UNtTS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAYE READ ANO EXAM�N�O THIS APPLICA7IQN 1 STALLS GARAGES
AND KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS bF �AN13 VAlUAT10N SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL QE CpMP�IED @
WITM WHETHER SPECIFIED HEREIN OF NOT. THE GRANTING OF A CERMIT W2,144 �1 .O7
DOES NOT PRESUME TO GIVE AUTMORI7Y TO VIOLATE Ofi CAMCEL THE pEqMIT FEE SAC CMARGE
PROVISIONS OF ANY OTMER STATE OFi LOCAL LAW pEGULATING CON- @
STqUCTION OR TME PERFORMANCE OP CONSTRUCTION �83.25 re SC .pZ.1�F
PLAN CMECK FEE OTAI:EE
$86.46
S�GN4TUpE0�CON:AALT AOpAUTMOA�2EDeGENT iO�TEi N RLY V L ATED TMIS IS VOUR PEpMIT
� °�o.f'� � ' �.3'_'���-
S�GN4TUAEO�OWN A�iFQWNEABU Fp� IDAiE� ' .r9LDC+ � 5� � ���TE
NEW [)
ADDN (j
�.�R Il
� Construction Address: �
Legal Description:
CITY OF FRIDLEY Effecdve 1/1/2002
6431 Universiiy Ave NE� Fridley, MN 55432 (763j 572�604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�
� � �'
� Owner Name 8 Address�a���' `� �m n rd,,Q t\ �-o.�,`-e Tel. #7 (� � r 7g o— g�' �Sf
Contractor. �v � -� � � �.r � � � � �,�-e v�• MN LICENSE #
Address: S� 3�e���s- ma -�� S k. `� �.. Tel. #`�lLo '3 ��S U 9, 5/.S`"
� 2���� .
�� Attach to this application, a Ce�tificate of Survey of the
lot, with the p�oposed construction drawn on it to scale.
LMNG AREA:
GARAGE AREA:
DECK AREA:
on�eR:
DESCRIPTION OF IMPROVEMENT
Length Wdth Height Sq. Ft
Length Width Height Sq. Ft
Width Hgt/Ground
�.!/_ lA)�� �`r \n �� ..Y� . `CJ�I /L `UY
Construction Type: Estimated Cost: $ °�l ` 1
Driveway Curb Cut Wdth Needed: Ft + 6 Ft = Ft x$ _$
xDATE:� 3a O a APPLICA� � Te�#� 7$ 0 � S 1�
/'
Call (763) 572�604 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
$ �3.�s
� ,.�- r
$ /. D �
$
$
$
$
$.
$
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit
$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 [ ]
TOTAL $ �C�• i" lO STIPULATIONS:
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 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 to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,(}(}0
$2,�1 to $25,000
$25,�1 to $50,000
$50,001 to $100,000
$100,001 to $5�,000
$SQ0,001 to $1,Q00,000
$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,OQ0 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,(�0 plus $7.Q0 for each additional
$1,(�l0 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
$1,0(� or fraction thereof, to and including $1,000,000
$5,608.75 for the iust $1,000,000 plus $3.15 for each additional
$1, 000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00.
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site. .
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the elcisting foundation will be required before
proceeding with the framing. New Houses Onlv
�
Building
Inspections
763-572-3604
763-502-4977 FAX
DATF.�v' � � ` c7
S(TE ADDRESS �
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE, BOND AND
CERTIF[CATE OF
INSURANCE
PERMIT TYPE
TYPE OF WORK:
PLUMBING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
Permit No.
Received Byi
Da�'c��
YOUR E-MAIL ADDRESS �l�ic � SO(.c�b°�C'(J 1v�c/a, �
, �' t(k'D �T � !
❑ OWNER • L�CONTRACTOR
ADDRESS: �%3 ��2?�T�/iyio�s[ i� CITY ��cC�t STAT�/ ,U ZIP S��
PHONE: 76� -%$O �/,S
nn�f��ti�
STATE UCENSE #_ 0�3� 3 �� EXP DA7'E /c�- 3!-b%
STATE BOND # ��% /�f le EXP DATE �a- �f-O �
ADDRESS: C[TY
PHONE FAX
�INGLE FAMILY
O NEW
DETAILED DESCRIPTION OF WORK
❑ TWO FAMILY
�d'REPLACEMENT
�6 �
O TOWNHOUSE
�
ATE ZIP
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER� OF EACH BELOW). MINIMUM FEE
$35.50.
BATHSINK/LAV FLOORDRAINS ' SHbWER
_ BATHTUB � GAS PIPING (NEED CITY LIC) SWIMMING POOL
CLOTHES WASHER � KITCHEN SINK WATER CLOSET
�C DISHWASHER _ LAUNDRY TRAY WATER HEATER ($3S)
WATER METER
THIS IS AN APPLICATION FOR A PERMIT-NOT VAL(D UNTIL PROCESSED
WATER PIPING
WATER SOFTNER ($
_BACKFLOW PREV. $1 )
FOR IRRIGATION
_ OTHER
I hereby apply for a plumbing 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 Fxidley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance
with the approved plan in the c,ase of all work which requires review and approval of plans.
SIGNATURE OF APPLICAN'���!��' — PRINT NAME ��52Z��r�'� Qi DATE lc�-�'a %
/— �
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977