AF - 42313i��o �.����
_�,
ue: i inicw =_� F�r LE ROY :i. YVINNER &� ASSt3�1A�E5, lNC. aos No. ----�:-'-�---- --
.�r� .�o� q� pascd �'ivu�e.eyo,t�. art. ..e,�9__ r�. ---7s------
Rpiar•..d Under Inw. ef SM� of Mien.wM
LeROY H. 4VIP11ER � ASSOC., INC.
Phone 78d-0270 LAN� SUR'JcYOR'S
8729 CE�diRAL AVE. N.E.
CERTIFiCATE OF SURVEY B�INE, NiIi�NESOTA 55434
PHONE 784-0210
iV'FY FOR: LYON CGYST�UCTION CUt6PpYY �
iCRI�ED AS: East 75 feet of Lot 15, Auditor's Subdivision No. 129, Anoka County, :v;innesota
lying Northerly of the Southerly 130 feet and excepting the North 50 fest thereof
for road purposes.
�■
_� 121.
Q�R"
�
' c� I eo
� l�
� �
w
w
aoi.z I �
z --- — -�+ c~n
T --/� �3G_CO --- �l
�--ATT:CHEC ---I't----- --�`] 1
; ^ GAkAGE '�� '' � � i
% yo (RtOP0.5ED) o oi
7!� i
�-�w�.BLK. - h i�J {�'-'�.
�� FOIIMDATI � � I
J�? � � I I �
? ' —�' --- �
I �
�
:� �
,�
� ,
� ,
, � �
� __
�
� -�
__'— _ _ Fa�VG�''�-E __ _ __ _ _
---C-E�J-�RAL—_ _ _ ---
g {C. S. A. A.
�29
Q
�
�
�
�
. ; �
�
�,
M
—_""'___ _ _"_ - �. �... .
i�i0.35) �
CE3{TIFiCI.�E Cf lO�A7iOt�! Of BUIt���vi3
� . � �...3�Y <«,:�f Ma�.�---� -��---�917R
, mc�fe e �Vrrsy a� :he bcation ol tF� bv��d�ny�s) an 1hs abosa
Jy.�..6.n ...n....1r nnd IYnf eh. Lv.win. ..t ....A w.l.�.�.�.i t.
�
F l� � •,
�r . � ,
.. � m
� � �- `+ t? � -' n :, � � :
u � �
' k �' � w :t. �� � n E r a L�
� ?. � „y G1 � n " 'Y M �o � �
�Cl C' � ... � '� �♦
• � �� i n x M� U ..• � x ;�i --�
M I'1 L. '° ��` C
V M ro C: I`1 r 3 :�� � «C'.i �
� 'A .� � ca e a. 'D . ro � K `�
. o � H " .v ~ , p m � c�
Y �
� `{ .. � • '� r � • � �7
. U i� • � a v �' � N Y �'
. � � � • � a ; q � , -+ ;u
, N . • o t, a . � ,--�
� � � ti
' ;d CO , � iA �i . �. w � �„
• � . .
• .: `� • ' LL � � a' . . �
• A � � � • .
• N � � • • : �
.N • � � � �
� � � • •
0 • � • • • • •
• ci • • • • • . • �
,. � . . . • . c�r�
• � � • • • •• .
� � • • . • • • � �
! � � � � • • . .
� � • • • • • /�
. �
. _
• rn
. � . �
n x M �
ti
� Q 0 �
�"" • ,' K X 1C M X X X X X X m
�+ . W N �� �A l,a � N IJ ^�.7
� � <n W
�
�t ; �i t'ai� � � �> c.^�i � c�'n o � A .�{
t�1 • � M
.L� . t� fn e* 4^ w en tn e� � aa
' a I I �
• � � ,j � O
- 4 � I �'
ui , • r I l% 4.
