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AF - 42017BUILDING PERMIT Village of Fridley, Min.n. N� 2 5 3 6 Date �� .�� ::.�. .� � . . . .. . . .. .. . . . . .. . . . �; �.�, Builder ��-�G.;� Owner .�� Z. �..�... ........... •• ......................... r'/ � Address ��l�J, . . . . . . i....�--a�..—... Address ......................................... LOCAT(ON OF BUILDING No. . . �S (o.�. . . . Street .�'� :�:` :`:'. :'?. .�� . : . . . . . . . . . . . . . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . . . . Lot ........��%...... Block J:44x;'�'.`-�'��% Addition or Sub-Division .. �;,�".�,�,,.......� ....................... � . � Corner Lot . . . . . . . . . . . . Inside Lot . . �. . . . . . . . Setback �5��%�. . Sideyard �,� /.'��9!+ . . . . . . . . . . . . . . . DES�CRIPTION OF BUILD(NG To be Used as: i . . . . .�. . . . . . Front ti�. ¢, . . . Depth .�� . . . Height . . . . . . . . . Sq. Ft. �� . Cu. Ft. . . . . . . . . l+r .................... Front ...... Depth ........ Height ......... Sq. Ft. ........ Cu. Ft, ........ Type of Construction .�'°.•�'� ;��; . . Est Cosf ' � . �� , , , , , , , , , / .%�' �++'� �'�� To be Completed lF.:�j�'��`,� „ In consideration of the issuance to me of a permit ta construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the village of Fridley. .�...... . .[P.:. .. .......... In cons'de•r ' n of the payment of a fee of $. .,�il� .�,�, permit is hereby granted to .. to construct the building or ad dition as clescribed above. This pe �'t i5 granted upon e expr s condition that ihe person to whom it is granted snd his agents, employees and worlunen, 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 with- in the village limits and this permit may be revoked at any time upon v�'olatior�f any of the provisions of said ordinances. _ A � ' , f�' �'� + r . . . . . � �° �! . �`.j"i"i�.�l+ Bll]IC11I1 "• g Inspector ° � NOTICE: ,.-_. This permit does not cover the cons4ruction, insta Ilation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. t� � � SUBJECT �. City of Fridley � 12618 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T • i � � � RECEIPT i Ly _��_�'� COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. /�7 7/ 2 1 . i � (T `! �' � /��1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV ""� � ,�� 612-560-3450 910-F15 % 1 74 � � JOB ADDRESS 1568 Ferndale Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 �illCle ►�'Llb. #92 SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Darrell G. Gudhus 1568 Ferndale Avenue N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. James Gusa Princeton Minn. 4 ARCHITECTORDESIGNER MAILqDDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LIGENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE � REMOVE 8 DESCRIBE WORK Reside D�elling 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE 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 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R'�1. 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 �`�.�J�OO.00 .%rj DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHEF STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � yi`9.00 PLAN CHECKFEE TOTALFEE r� � $9.75 '� SIGNRTUREOFCONTRACTORORAUTHORIZEDAGENT �DATEI ' -� �„ �� WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT = WllU J ` e �t _acQ . `l �� -�_�_ n p � p ) c/ SI NATUREOFOWNERIIFOWNERBUILDERI IDAT _ BLDG INSP D TE APpLICATION FOR RESIDENTIAL, ALTERATION, OR AllllITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME :, �dk? Rk� L��c. ��,.�uS BUILDER: �,4� S �ii��A ADDRES S: IrSb J� ,��i2N� � L E f 4✓F�ADDI2ES S: �.C' � It,hETD �) %�7 i//J /l� . No : . f s� P s�E� • ��_ ,,�.� �.c � Ay � �,�� LOT:� BLOCK: ADDITION: __ /4u� 5u � �g2 CORNER LOT: INSTDE LOT:�_SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Sulcvey of Lot and proposed building location drawn on these Certificates. � DESCRIPTION OF BUILDING To Be Used As: ��< rd,2• �► a u s P_ Front ; Depth : Height : Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: . /�OD .O O �pe of Construction: ��ao.�- ALurhi�.Nw� S��, Estimated Cost: $ f�� - - To Be Completed: 7_ � _7cL The undersigned hereby makes applicativn for a permit for the wo�k herein specified, agreeing to do all work in st�ict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. M 1 • i � � . . �r , , i , r �r �._..