AF - 45144•
�
Caty o��Fridley, Mirm..
BUILDING PERMIT
��: 'August 11� 1965
�: � Ronald Pari aek
B�� � Gunder Anderson
3�6�/
N� 8353
Address _........_..__. .._..._._..... Addi�ess 1,0�1�_. � �.Oth Avenue .�J.x.#��,.__�
Minneapolis, Minnesota
LOCATION OF BUILDING
Na 5258_._.. s�t __��'toxE s�T �t. E.. _....__. Part o# Lot ..—_..... _
Lo� ._..__�.—.�__ 81ock _._..__.��..+. Addition or Sub-Diviaion ._._.Mar? on Hills �.dditi �n
Corner Lot � Inside Lot _. a Setback .��.._:_._.__. Sideyard __._1r'.!._��___.._..
Sewer Elevatian .� _.._. _... Foundatiaai Elevation
DESCRIPTION OF BUILDING
To be vsed ss:
Famia� Dwelli.n.K ._... F'ront �1� nepth ...?L._ xe��ht �..��_._�. sq. Ft. ]2 o Cu. Ft. 2�,�
G�'a�e �t 22 n�ptn 22 x�t,t _..lo.___ sq. �t. _ 48�:_. cw. �t. __?�}8�0
Type of Co�struction f'?�..._...._..__.. Es� Cost ��8��..���...... To be Canpleted _.___._......_...Y.�..__.._.
In co�ii�ersation o! the issuance to me of a pexmit to cons the building described above, I agree to do
tha propooed war�k in ac�rdance wlth the d�scription above and in c�om ce all ' ons of
o�^dinanoea o! the dty o! Fridley.
In cans[derattan o! the payment of a fee of � 3�� , Permit is herebY granted to GUNDER A.�1D��SON
to construct the building or additi� as described above. This permit is graated npan
the exprees oonditioa that thepe rson to whom it is granted and hia agenta, employees and workmen, in all work
doae ia� arotuid aad upon said building, or snypart thereof. shall canform in all respects to the ordinances ofi
��Y, Minneaota regarding locatia� conatructi�, alteratio�, maiatenance, repair and movIng of buil�ing�
within the dty limits and thia pesmit m�y be revoked at a�y tiine upoa� violation of any of the Provisians of sa�d
o�diaaaoes.
�SS�N G. JENSEN g„�� ��
NOTICE:
11�k p��eM doM �ot oowr tM eo�lrualky 1�sqNka hr wMw. PlYwbh�W N� MNi�W aw�r er wNrr. d� wn fo aM
tM lvildlso Ie�qee fer a� p�tb tor tY� iNAS.
$.• �+ -+. .r
APPLICATION FOR BUILDING PLRMIT
CI�'Y OF FRID�LEY, MI1�INESOTA
OWNER' S NA1��N/Sx%/J r/� /� /�,E � _ BUTLDER�I//�l06i� fr'til��.�So/J%
ADDRESS ADDRESS�D�,�� - �� ��7 �
iJ�. �,
LOCA7"IOAT 0� BUILDING
N0. �'oZU�� . ST'REE�' �i��JH�wZB vT. /// � PART OF LOT
LOT � BLOCK � I ADDITION OR SUBDIVISION �%%/Z �.Q�►�' /7 i��s /����
CORNER LOT INSIDE LOT � SETBACK u S SIDE-YARD �— �,`,� �
SEWER ELEVATION FOUNDATION ELEVATIQft
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as ; �_
�'�-O o2 `b � %
�i�jyl i,l� j� 1N� %/„v q Front`�Depth_�eight
/:�Z�S'u _ � � o �
Sq. Ft. u. Ft. �
' �.
Front ot dL Depth oZ ci-Height / U.
Sq. Ft. 8 Cu. Ft. ��� Q
Type of Construction�,�%,-y� �e Estimated Cost �/� Q-z�-o.
To be completed�m �, . f� _ f���
The undersigned hereby makes application for a pexmit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that a11 the facts and representations stated in this application
are true and correct�
DATE c�-� // — �,5�
(Schedule of Fee Costs can be found on the Reverse Side).
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c�ty of Fr�a��y . 14404
AT THE TOP OF TH� 7WINS' BU � L Q�{ �4;� P E R M I
i • RECEIPT NO.
` � �� _ COMMUi�FlTY DEVEtOPMENT DIV.
- �' � L�_-+�_ � PROTEC'�tV� fNSP�CTIQN SEC. �
. �. i � . . . . . . . .
.� " � : � . . . .