�
. � � � . :; . .
w • !�'.' �'' �:; � ��A �� � �
�:r Ici « � �Storid �
� '
x`i _ _ _.�
a, w,,,.�
t: � ��,os„ s ,
� P _� __
>; �l u�iw�s ,
{ `� ►ATN I
A
S� T�/oi �
O �
a �� .�_ .,,s�HC x �
� �
� � S�NC3 �
y �� � �
4, �, ,. ^�. Y d
� , ,MYS • ca
�� � �� _ .� cn
oauu, C n
iov�rr. ,i.i ��
. yc�vR1. P r�
fl6J� ry �
O0.AINj
�
�J.T[M ry Q
� � MSIffS �� �•�•
7 `
{3 AUlO � .
f� � ww:r�� o U
.� — =�
c..s `�1 .'3
� ^''�-
.< ! �
� c�s i? f �
{� RANGC o � �
u, GAS ~
.
poE rt+kGS �
�. e "
(�
z s :� .
� ` E �
�' G'1 "' > . '�
,� a : . �
g � a Z f?
N � I f �i �
�D " ;-, .�
�
- , N •
�C � '. � x � o � o c x �Q
a G � - a' . � a a �e
�
ft t' p z W � � »•n
a x � a a �
� �p . �
i
�
�
� , .
.
. � � '. .
. • .
cW
�
�
•s
n
�
0
�
i
. . p
�
�
G N � �
� � �.
•',1+ R. Oa
� N �ov
� �
w O
pN o `�
� i
\� ,
�.
� �;�„ •�
:;•• c�
. � -�,
� � � o
w cu y A � �-�•
� � � � � .� `G
a a ;; �e ;
�� ~ o � f
. _�', � `� o �'�1
: N � G � • � �`j �
� o � � . � P-.a
(]� MM
H � (J � �'i�
��:? � �` � �i
O N M � ►� �
�
H � � �. � � `�3
ti o i7
►. �, � a x
� ���� � �
p. � u " '•
io r` `� � �G w �l
� p � � y� .
e,, [�' o o � 2S
r! ,,; " x. x
� ���� ,
5 b
�. (L �: v
e":7.ti. ' � .
�. �` n
Q ,- w
t� a � o•
� a. � �
� 7 � o , •
� + a' ~ •
r_fO=�w
n v ^
� � � .
�
i�, � E � �,
a��;: � �
a�•Y� .
��
����
•- u ''
' r 4 :
r� a .
r � K '
>
n �i� '+
� �� x
'° ; .� , �
�. n
�
a
u
H
�
w
� �
� �
�
�
�
�
� � �
��� � �
y U
� � r�
���;:
� 6i � �
� � � �
�:' :; u
� � �� W�
�
� N
rt
w
8 `�
�
s �
��
'
� �
J `�
�.
�C1 V
.,
�
�
,A. ?
O� C
V rn
n�
T
n �
0
o m
� �
� Z
n
�
� �
� 4 � � �
�- x i�
" � :�f
� � -� � `
� "� � rl ti d
�����b'
� � N " cJ
� � �
�H
�
�
t
�
�
I I �
p, I � i �
� � � � O
� a �
$ � 8 �
w �
N N H �
, «�
( H
� I O
O I I �
n
�
Q.
�
�
�
�
0
r
bo
Q
x
7.,
r
0
� s
� w
� �
H ~
H �
a `'
O 7-
C p
-J,_ c
X' ~
�
n
�
�.
fD
a
$
M
�
i
G ° °' � �
�� p� a
n = " �
,� � `� a z
I f � �
� � °
� � i
a � �
( �
i � �
� L7
� � ���'
� �
� � �
."�3
�
� O
� �
a �
�
� � N � �a
� K � !i �
U � O �
�
G
. �
. �� ,
�
a+
�
N
a
�����
x � � � o
r y � n N
ii w �n ;n x
w .� Y s ,V,d
�, � G �
n r .