�C._. . (See Reverse Side For Adclitional Informa,tion.) � �,.o� . e� � � Q �S � � b�� k . BUILDING �PERMIT FEE SC�EDULE SECTION 2. The Inspector oL Buildi.ngs shall, before issuing permits for the erection of any building or structure, ox for any addition to any existing building or structure, or for any altexation or repairs to any existing building or structure, upon application therefore, requixe the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner he�ein provided to-wit: UNIFORM BUILDING CODE: Type 1, 2& 4-$2.15 fox each one thousand cubic feet, or fraction thereof, in such cubical contents. �pe 3& 5-$1.85 for each one thousand cubic feet.� ADDITIONAL INFORMATION 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 (6) inches below the floor line of the basement ox the cella� to the average heights of the upper surface or �o the average.{ height of the roof surface of the ma.in gable of a pitched roof. For repaixs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollaxs ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any permit as set forth in Section 2 be less than $5.00. VERIFICATION OF FOUNDATION NOTE: 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. A Certified Survey of the lot, showing the location of the foundation, once it has been constructed,�will be required before proceeding with the framing. CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of a.ny structure fox which a building permit has been issued; and said structure shall not be used ox occupied uniil a Certificate of Occupancy has been issued. �� sue�ecr PE . - c�ty of Fridley 2 O 4 7 8 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T r ; � RECEIPT NO � • COMMUNITY DEVELOPMENT DIV. � j V ��'� �� r � � PROTECTIVE INSPECTION SEC. � � . � i_--• � /"'1'; CITY HALL FRIDLE� 55432 NUMBER AEV OATE PAGE OF APPFOVEO 8V L J\' � 612-571-3450 910-F15 7/16/9.0 / / JOB ADDRESS 1568 Ferndale Avenue N. E. 1 LEGAL �OT NO. BLOCK TRACT OF ADDITION SEE ATTACHED DESCR. % Auditor�s Sl]vC31V].SlOri #92 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michael Bargy 1568 Ferndale Avenue N.E. 572--2246 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ame d 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 WOf;K ❑ NEW � ADDITION ❑ ALTERATIOId O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Construct a 27� x 20� Deck 9 CHANdE OF USE FROM TO STIPULATIONS See notations on plan WARQ�� Before digging call for all utifity 9ocations 45�+•0002 REQUIRED P�Y LAW SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBINO, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONDITIONINCa. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO fOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. N0. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV 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 $3,900 ySl„�.5 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHAFiGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. S63,OO PLAN CHECK FEE TOTAL FEE .95 SIGNATUREOFCONTRACTORORAUTHORI2EDAGENT IDATEI WHEN ROPERLY T D T IS YOUR PERMIT p. /' / SiGNATURE OF pWNER iIF OWNER BUIIDERi IDATE� Bl �NSP qaT I � � �: .�r. �4�;� � � [ ] R-1 AND R-2 Building Permit Application Cor�stniction Address: ► S(a ��'ew� �1�c`le R� �/ � Lagal D�escription: Lo-h -7 �i uc� � s v�, � 9� Effective 1/1/90 �W2'lei N� at �Y'�S.S: Y��SGV.tx�� a�l � S�� .1. � '��i -aa y,� Gontxactor: _ �e j� �. # Addr�s.s: Attach to this application, a Certificate of SuYVey of the lot, with the prop�d construction drawn on it to scale. DFSCRIPTI�J � II�ROVII��P LIVING ARE�� Tpr�Fh � Width Height Sq. Fk. GARAGE AREA: L�ngth Width Height Sq. Ft. D�CK ARF.�: I�rigth •�� Wldth �� Hgt/Gr�u�d // � ? C Sq. Ft. � . � ! ��'" �•°�-� � ��,��r�r°� Cbrnex L�t [] Inside L�t [] Ft. Yd Setback Side Yard SetbacJss � T��e of Construction: _ I w e� cl e�� C� c�c�.�- Estimated Cost: $ Approx. Ck�npletion Date: � �h,�,-� Proposed Driveway Width If New Openirig Is Desired: Ft. $ $ Width + 6' See Bac]t paqe L�ATE: l--/n-�PO APPLICANI': �u�-�" Te1. # S 7� ^�� t%(o PeYmit Fee State Surcharge SAC Ct�azge Driveway F�crvw Park Fee Sewer Main Ct�arge . v S'I'IP[TLATIONS: $ � $ I A�� $ $ CITY II3E �Y Fee Schedu].e on Revesse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above mined bY F�gir�riryg N�Y [ ] Not Neoessary [ ] r1 '� � � i , � � r � ,� � . 1:11J1 � �� C �:ti:JO��1 :y�l' :�,131� 11 " Zhe Chief Building Official shall, before issuing permits for the erec-tion of any �� i 1 ding or structure, or for ariy addition to ariy existing builclir�q or stnicture, or for ariy alteration or repair to ar►y existinq t�n, i 1� or stYVCture, upon application therefore, r+equire the payment by the applicant for such ��;t of fees to the amount her+ein below set forth ar�d in the manner he�ein pravided to-wit: �I'AL VALUE $1 to $500 $501 to $2,000 $2,001 t� $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 tA $500,000 � �.