�� /�"1 � CITY h}ALl :� FFiCp�.EV �� 55432 � NuMeea REV. ��ATE PAGE OP APPROVED BY � �
�---�� � �'J s�2-580-3s50 910-Ft5 � �
L� 6 � �
�os nooaess 52�� Fil��e Street NE
1 L�GAt ' L�T NO. BLpCK 7F;ACT OR AQOtT10N SEE ATTACHED
oESCR: 2 �, Mario.n Hi11s Addition sHeer
° 2 PROPERTY OWNFR MAIL ApORE$S ZIP PHONE
i : -
3 QONTRACTOR MAILADDHESS ZIP PHONE UCENSENO.
! ARCHITECL OR DESIGNER MAI� Al9DRESS ZIP PHONE LICENSE NO.
5 fNGINEEA MAI!`ADDRESS ZIP PWONE LICENSE N0.
6 USE OF BUIIDtNG
r c�nsso�woRK � NEW ❑ ADDITION � ALTERATION � REPAIR � MOVE ❑ REMOVE
& DESCRt6E WORK
Ins a1 a ion of waod ea��
9 CHANGE OF USE FROM TO
_ STIPULATIONS " _
SEPkRATE PERMITS'ARE RE�UIHED fOR ELECTH1CllL, PLUMBING, HEATINC,, TYPE OF �ON$T. OCCUPANCY GROUP OCCUPANCY LOAD
- V�Pti11A7tG16 OR AtR CONQITIONING.
THiS PE�M1T `B�COME� NULL AND -V�ID lf - WORK OR CONSTRUCTION ZOMNG SQ. FT. CU. FT.
AUTHORlTEO IS N07 CQMMENCED WITHIN 80 QAY$, OR IF CONSTRUCTION •
OR WQRFE I� SUSPENDED OR ABANDONED fOR A PERIOD OF 120 DAYS AT
ANY T{M� RFTER WORK IS-COMMENQED. NO: DWLG:-UNITS OFfSTREET PARKING
1 HEREBY �ERTVfY TWAT I HAVE REAO AND EXAMINED THiS APP�ICATION STALIS GAAAGE$
ANQKNOfNtHE SAME TO BE TRUE ANDCQRRECF. ALLPROVISIONS OF LAWS VALUATION SURTAX
ANO ORDINANCES GOYERNING THtS TYPE OF WORK WILL BE COMPLIED.
W17H WHETkEA SPECIf1ED HERNN OR NOT. THE GRRNTING OF A PERMIT $E►SE�.��i .SO
OOES NQ7 PRESUME TO GIVE AUTHQRCTY TO VIOIATE OR CANCEL THE pERM{T FEE SAiC CHARGE
PROVISIONS OF ANY QTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTIpN OR THE PERFORMANCE 0F .CONSTRUCTION. %� �
° PIAN CHECK FEE TOTAL FEE
, ,� _ $.0�
r�ttAi .� F` '.TO OR�ufiH RtY�bA�ENT IDaTEi WHEN PROPERLV VALIDATE THIS IS YOUR PERMIT
. .,
,�� �_77�
` ~ .,-� .� .SFGNATUHE-O ��OWAFERIIFOW BUII..QERI � ,���. � IOATEI - .--: . pyLf3f..INSP �� .. � DA
0
� CITY OF FfZIllLEY
0
' APPI.ICATIQPJ FOR RESIDENTIAL BUILDING PER��IITS
iNEW, ALTERATIO�tS, ADDITIDNS, OR REPAIRS)
s
, . .
OWtdSK: • BUILDER:
Address: , -�a,--r',,� ��/GQ�J�-?-���� , Address :
�
Tel . No .
Na. : ���v Q' Street: �z,Q
LOT: BIACY.: � ADDITION: a �_''�`-'�-tL %
CCTRNER LOT: INSIDE LOT: SLTBACK: SIDEYARDS:
Rp�licant attach �to this form �ao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRI PTIOPJ OF BUI LDI NG
To Be Used As: .
�6 O D �� �'T� � �'�'ont: Depth : Height:
5quare Feet: Cubic Feet:
Fron t :
Depth:
Height:
� � 5quare Feet: Clibic Feet:
Type of Construction: Estimated Cost: �.�4
Zb Be Completed:
A1�. A Alt. B
Proposed Driveway Widt�h If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict 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. See reverse side r ddit' n in ation.
� 9 SIGNATURE: `
��: GT �� / T%
Sti 1 'ons:
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5�
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�
sue�ecr PERMIT
City of Fridley � g g 2 g
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T
r
; � RE .