�i o +�' 1�' Y
� � r �� c�
� 7
�
� M 9 '^ �
� x o a �
� � � + �
o � �, �
7j � � u
� � A
-- ;�
M b
�' b
��
o �'
� �'
. � �
.�'.
tA
fJ :a O O
g � � :�
N M !A �►
�
W
�,�� ��
� � � �;
� R� � �� �
> i, � {�, �T
O p � �
� � M �
[? C. �% � �
� U � rrr111
r7 O �
.i. � 9
a�+ C � G �
7 h � �'
^� � S
�. �
N O �
� $ : �.
$ bd
�
IA
W 01 O� G: O
� g d � $
M N IA H N
O � �-I C 7" �
a �. �, � a �
Y � 7 m 0 ~
�9 J � ~
E �. 3 � a1
ti �
E � � �
h• N y
a �
�
b ( �
�
7
o a
I ��
i CC�.
( �
I
� I
�
0
�
�
n
�
�b��,y
� v � �
." °= „ `��
'� ••'• `� i
� R' � y
'a• > � •��+ ;�
y %� O �
� � M � �
i � � '�
y t(� �
�
� c � �
.r 'd �'
e� O
�ra „
Ln �
o g
Oq
O
. �" �
�
C ZS O O �
N M
.�
�
m zr � (�
� �b
�
r a' n `C
r ~ � � 0
..- � p
C 7,�n �
:;, � �, - .
���� �
.' " " 3
^ ��
.7 u
C •D 7 „y
� .�
Na �w '° e
�+ v � 7' .
�n �
..:� � �
- ' ���
��
� � �
= .°. o a
v � X
n, �#t�
v =
'c: _- � w
C�yO
� , v
'� � y � .
C � � m
��,�c.
�•�n�
i �' o
7�"�
�� O
,d�
��n�
�'� f��
���»
`�m�
�-�nn
��
a
tr•��
n y
MM ro
T � � --
�
�
�
�
ry
�
--�
�
ci
7
i! �
�'
�
rv
�
�
�
�
.�,�
°x 7
�
aj
��
�>
«;�a
R�
��
i� r+�
•
y, . .�
!}
� A�,
� 4�
:.'�i `; %
�.,, :��,
f 9 �ao
�'.S n :»
. e r'i
aaJ �-;
!;�
: 1�
�' �
c
�
t,..
t� °
^� t
� ¢i
�u.�,� °_�
� �;
<:a t�
�`s. r�',
�y r=�
'`�� '��
�, .
E�
�
`� .
r
f3
e.;g
e: �
r•�a
E� �
Ed
a�l
f`.1
m'a
�
�3
` a�`i
�
sue�ECr PE NO.
c�ty of Fridley , i3358
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
� � PT N
� ; L _.__�_ COMMUNITY DEVELOPMENT DIV. � � /
r � � PROTECTIVE INSPECTION SEC.
1 ,
'4 � �"�1 � CITY HALL FRIDLEV 55432 NUMBEF REV. DATE PAGE OF APPFOVED 8V
""'� � ,'� 612-560-3450
910-F15 1 23/76 � �
JOB ADDRESS 1370 Fireside Drive N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION � SEE ATTACHED
oescR. Part of 5 Auditor s Sub. #129 SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Kevin Olson 1407 Adams Street N.E.
3 CONTRACTOR MAIL AODRESS ZIP PHONE LICENSE NO.
Lyon Ente rises, Inc. 12 Brid e S uare, Anoka 55303
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
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 24' x 41' Dwellin and a 23' x 24' Gara e
9 CHANGE QF USE FROM TO
STIPULATIONS provide a hard surface driveway. Provide a verifying survey before
capping. Provide sod in the front and side yards.
SEWER IACATION: (Approx. 9' Deep) 129' East of Manhole (Inv. 885.3�,,,,-y;�, �...,� .�,,.
Wye Elev: 887.94 ���`��' �"�i` G `-�''=_� -�
Top of Footing: 890.94 Minimum NOTIFY THE F[�l�LF_Y �N R.