� $15 (Mininaun Fee is $15 plus surrhaYge) $15 for first $500 plus $2 for each additional $100 or fraction thereof, to arid incl� $2,000 $45 for fiYSt $2,000 plus $9 for each additional $1,000 or fraction ther�of, t� and including $25,000 $252 for fiust $25,000 plus $6.50 for each additional $1,000 or fraction the�eof, to and including $50,000 $414.50 for first $50,000 plus $4.50 for each additional $1,000 or fraction t�eteof, to and iricl� $100,000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional. $1,000 or fraction thereof, to and includirig $1,000,000 $1,000,001 arx� up $3539.50 for the first $1,000,000 plus $2 for each�additional $1, 000 or fraction thereof DRIVEf��Y DEPRESSI�1 ESQbO�W (Cbncr�te Curb Stseets On1Y) Alternate "A": Remaval and replavement of curb ar�l gutter only - Drive�ray width plus 6 feet times $13.50. Alternate "B" : Removal ar�d replacemer►t of c;urb and gutter arid install a 3 foot wide approach with 6 inch depth - Drive�,ray width plus 6 feet times $15.75. � �+• ■ v� •; • � • � i� • •; Penaits for construction will be issued a gnininn�n of 24 houts frc�n the time of a�lication to allaw for proper review of the propo�.,ed structure and of the �tion site. A Certificate of S�YVey of the lot, shvwing the location of the fo�ndation once it has it has be�n �onstructed will be requi.red befo�ee prooeeding with the fzaming. � ,.�, � � i � � ! s � F � �' P ,� , � � 1� � �� sue�ecr PER , City of Fridley ��. 4 4 3 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T r ; ;, CEIPT NO � `y _ COMMUNITY DEVELOPMENT DIV. �� r � � PROTECTIVE INSPECTION SEC. � . � � � /""1 � CITY HALL FRIDLEv 55432 NUMBER REV. DATE PAGE OF APPROVED BY �---•� � ,•� 612-571-3450 910-F15 7/14/92 � � JOB ADDRESS 1568 Ferndale Avenue NE t LEGAL LOT NO. BLOCK TRACT OR ADDITiON SEE ATTACHED DESCR. P't. % Al1CI].'tOY� S SL1bC1].VZS].Ori #9Z SHEET 2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE Michael Bargy 1568 Ferndale Avenue NE 572-2246 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. S ame A ARCHITECT OR DESIGNER MAIL ADDRESS IIP PMONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PFIONE LiCENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK �1 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE 8 DESCRIBE WOHK Construct a 22' x 20� 2nd AccessOry Bui,lding 8 CHANGEpFUSEFROM TO STIPULATIONS See Counca,l app�oval of Special Use Perm.it. �� Sefore di�ging catl fos 211 utilit� tocatiu�s 4�4��' �E��. ��,�`�� i� ��LAII� � ��rr� �lIIIRt�tC, Hf.qT�! �i�fFREp- �Q�' � Pl.l��Bl�[�!� �;; ��'. �,� �-_ ; _ SEPARATE PERMITS ARE REQUIRED fOR ELECTRICAL, PLUMBING. HEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING S�. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONED FOFi A PERIOO OF 120 DAYS AT � ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 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 ypLUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $6 �926 $3. Lj6 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEHM1T FEE SAC CHARC3E PROVISIONS OF ANY OTHER STATE OR LOCAL LAW RE ULAT NG CON- STRUCTION OR TF�€ PERFOR NCE OF CONSTRUCTION. S9O.00 Fire SC $G.93 ,. �� '� �P� PLAN CHECK FEE TOTAL FEE � $100. 39 SiGNATU F CON7RACTOR OR AUTMORIZ A E T IOA 1 W N PRQPE Y V LI A7 D THIS IS YOUR PERMIT • �"_'' f� A , y �` � a �� S�GNATUREOFOWNEAtIFOWNEABU�LDERI IDATEI BLD� �NS�� OATE NEW [ ] ADDIV [ ) ALTER [ j CITY OF FRIDLEY 5INGLE FAMILY AND DUPL,EXES R-1 AND R-2 Build.ing Permit Application Effective 3/ 1192 Construction Address: ! S � �' F��^�aQi�.,B� �,v ��. Legal Description: '�jE+ ru� 1� .§�e�e-� o� °t ha �a.�F°�� S�e�. ��PC� i'�e S�fi�d B`O �Iiern�'�t� �Qc� �to� � B ia �� .o�� "� �— Owner Name & Address: ��,� � �� eu �-E s�s;�•� P��. Tel. # S 7� °�.�'�� Contractor: �e% MN LICENSE # Address: Tel. # Attach to this application, a Ce.rtificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IIVIPROVEMENT LIVING AREA: Ix,ngth Width Height GARAGE A►REA: Length �� Width � E� Height � DECg AREA: Length Width Hgt/Ground OTHER: �� ,y� �,�.�A� '`�'�'G� �� . �� Corner Lot [] Inside Lot [ J Ft. Yd Setback _ Type of Coast�vction: � 0 0� Approx. Completion Date: /� � /� �- q�- Driveway Curb Cut Width Neaied: Ft. + 6 Ft = Sq. Ft. Sq. Ft. � Sq. Ft. �" � Side Yard Sc�backs Estimated Cost: $ � � r � �� (Cost on Back) Ft x $ _ $ DATE: � /� �9'�- APPLICANT: � TeI. # _.�'°7� "� � 4�� Permit Fee $ ��,� �� Fire Surcharge � t� � � � State Surcharge $ � e �' � SAC Charge $ �"� License Surcharge $ Driveway Escrow $ Park Fee $ °�'° Sewer Main Charge $ � TOTAL $ - �� STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Vatuation (i/lOth%) $.SO/$1,000 Valuation $700 per SAC Unit $5.00 (State Licensed Residential Contractors� Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary j] Not Necessary [] . . �_�.�, BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing per�nits for the erection of any building or sbructure, or for azry addition to any existing bailding or structure, or for any alteration or repair to any existing building or structure, upan application therefore, require the payment by the applicant for such permit of fee.s to the amount herein below set forth and in the manner herein provided ta-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,� $25,001 to $50,000 $SO,i)Ol to $100,0a1 $lIX},001 to $SOO,OQO $500,001 to $1,000,� $1,000,001 and up FEES $15 (Minimum Fee is $15 plus surcharge) $15 for first $500 plus $2 for each additional $1� or fraction ther�f, to and including $2,000 $45 for first $2,004 plus $9 for each additional $1,�0 or firaction ther�f, to and including $25,000 $252 for first $25,000 plus $6.50 for each additional $1,00(? or fraction thereof, to and iacluding $50,000 $414.50 for first $50,� plus $4.50 for each additional $1,000 or fraction thereof, to and including $100,000 $639.50 for first $1�,�0 plus $3.SU for each additional $1,�0 or fraction thereof, to and including $500,(�)0 $2039.50 for the first $5�,� plus $3 for each additional $1,(�l0 or fra.ction thereof, to and including $1,000,000 $3539.50 for the first $1,�,000 plus $2 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Gurb Slreets Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 f�;t times $13.50. Alternate "B" : Removal and replacement of curb arid gutxer and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the const�uction site. A Certificate of Survey of the lot, showing the locadon of the foundation once it has it has b�n constructed will be required �fore proceeding with the framing. �� , a � S W E V N lA9' I �1 i c-� �E� B��y �,t..Tl �l T1' S�� D � Is6� FERn�D�r� �U�N�-E O�o�T-��1�-� �QID� `r �n r� �s� 3� � <}fee�- � � � J� _ �' ; . , -- __-- � z -� ' w �.-<. � �� 5'� � �` Ut��►tY H 3-�e+ ,�. � Provide a hard surtace driveway, 3 feet from the side property line, or closer with consent frorn neighbor., F--- a 3` —� 2D ; sN �� J "i . � �"` � � FLASH 01�iER ALL EXPOSED EXTERIOR OPEfVINGS � j � ; 1{0� � , .3-�; P_L�P CON5i'� WASTES p111LY ; STO�tE IN A�N APPROVED AAAN�iER 1 . rt�t�VE ALL REFUSE EEK Y ' , __ gZ, ��s-' 0 0 �� f _ '�:�r:�:�_ ;�,��,., ;� I ', - . i- � �` �' � i (` � .. 4 S�f12CE. G� 1 Y� v�Sl C3ri E �rOX�I� ) . o0 fi � � i i � �' . �� l � ��.= 4 �e� � CIA �TUD SPAC I NG - .C. FROM RNER OULDING � ND WINDOWS SIDING SHOWN XPOSURE i �IED OUTS I DE �� FOR LAP � I t� l� b� � TION EZE E �TUD � �.C. F '�RNER ,L 2'� �EL D( ELEV� - ADD FOR OPT I C INES i'0 x 4" THICK >TOOP 16",O.C. 3•_0�� 2-2x12 HEADER Ib! �-0" R.O. 12 �� 0 � 0 i � 2x8 RIDGE 2x6 RAFT RS � 16" O.C. REFER TO DE7AIL � 2-2x6 HEADER 1x4 LET-EN BI SIDES AND RE� , _�� Zx4 STUDS � 1/2" PLYWOOD � FRONT WALL DOUBLE 2x4 J, C�D 0. H. DOOR i REFER TO DET FOR CORNER — BEGIN STUD S � 1f" O.C. F THIS CORNER FRONT FRAMING ELEVA7ION � SCALE: 1/4�� _��—o�� 22' '� � h+Y�E ALL DEP7N OPTIOfdS 4/12 ROOF PITCN ��F ONE DOIJBLE DOOR f2EAR FRAP7IiV� ELEVA7IOIV ^ _ SCALE: 1/4" = 1'-0" 22�0" VIDE 4/12 ROOF PITCN �o.c. ALL DEPTN OPTIONS RIGNT SIDE FRAMING ELEVATION SCALE: 1/4�� _ ��-o�� • -n- �rTnc aa' D�PT1..1 (1DTTnld REFER 70 DETAIL 2-2x6 HEADER BEGIN STUD 5P C�D 16" O.C. FR THIS CORNER GRADE 2x$ RIDGE 2x6 COLLAR 71E� � 48" O.C. 2x6 HANGER & 2x4 WALL TIES � 48" O.C. 2-2x6 HEADER - OPENING FOR OP710NAL PERSONNEL QOOR 2x4 STUD5 � 16" O.C. 1x4 LET-IN BRACING � SIDES AND REAR BEGIN STUD SPA Cs� 16" O,C. FRO THIS CORNER - O � Z � � Z O O " Z � � � � v m v� W��z�W�oz w o� d � d. �. �D a i -' r�• � c�i a, c°�n .. .. .� 3 9 �°� c�u o Q(/� �� l� ��'� C 3' �-� -�' � � � � (G � � (p f�D .�-« pWj � � �. C �D � ' G o m .,. .,. �, �' � �• � � � � c D � m � � �' �c �' � � m Z a m � � d � 'o -� � ' f r � � c��u � g; �°—. � � � � � � � � � o m = .� �C � � 1 � ' � � � 'A♦� i� � V! `/ D o � � v �' � D , v .� � -r-I Z � r C � W Z � -�i C � m � VJ m m o z m � I I I I I I I( I I I I�� 0 z �� c�, o 0 0.i o.i .i .i � c�, A. .i m � o° °o °o °o o °o °o °o °o o° °o o° � R�� p, � O �� `� � � � , � � � y � .o � C � . � m W m �c a W z 8. c � � � � � 10 � a .��'• c' � �--� � 0 o � � � C � m � 7' � � � I � .. ,7 � � r � Z v ° m � m W � � � QQ' � � i h . 