� '` _���_ COMMUNITY DEVELOPMENT DIV. � � � ��J
r � y � PROTECTIVE INSPECTION SEC.
i . �
�� � /""1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE. PAGE OF APPROVEO BV
�'""� � ��� 612-571-3450 910-F15 4/13/89 / /
�oe no�AESS 5258 Fillmore Stxeet N. E.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
�ESC�r: 2 1 Marion Hills Addition SHEET
2 PROpEATY OWNER MAIL ADORESS 21P PHONE
Ron Parizek 5258 Fillmore Street N.E. 571-4633
3 CONTRACTOR MAIL ADDRESS ZIP PHONE �ICENSE NO.
Minnesota Fxte�iors 295 Highway #55, Hame1, MN 55340 478-6001
4 ARCFfITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO.
5 ENGINEEFi MAILADDRESS 21P pHONE LICENSENO.
6 USE OF BUILDING
Res idential
7 CLASS OF WORK
� NEW ❑ ADDITION O ALTERATION �I REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
IT1S'tdl�. SO£�7.'r��3GJ.3
9 CHANGEQFUSEFROM TO
STiPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR EI.ECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAO
YEN7ILATING OR AIR CONDITIONIMG.
THIS PERMIT BEGOMES NULI AND VOID IF WORK OFi CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCEO WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WQRK I$ SUSPENDED OR ABANDONED FOH A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS 60MMENCED. NO. DiLG, UNITS OFFSTREET PARKING
1 HERE9Y'CERTiFY THAT I HAVE READ AND EXAMINED THIS APPLICA710N STALLS GARAGES
AND kNOW THE SAME TO$E TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND .ORDINANCES GOYERNING TMIS TVPE OF WORK WILI QE COMPUED $1, 415 $• 73
WITH WHETHEF SPECIfIfD HEREIN OR NOT. THE GRANTIMG OF A PERMI7
DOES NOt PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW qEGU�ATING CON-
STRUCTION OF THE PEHFOFiMANCE OF CONSTRUCTION. $35.0�
PLAN CHECK FEE TOTQI FEE
� $35. 73
SIGNATUfiE�OF CONTRACTpR OR AUTNORI2ED AGENT IDATEI ��„�
WNEN PROPER VALIDATED THIS IS YOUR PERMIT
SiGNATUREOFOWNERIIFOWNERBUILDERI � IDATEI BIOG �NSP � E
� [J
ADDN � )
�'� [ ]
.!•,� 7 s ._K ..� :.. s�
_._ �- « . .�
. - .,�� -
.. .
� .. - ��
R-1 AND R-2
�; � cli.ng Permit Applicatio�n
_ . � n
F
I.IVIIaG ARE�i:
C�iR1�L�E AtiE�:
DDG'R ARF�I:
O�li�itt
� �. � i . _ , -- �--�r i.v� , .- r-
Effective 5/1/88
�. # S7(-- �� 33
Te1. # � > �-6
Attach to this application, a Certificate of S�vey of the
lat, with the p���osed voa�struc.-ticaz drawn a� it to scale.
�tIPTI�i �' II�AOVIl�fl'
Lerygt�h Width Heic�t Sq. Ft.
Length Width Heic�t Sq. Ft.
Lp�x�th ,]� ldth . �y�t�Gro�xl Sq. Ft.
G�l., -f _ � �l� ,� ''� _ . � i�e
Corner Iat [] Inside Iat [] Ft. Yd Setback Sic1e Yan3 Setbacks
ZYpe of oo�stnx.-tion: Fstimated oost: S 1�i (.� �—
Approx. Cc�letiom Uate:
Proposed Driveway Width If New Openit�g Is Desired: Ft. $ S
i + 6' See Back Page
OATE: �� 3`� APPLICANP: ��J' Te1, # G%��� �O f�/
CTPY tTB� �II,Y
Permit Fee $ � S. O O
State SumhaYge $ � ?
SAC Cl�arge $
Driveway F�crr�w $
Park Fee $
Sew�er Main Q�arge $
: �.
sri�TTals:
S ,-�� 7 �
Fee Sciyedule on Reverse Side
$.5U/$1,000 ValUati�
$575 per SA�C Unit -
Alt. "A�� ar' Alt. ��g° Above
Fee Det�e�mined bY �4�r'�4
Ag�ent NecessaxY [ l � �-��'Y [ l
_ _..
�
�
SUBJECT
City of Fridley
AT THE TOP Of THE TWINS g U I L D I N G P E R M I T
;,
� �
� • COMMUNITY DEVELOPMENT DIV.
� .L _.____�
r � � PROTEC7IVE 1NSPECTfON SEC.