WATER LOCATION:15' East of sewer service. DIViSlON REGARD;l�G CU B
REMCiVAL AND REPLACEM Ni'
NOTE: The City does not quarantee accuracy of utility locationsAT DRIVEWAY OPENING
1�►ARNf�iG
,, Before d�g�ing cail Iccal u�i�itits
r� �; .�, � �.:�,t�,.;:°`�-.`.� ` '�'' '`i,,�`•.�. TELEPHONE-ELECIt�iC-GRS Etc.
� � � P �il� r. ,- �_ : ,
5_..t'_ �
t�E�T��; , j��...���,�-;��it�i� ��� ��c�r�s, REQUIRED �Y L�,l�'
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOC� FY'dIR2
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 2'7, 744
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R 1 22].% +552
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEAEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STAILS 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 34 3%O 17.19
DOES ESUME TO GIVE..B.IlTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
P ISIONS O ANy--Q7HER STATE O CAL LAW REGULATINCa CON-
TRUCTION OR H'E PERFORMANCE OF CO TRUCTION. 51.33 325.00
�' PLAN CHECK FEE TOTAL FEE
� L���� 418 . 52 •
Si RE-0FCONiRACTORORAUT eonGEN7 IDATEI WHEN PROPERLY VAUDATED THIS IS YOUR PERMIT •
1— ��� �7<.�
SiGNATUFEOFOWNERIIFOWNERBUILDERI IDATEI BLDG iNSP �ATE
APPLICn'I'ION FOiZ RL'�IllLP1T'IAL, ALT�;RA'I'ION,
OR tillllI1'i0N 13U11.,DING 1'rRD9IT
CITY OF FR1llLEY, MINNLSO'TA
�" � , G
,. .v T� ti(� rL � 2 E� .��'
, a /' ��
OWNER'S NAME: �l.'�'�; ���=��-'� � BUI:LDER:�i,��'/C� ��'�i�'��''C`ff�/`/�'�C` �',
ADDRESS : l�C'7 i�-���r � � i` ��' ��.� ADDRESS :1� U'� r �Jr � ��� , /��,'��f�.�— iZ�,c '.
� �s s ;�? �
�
�� : r � �� TR�ET : � , � � 5 � �� � ��;� ► � ► c-
LOT :��R �e�� � BLOCK : ADDITION : /� � � � � l � %
COI'u'VER LOT : INS IDE LOT : � SETBACK : SIDEYARD :
Applicant artach ':o this form Ttao Cert.i_f:icltes of Surve�� of Lot and propesed
buildii�g location drawn on these Certificates. �
DESCRIPTIO:�i QF BUILDING
To Be Used As:
4C[ _S L... � Front : � L� Depth : ���
Square Feet;_��� � Cubic }�'eet:
� �
Iieight; ���Z��� � �� -
���d lr'��'-�t� �- Front : - .�-- � Depth : ��._Height :
Square Feet;
Ct�bic I'�et:
� ; �- � "`�
Z`ype of Construction: ~�./���: �=, Fsti.r.iateci Cost: $ 7-
�� _�.�_._
T.c Be Completed: -�� r��f�'�� � '�
lne undersigr.ed hereby makes applicati�n for a rermit for the work h.erel.n
spe�ified, agreeix�g to do all woxk i.n st'xict accordance wi.th the City of
Fxidley Ordinances and rulings of the Dep�.rtm�nt of_ Buildings, and l�ere�y
declar�s that all the fac::s anci rc�p;:e.sentations statecl in this application
are true and correct.
DAT� : 1 ^ �� � T (c� � SIG?�Il��'iJi'.� :
(See Reverse Side For Additional Ir.foxma,
����d
' ._3`% 3 3
• 3.�"0 , o v
i�• �9
y�s/3- 32
� � �/tJ �. L�
�.2�-,i�ca`
��G
s����
� - �KOv��� -
�.��� ��G r:.� '
t
y
, ;
(
. �
. �
I
`;�
BUILDING PLI<MIT F�E SCIILllULL'
SECTION 2. The Inspector of Buildings 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 repairs 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 fortli and in F.
the manner herein provided to-wit: �
UNIFOItM BUILDING CODE: Type l, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3& 5-$1.85 for
each one thousand cubic feet.