1�_y Vv � � � � �� -�— � � � C � j � � � i � � � � a c� i ' 2 3� ! I i � N � � �' �o � i � � � : i � m � � ' C� O ! h o; a ; � � o ., h L � � ' � 0 � I � I � N � I i O � i > > � � � y 1 ;'agi ; � d i � : � m � � I n, d � � �p � � � � � � � � � i � g , °; m � � �� ; � a • y y i � W � � � • � � r � r �. COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When realacina an existins� furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, Y� �� No () and is securely supported and firestopped where required. The venting system is plastic/PVC and meets all current codes and man�.ifach�rer specifications including sizing, length, number of elbows and terminatiora. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's spec�fcations. This does include AGA GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existina combustion air is sized and installed to meet the current codes and manufacturers specifications. When required to install a new combustion air. it wilB be sized and installed To meet the current codes and manufacturer's specifications. Yes ( ) No ( ) '��ss ( ) No ( ) Yes ( ) No ( ) When installina a new ventin�t svstem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specfic�tions. This does include AGA GAMA Category I Central Fumace Yes () No () Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No () Aaaliance Tvpe and Size/Common V/ent and Vent Connector Information Appliance #1 Type BTU Input � Fan Assisted o� N�t Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type ° BTU Input � Fan Assisted or Nat Total Appliances Total Btu Input ,�, Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connectoc Height ft Length ft Diameter i1 Type Appliance #2 Vent Connector Height ft Length ft Diameter in T'ype Appliance #3 Vent Connector Height ft Length ft Diameter �n Type ALTERATIONS• (Describe) - HEATING CO: Signed By: Date : � aue�e�� City of Fridley AT THE TOP OF THE TWINS � � � L D I N G P E R M I T ;, � � � ; V __��_ COMMUNITY OEVELOPMENT DIY. r � � PROTECTIVE INSPECTION SEC. 1 = � `---- A��,'� CITY FIAIL FRIDLEY SS�3i NUM�EN NEV DATE PAGE Of L �� 612-571-3450 910-Fts 1/18/00 / / JOB ADpRESS 1568 Ferndale Avenue NE t LEGAL �OT NO. BLOCK TRACT OR AODITION oesca. pt 7 Auditor's Subdivision ��'92 2 PFOPERTY OWNER � MAII ADORES$ Peter Olson 1568 Ferndale Avenue NE 3 CONTRACTOR MAII ADDRESS Same 4 ARCHITECT OR DESIGNER MAIL ADORESS 5 ENGINEER MAIL ADDRESS 30630 CEIPT �� PROVED BY SEE ATTACMED SNEET PMONE 502-1543 PNONE LICENSE NO PNONE LICENSE NO. Z�P PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION �] ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Install basement bathroom 8 CHANQE OF USE FROM STIPULATIONS See notations on plan. CALL FOR FINqL INSp��Y ��: w�TH'N 10 o�YS oF wo�r� �oMP�Erio+u COPY TO HOI��R�e�-� TO SEPARATE PERMITS REQUIRED FOR: WIRING HEATING PLUMBtNG� AND SIGN� SEPARA7E PERMITS ARE RE�UIREO FOF ELECTRICAI. PLUMBING, MEATING, �TPE OF GQ VEN7�LATING OFi AIR CONDITIONING THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION 20NING AUTHOR12E0 IS NOT COMMENCED V111THIN 80 DAYS. OF IF CONSTRUCTION Of1 WORK IS SUSPENDED OF ABANOONEO FOR A PERIOD OF 120 DAVS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. I HEREBY CERTIFY THAT I MAVE READ AND �XAMINED THIS APPLICATION ]. AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION AND ORDINANCES GOVERNING TMIS TVPE OF WOqK WILL BE COMP�IED @ WITH WNETMER SPECIFIEO MEREIN OR NOT. TNE GRANTING OF A PERMIT �pSOO DOES NOT PRESUME TO GiVE AUTMORITY TO VIOIATE OR CANCEL THE pERMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUlA71NG CON- STqUCTION Oq TME PERfOfiMANCE OF CONSTRUCTION �23.SO �TUAE OF CONCRACTOA ON 4UTMOA�ZED OGENT �OATQi �� ` � � � � �TU�7E O� OWNE�7 �ii OWNER fiu1L�FA� �n��e. SO. FT STALLS FT ET PARKIN( IGAFAGES �.5� 4C CHARGE Fire SC $.50 �TAL E 4.50 IS_ IS VQUR PERMIT f�(. LOAD �w [ ] ADDN ALTER [l [l Construction Address: Effective 5/10/99 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUII,DING PERMIT APPLICATION (S �g F«„d��L AU� rt� F�,�<«, ss�r3� � o� � � � � Legal Description: Owner Name & Address: Q�� <�- CS ( San ^� a� e Tel. #� I a- � S O� `� S Y� Contractor: 5�,1 � MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LNING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: I.ength Width HgtlGround Sq. Ft. o�R: . g„��.�`�,, °� � � � , Construcrion Type: (� v v�1� — i� 3 w,� I 1 S Estimated Cost: $,� Q CS �`�$'1^I� P�J/w��C d Driveway G�rb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ - DATE: � ' � � — 4 � APPLICANT: *-� ' � � �'" � Tel. # �, ( �- ° S � `�. " ) S � � Permit Fee Fire Surcharge Sta.te Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: � �• J� $ . �� $ -sv $ $ �_ $ $ $ $ � � .