� �
� � �"'1 • CITY HALL FRIDLE� 55132 NUMBER NEV OATE
�'._".�' '•� 612-571-3450 9�0-Ft5
12/1/97
!08 ADDRESS 5258 Fillmore Street NE
1 LEGA� �OT NO. BLOCK TRACT OF AODITION
DESCR. 2. 1 Marion Hills Addition
2 PROPERTY OWNER MAIL ADDRESS ZII
Ron Parizek 5258 Fillmore Street NE
3 CONTRACTOR MAIL ADDfiESS 2�
Metro Chimney 1G808 Portland Ave, Burnsville MN 55337
e ARCNITECT OR DESIGNER MAIL ADDRESS ZII
5 ENGINEER
8 USE OF BUILDING
Residential
7 CIASSOF WOfiK � NEW
MAIL ADORESS
PAGE Of
/ �
570E
RECEIPT NO.
a�
APPpOVED BY
SEEATTACNED
SHEET
PHONE
789-5242
PHONE IICENSE NO.
942-9422 City
PHONE LICENSE NO.
ZIP PHONE UCENSE NO.
O ADDITION O AITERATION �7 REPAIR � MOVE � REMOVE
8 DESCRIBE WORK
Repair the chimney from the roof up
9 CHANGE OF USEFROM TO
STIPULATIONS
SEPARATE PERMITS ARE FiEOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST.
YENTVIATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING
AUTHORI2ED IS NOT COMMENCE� W�THIN 60 DAYS, OR li CONSTRUCTION
OR WORK IS SUSPENDE� OR ABANDONED FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWIG. UNITS
i HEREBY CERT1fV THAT 1 HAVE READ AND EXAMINED THIS APPIICATION �
AND KNOW THE SAME TO 8E TRUE ANO CORqECT. AI.L PROVISIONS OF LAWS VALUATION
AND ORDtNANGES GOVERNING THIS TVPE Of WORK WILL BE COMPLIEO
WITH WHETHER SPECiFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $675
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERM1T FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGU4ATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �ZG.SO
PLAN CHECK FEE
S�GNA HEOF N'RACTOAOAAUTHOAIZEDAGENT IDATE� �N R�
nTUFEOFOWNEA��FOWNERBU0.0ERi . iDAIEi
0
y �/ i
OCCUPANCYGROUP IOCC
CU. FT.
OFfSTREET PARKING
STAILS GAFAGES
SURTAX
�� $.50
SAC CHARGE
Fire SC $.51
TO ,AL FEE
$27.51
VAII D THIS IS YOUFi PERMi
Li' /f- '/ �
LOAD
NE�'V
AQDN
ALTER
[1
[I
[1
� ' CITY OF FRIDLE�'
S[NGLE FANI[LY AND DUPLEJ�ES R-1 AND R-2
BUILDING PERM[T APPL[CATION � ��
Effective �1 / 1/97
�s�°� .
ConstcuctionAddress: �� � �� ��,�,� o�� S�-
Legal Description:
Owner Name & Address: �� �q� ; ZQ ���� ���Q �..� Tel. # �� - ��►-�'�,
�- --,,—► ics
Contractor: �� (��aMn-�� MN LICENSE# (� �� _4��-� ��-�
Address: ���p� �or���� d��S„' ��� Tel. # ��-('�, .°t��_
L1VING AREA:
GARAGE AREA:
DECK AREA:
Attach to this application, a Certificate of Survey of the
iot, with the proposed construction drawn on it to scate.
DESCRIPTION OF IMPROVEAZE\�'I'
Length �'icti�t Height
�ng� Width Heiaht
Length Width HatlGround
Sq_ Ft.
Sq. Ft.
Sq. Ft.
OTHER:
. oa V P
Construction Type: C. ��� �Q Y �,� Estimated Cost: $ C��S OO
(Fee ScheduZe on Back)
Driveway C�ub C�t .Width Needed: Ft. + 6 Ft = Ft x$ � _$
DATE: t'�.� 1- �i"1 APPLICANT: Tel. #� 4�i� ?��-� �
Pertnit Fee
Fire Surcharge
State Surcharge
SAC Charge
$ �.5�
�� $
� C $ �-
$
I.icense Surcharge $ -�
Jriveway Escrow $
�rosion Controt
Yark Fee
�
�
�ewer Main Charge �
TO"I'A L � �
�'7. .5 /
�,�rt t>u r_n�r[o;�rs:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 i l Oth %)
$.50/$1,000 Valuation
$950 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Decermined by EngineerinQ
Agreement Necessary [ ] Not Necessart� [ ]
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