AllDITIONAi. INFORMATION
For the purpose of computing fees fox 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
o�- the cellar to the average heights of the upper surface or L-o the average:
height of the roof surface of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
In no case shall the fee charged for any perr.iit as set forth in Section 2 be
less than $5.00.
VERIPICATION OF i OUNll!�TION
NOTE: Permits for construction will Ue issued a minimum of 24 hours from the
time of applicatien, to allow for proper review of the proposed structure and
of the construction site.
A Certified Survey of the lot, sho��ainb the location of the foundation, once it
has been constructed, will be required before pxoceeding with the framing.
CERTIFIC�'\TE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for which a Uuilding pennit has been
issued; and said stxucture shall n�t be used or occupied until a Certificate
.
af Occupancy has Ueen issued.
,
0
a
�i� -
- /.3�C� - �'�� s�,o� -
s��e�1r - �d .r ,� 3. ;� _ � 9 �
� --�- - —1!0 , 3 x �!�-= `3 % � --
/�9S �..z
�a X a3,o -- _�o��
�� x �5; o � �,�L
�� z z
-- --� __
i
�
- ---+-__
i�,3>�
-__� �� a__�_ 3
'`,r iz = i..� �6y�` `�
(,t-� 3' _� _ ,��z _ 2 x lv = 5 .T�-- --- -
--- - � � yyy - �- 3
., ,
!_'_ __ --_~_ -_ --� �� '.-_ _-.. - __'___-
' - io 96 '�r � �"v = _ � � q�2 'Y, ,30
- —�---
- �/Z z ` � � a � , �-,e = �o?.S'. �.3,5 �, a? o
• - s.� ,z ' x
`��� Qoo =
.
��o = y a 8y, 8a _y
�
`� .��! �3 G , .3"� - - ----
1
�9 �' �Y� � �a • °.� — --
- ��,�.) ��y�y
3_ X � �L���/D�IO j =--- _ __ 3/. .� .3 —
��4 c. 3,�'d , o 0
, —_ �
� �%�. ,�.� -�_-
a s. 6 �
-�- __---�--°.._
-�-��� z ��
„�,.. .<...,.�...V.�o...�....�..._,..ro.�.�.. _ _.,..w...._..�.,,........._.,... ,.,...��.�.,�,.,�..,�.....�
�.. ._.,.,� _.._�.._, .. _ ��
�
r
: J1! � �P j
” 1n...� ,�lo•�nint� ��/i�'�f `�1� /� 8$7: Hiytiv.�� r< •j i�t F
i S5 ��t_. 3UYkR'tV7[� � M , � _
� �;. resr� :-� � f'I �« �,�t������%�!¢ , � ' n. } l.,F j'�593�
� � • �,� 1 f . t:;
�� � - r,� �r� � � �
c ;:�t� ,-, erenQ T••ie�, f.. 'L'� r�4bG
� ` iuo ;°�c�it7eCrirtg �'r3��1I1£�@I"°i a�.: .f'91IiVt��% � e.c;.irs h?a �
i' �'._
'�
I
1� , �. 1 .. ' _ .
�*,./ n� i E. i. .i. i 4�+ (i� L � 4:T� ►.�% 'ti.1 Jt � �i �fT �'i..l ` � � + . ` i;. . r� � � ��`��. ._.. _..__...
�
�} J
t���:.+
` - � ;- � T'^ ,
, t i �;'� r `
�. t� r_ � . �. � �. '-
�,..�...._.�.�.. �._.�.._ ..�.._._. �.n $�� - -
l
'� ;
� i5� � _
�" `
Y
t�
_ 1 •
. � i K �
` e �
_ .., r
I f�4 � Q��j � .- , ,
E �
--!_MP4RTRNT- '
N�TIFY THE FRfDLEY ENGR.