�56 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) a$.SOI$1,000 Valuation per SAC Unit $5.00 (State Licensed Residentia.l Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined. by Engineering Agreement Necessary [ ] Not Necessary [ ] Q BUII.DING PERNIIT 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 $2,000 $2,001 to $25,000 $25,�1 to $50,000 $50,001 to $100,000 $100,001 to $500,0(}0 $500,001 to $1,000,000 $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 $1,0(}0 or fraction thereof, to and including $25,0{� $391.25 for first $25,000 plus $10.10 for each addirional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for fir�st $100,000 plus $5.60 �or 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, (}fl0 or fraction thereof, to and including $1, �0, 000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION 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. A Certificate of Survey of the lot, showing the location of the foundation nnce it has it has been constructed will be required before proceeding with the framing. �(�� L� � / �� 2 d�l�� /� � l �..� �a9 �� l �'� �� i �� .,�� . �-b v�`� jc � �c � s�r dh��` �,� �� ✓� . � �'C�°� �" '�s'� � �r I !� �� ` l � S/ 0�:.� y� v �� ' � a, � ,� �•�� 5.�s e� Jl � W�� S , 1 L w� c t.. �F �r� ic�.,t�d ba'��o;.. P1•.�� y �� cc �co�� I1��' � �2�-� �� , U � � �,,�. � y �d�or �.,�__ ^ _ _ _- � ; -X� . � , � _ . , .. . ��x�s�o� �� X� -�y / 1 � ..�,� j 11� �L � �!, �� lJ" ; � � �. ., ,� �.�' � �' �1 ;..��` �� _ � F � �E_�.. �/ f �l�,�lL�- �� ✓ �'��/l��i�/�r- i'� � L��/��/l�� .�-N �-� � ' �� n� �� q�� /� f � �U � � � � �`� M ^ y � � NEW [ ] ADDN [ J ALTER .. [ ] � CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/2001 (763) 572-3604 Bldg Insp . . �� a� Construction Address: � S�� F�r^ � A � � �i�`- �'� � Legal Description: Owner Name & Address: �C �« d�S o^ Tel. #°"] L 3^ S�� 1 S�F 3 Contracto� MN LICENSE # Address: Tel. # LNING AREA: GARAGE AREA: DECK AREA: OTHER: 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 Height Sq. F� Length Width Hgt/Ground Sq. Ft Construction Type: Estimated Cost: $ q �U � Driveway Curb Cut Width Needed: �Ft + 6 Ft =�Ft x$ _$ o� �� DATE: �~ I � ^ � ! APPUCANT: �� ~� �'S�� Tel.#��'3 ^ S�a�1 S�3 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 $ - Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1150 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 [ ] $ � � � � ' �', � � �- 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 $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,OQ0,001 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 $25,0� plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,0� or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,0(?0 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Altemate B: Removal and replacement of curb and gutter and install a 3 foot wide " n approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before pr�eeding with the framing. New Houses Onlv � ' OVO�CV� City of Fridley ` p AT TME TOP Of TME TWINS g � I L D I N� P E R M I T r � . � � � ; L __�__ COMMUNITY OEVELOPM�NT pIV. r � � PROTECTIVE INSPECTION SEC. 1 = , � �"'1 � CITY MALL FFIOLE� "�32 NuaBER REV D�TE �'"'"�� ,�' 612-571-3450 9t0-F15 5/26/02 , J08 AODRESS 1568 Ferndale Avenue NE t LEGAL �OT N0. BIOCK TRACT OR AOOITION DESCR. Pt 7 Auditor�s Subdivision ��'92 2 PROPERTY OWNER MAIL ADONES$ �IP Peter Olson 1568 Ferndale Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP Same A AHCHITECT OR DESIGNER MAIL AODRESS ZIP ZIP � � 3254 RECEIPT NO. �� vvnovEO Br SEE ATTACMED Sh1EET PMONE 763-502-1543 PNONE LICENSE NO PMONE LICENSE NO. SE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � AODITION O ALTEAATION O REPAIR O MOVE : O REMOVE 8 DESCRIBE WOliK Construct a 25' x 13' Addition to Dwelling 9 CHAN(iE OF USE FROM STIPULATIONS See notations on plan. SEPARATE PERMITS REQUIREa �OR: PO.U��9N� AND S16�S R ING �efore digging call for �11 utitity Iocation� 454D002 �E�UIRED �Y LAUV SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, MEATIN(i, � TrC vr �;pnsr. VENTILATING OR AIR CONOITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING AUTHORIIEO IS NOT COMMENCED V�(ITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANQONEO FOR A PER100 OF 120 OAY$ AT { ANY 71ME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS I HEREBV CERTIFY TNAT I MAVE READ ANO EXAMIN�D THIS APP�ICATION 1 AND KNOW THE SAME TO BE TqUE AND CORRECT. ALL PROVISIONS OF LAW$ yp�UAT10N AND ORDINANCES GOYERNING THIS TYPE OF WqRK WI�L flE COMPI,IEO @ WITH WHE7MER SPECIFIED MEREIN OF NOT. TNE GRANTING OF A pERMIT W3S s OOO DOES NOT PRESUME TO GiVE AUTMORITY TO VIOIATE OF CAt�ICEI THE pERMIT FEE PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULA7ING CON- STRUCTION OF 7HE PERfONMANCE OF CONSTRUCTION $492. ZS S�GNATUA F CON" q�TMOai •GENT �OATE� � � � � ..,,��/%/%��77 � �GNU7U EO�O EA��FOWNEpBU ilar�'G�/�G/�O�iQ— OCCUPANCVLOAD CU FT OFFSTREET PARKING STALI$ GARAGES SUi;TAX $17.50 SAC CNARGE Fire SC $35.00 ror fEE 44.75 / V VAUOAT 7H1S IS `R +T � �1 � U NEVV [ j �wDN Il a�rER Il � ' CITY OF FRIDLEY Eftectivve 1/1R002 6431 University Ave NE, Fridley, MN 55432 (763) 572�604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R 2 BUILDING PERMIT APPLICATION Construction Address: � S � � �t r � c� a, �t � � .� `�� Legal Description: Owner Name 8 Address: P� �-�r Q 1 S d� Tel. #��3 " S�a "� S`� 3 ConVactor. O w�« MN LICENSE # Address: 1 S � � �-��cl ..1� ��` }�) L Tel. # Attach to this application, a Certficate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LMNG AREA: Length = Wd� � 3 ��' Hei ht �, 9 Sq. Ft GARAGE AREA: Length _ W�d� Height Sq. Ft DECK AREA: orHeR: Length ��s � �• '�a (1�-� � Construction Type: � �� d � � � � � �,�}Q(� �! � Estimated Cost $ , �� Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$ DATE: �� - � a APPLICANT: Q� �{r C� �S u� Tel. #��3 � So�- 1 S N 3 Call (763) 572�604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card a�d we will call you tor card number. PeRnit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ � �.��"' $ �� $ � � $ $ $ $ $. $ CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1�000 Valua�on $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 [ ] $ � �" STIPULATIONS: BUII.DING PERNIIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any e�cisting building or structure, or for any alteration or repair to any existing building or structure, ugon 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 $5(� $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,�1 to $100,000 $100,�1 to $500,000 $500,001 to $1,0OO,OQO 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 $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 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 $l,(}00 or fraction thereof, to and including $1,000,000 $1,000,(�1 and up $5,608.75 for the first $1,0(�,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 feef times $17.00. VERIFICATION OF FOUNDATION 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. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. New Houses Onlv — 1rIldcheck COI�LIANCE REPORT Minnesota Energy Code 1rIl�Tcheck Software Version 3.0 COUNTY : •��n �+`�rL-"i:� 14�i STATE: Minneaota ZONE: 1 CONSTRUCTION TYPE: DATE: 4-19-2002 Single Family DATE OF PLANS: 4-17-02 TITLE: SO4401 PROJECT INFORMP,TION: OLSON COMPLIANCE: PASSES Required UA = 89 Your Home = 80 9.7� Better Than Code t i I I t Permit # � I I I I I Checked by/Date I I I Area or Cavity Cont. Glazing/Door Peri.meter R-Value R-Value U Value UA ------------------------------------------------------------------------------- CEILINGS 325 38.0 0.0 10 WALLS: Wood Frame, 16° O.C. 456 19.0 4.0 23 HSMT: Conc. 7.0' ht/6.5' bg/7.0' insul 357 10.0 0.0 24 GLAZING: Windows or poors, Above Grade 67 0.350 23 ------------------------------------------------------------------------------- COi�LIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The propos� building has been de�igned to meet the requ'r�ents of the Minnesota Energy Code. Builder/Designer � Date ��q-f�'L,� 4f�i ��' � j�'b,� t" �'is`..� ` R� �` �i;��H ��, "�� 1 . ��'�."��,��.i�(y� �� r��,.'{��'� t�y� I � P*yF��Yf��A`",�y�„�,il�M r ��l��r;,pR�`�a�''(.�l��r�'�`y,��y�+,''d"'ki ''i, �y � . 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L A, r �0.} ��, �i � N- 6 P� �"' � . . � d��t,.. c' - . . 3+ :�' �" �t .r �z F� �` A j}�'� i� iJ�� .d�y��v'� . � 1,1�. �i• • ,,�� T � ��. .. �b'" v �s�"{'k��,,''��C a�a'�FaaA�..`Ca �y e`�� -� �ek` �t�.�'�. �� 'w�+t Y,� -�j,7i� b�. . - iNy��p � .� r�`'., � . . � ;i y.,, r 4,.;'`a Y A �,�Mk�� f �f ':. fy 3 ', . ,,'� ;� , . , ; . .. ' . . . �t s�u. �, �:� r � ��* ,�„�� j f.r `, i �.� •y t r ' ..�ti,� ? ,,d.qSf�e �f °v i ip r +r ' `!'t.' .t` , 4° ,1! r .'' F l.f � t ��-i'b Y� r eWk �� . ` d r, .n� d' �. .... ' � ' ti'�. '7 .*-x " 5" .6''c��. et��" � ,�,��,,�?r ti;; } P <g; + � � . . . .. ��"� ' � �:�+�' � '° —�-•—,��w..w.� ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 iTNIVERSITY AVENUE NE FRIDLEY, MN 55432 s�z-36u4 r��: : 1568 FERNDALE AVE NE : 243024110028 : UNAVAII.ABLE : LOT BLOCK : ELECTRICAL : RESIDENTIAL : ADDITION/ALTERATION 571-1287 PERNIIT NO.: 200401833 � �,� � DATE ISSLTED: 10/OS/2004 VALUATION . NOTE: ELECTRICAL PERNIIT BECOMES VOID 12 MONTHS AFTER PERNIIT ISSUE DATE. INSTALL A SAVERS SWITCH. # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORPORATION 2300 TERRITORIAL RD ST PALTL, MN 55114- OWNER OLSON PETER A 1568 FERNDALE AVE NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 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 applicarion and know the same to be true and correct. All provisions of laws and ordinances governing this type of wor� will be complied with whether specified herein 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 regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERMIT FEE - MIN (RESn STATE SURCHARGE, ELEC FLAT TOTAL PAID WITH CHECK # 118132 SEPARATF. PRRNrrrc uFnrrru�r, �n� �.r,nv .,,,•..,�.., ...,, . �, ,-.,.,.,-.��_ .--� .. .��.� ....�,....� iiu�a� iiu�7�.1�1DDL HISV V�. 20.00 0.50 20.50 WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring H � Q��, CouMy Name WELL AND BORING SEALING RECORD M nlesota Unique Well No. " Anoka Minnesota Statutes, Chapter 103I or W-series No. ' � n�,�x e,m� bmwn> Totienship Name Township No. Range No. Secdon No. Fraction (sm. -� Ig.) Date Seeled Date We0 or Boring Constructed Fridley 30 24 24 Nvv, SL, N� 7/11/07 Unknown GPS ��de degrees_ minutes_ seconds Depth Before Sealing 197 n o�e�� oapn, 197 � LOCATION: Longitude_ degrees_ minutes_ seconds A FER(S) STATIC WATER LEVEL Numedcal SVeet Address or Fire Number end City of Well or Bodng Locatlon Single Aqu'rfer ❑ Multlflquifer F 3r 1568 Femdale Ave NE ��ORING Measured ❑ esnmacea Date Measured �� ' S i � ater-Supply WeII ❑ Monit. Well 140 Show exact IaxUon of well or boring Sketch map of well or b rin in sectlon grid with "X.° loc�tion, show(ng prop ❑ Env. Bore Hole ❑ Other ft. elow ❑ above land surface N lines, roads, and 6uildi g• CASINGTYPE(S) � � � , `.,+s" --i--- ---`-- -- `-- ---`- }- _ * ^' :'r� P �'' �[eeI ❑ Plastic ❑ Tile ❑ Other -- �--- -- -- `-- ---�-- WELLHEAD C06APLEI70N W � . � � E 1 --i--- --;--- ---F-- ---i-- Outside: ❑ Well House ❑ At Grade Inside: [�asement OHset � ; , ; '� Mae P�Iess AdapterNnit ❑ Buried ❑ Well PR --:.,, 1 0 --- --r-- ---; -- ---:-- 5 ' 0 wen Pn � s��ed ❑ Other � t nv�e � +��' 11 � Other P S NAMEICOMPANY NAME _ _ _ _ . — --- Cpgp�TG(g) - - _ -- - -- - - - - - - - - - `�e`�'� i�'s��n Diam�ter 0 DeptF� 93 Set in oversize hole7 Mnular apace infUalty grouted? Property ovmer's malling address fl different then well locatlon address indicated above In. frOm to 1 R ❑ Yes [.�rPd� ❑ Yes ❑ No �]°Unlmawn 1568 Ferndale Ave NE Fridley, MN 55432 in. from ro ft. ❑ Yes ❑ n,o ❑ v� ❑ No ❑ u��,o,�, in. irom to R ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unlmown W�jL�YViJ�R^�NAMElCOMPANY NAME SCREEWOPEN HOLE a G Gl V1JUI1 n W i in ad R remth��qo rty owners address Iridhh�tted atmve Screen from 193 � 17% ft. Open Hole from to ft. i��e�n�a e�Ve 1V L" e OBSTRUCTIONS Fridley, MN 55432 ❑ Rods/Drop Pipe ❑ Check Valve(s) ❑ Debris ❑ FlII ❑ No Obshuctlon Type of Obshvcdons (Dascribe) GEOLOGICAL IVIATERIAL COLOR HAp�NESS �p FROM TO Obs6vctions removed? ❑ Yes ❑ No Descnbe FoanwnoN If not known, indlcate esdmated tormation log from nearby well or boring. P��P SUBMERSIBLE Clay Brown 0 10 T,�e Removed ❑ Not Present ❑ Other Fine Sand Ll�t 1 O 70 M D USEDTO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE: Course Sand L,l�lt '�g 65 No Mnular Space Exists ❑ Mnular Space Grouted with Tremie Pipe ❑ Casing PerforatloNRemwal in. from to ft. ❑ Perforated ❑ Ramoved Hardpan Brown 65 75 fn. from to ft. ❑ Pertorated ❑ Removed Sand Cla Brown 75 85 Shako ee Slab Brown gs g Type of Perforator Fine to Medium and Li t 86 14 �°thef -- -__ __ " Clay Li t 14 26 �RO""N� �w'�Neat Grout ne beg of cem O= sa in�., o� 1�� bentonite = 50 Ibs•) 1 S St. Peter Sandsto e and vel 26 47 Groutinng Matedal from �o n „�g bags Shakopee Dolom te 47 67 TMom to n. ,�g �gs �.:. � � _ � ,� 1 � � - from to ft. yerds bags �=- � s=— -- OTHER WELLS AND BORINGS RE(Y�AA S-SOUR EiQF �i,pTA; pIFFICULTIES IN SEl1LINp Other unsealed and unused well ar borin on ro e �� r_ i � , 9 P P� ❑ Yes ❑ No Haw menyl e �_,i_1i ll. .t= i �_ Ci'.�i °i:,��_. ,_ � _ _ _ _ °" LtCENSED OR REOISTERED CONTRACTOR CERTIFICATION This well ar boring was sealed in accordance with Minnesota Rules, Chapter 4725. The informatlon corrtained In this report Geology From: 1583 GARDENIA NE Is true to the 6est of my Imowledge. Water Level in Above Well: 144 E.H. Renner & Sons, Inc. 1431 Date Water Level Taken: 03/20/ 1947 Condector Buslness e License or Registratfon No. Unique 206686 ° '`�"��''� 7/27/07 Ce�ed Representafire Signature Certified Rep. No. Date Kevin Scheiterlein LOCAL CO(�Y H�5 8 9$ 4 Name of Person Sealing Well or Boring HE-01434-09 IC# 140-0423 �pgp