@I�d1�lQN REGARDING CUR
�N�61��i�L ANp REPLACEME�
�� �RIVEWAY OPENINGS.
. �� � � *,a �, � �.�n
� ������.��
Before di��i�g cafl local utili�i2s
TELEPHONE - ELECTRIC - GAS Etc.
REQUIRED �Y LAW
� � .
� � ,
� { ' .
� i .
� '
! � r- � � - w ;.
. �
°� ��...,..,�...-,...�..� ` _ - , .
`,.�-----� ---- _ r _ _ __ t .
<< � , . �
,
,a , , • '
e Y � - , . . . � � � I i , ' , .
F, .1 t.'1, ` , .
1 \
� �. . . .,.` ., �.�� 4 ��'1 ' � a,' ? .��_ ��� ; �r t �-. . .
� '
�4 �: t.. ; . . ,f : � t t' I. / ta
.' .� .
,
,�'.� "
"' .n . , a` , , i.K i. , r_.:,
... �} � . ; _ 1
, �� .��� � _ .. _ � �,+ �����y.
!
1#sere�^y certiiy t►�ut this ia u t•ue and cu���c:t ��pres�ntccio�� of a..,rvey of the F33a:�3��4!'IPS o' ��,c aboti�
descri3se�! te�r�d� cinsi of �I�e`location o4 utt bu�ldings� •hereon� an� utl �. ,ibte en�rotetFmqnt+, ti �,^,y. frarr o� �,•,
ic3irl lond. As surveyed by m� lhis��^ dar of�_�!F,_,� —_--�A.17. 14 _
_ St��URBAN E�GINEER�lNG, it�C. .•
/'T ' �1 '; . :sr�ineers Sii�'ve.yOr3 ,
, . ;
-;{,_.�<< ,�,r)('�'1 = �, ! �,. • � � ,
. by ..�,.. . __.�--- . __ _�_.____!�.._.___..__.__
.,' •
.. f .�.....�....a.._�,..r.Y.._.,..,.�...�..,_...,......_.s..�....A..,..�., W...�.,...�..,.,... �,�...�,....,.<,.....�..�.n.......�.,.,:..�.�,.,.�.,�, . ,m,�.,..,,.,..
� � �. J� �� �'C . � / .�`�° � �
�� �
� g ' �; � �- �.���� C�--�w � � � �- 3 � �
2
wy�
���� - ���� 9�
/ o � ��
�
���
, z
1``w o c �-, n.� G - � � (� , �'� - _ . � � �
�� � %
! �llitl,��;'v,y�, '''' �'-� _ 3 ,�
� � � , � � -----
���� �
.
%� �- °�
/v a -� �- -.
N�
��
�` T�- �� �s
LJi! � / T y'
:
�,, ��°,',Y- �°�� .�1 � ,E�',�' l �" �.
� c�'� ca Y�- �' � �v T � �, �C � e.�� � � �-
�
�� �.� � � �c/.S
4
. E
: , _._ __ _._.�_ �....
� C
' � JVOJCL� ..
c;ty of Fridley
A7 THE TOP OF THE TWINS g U I L D I N G P E R M I T
� �
� �
i VV'�"�� �
COMMUNITY DEVEIOPMENT OIV.
f j ' PROTECTIVE INSPECTION SEC.
1 ; i
l_-_•�'��"' �'� CITV HA�L FRIOLE� SSIJ2 NUMBEN
i 612-571-3450 910-Ft5
JOB ADDRESS 1370 Fi resi de Dri ve NE
t LEGAL LOT NO. BLOCK TRACT Oq ADDITION
DESCR. Pt. of 15 Auditor's S�
2 PROPERTY OWNER MAIL AODR�S$
Laverne Carlson
3 CONTRACTOR MAIL ADORESS
William Mattson Constr. 11274 198th Ave Nu
� ARCMITECT OR DESIGNER MAiL A�DRESS
5 ENGINEER MAII ADORESS
6 USE OF BUILDING
Residential
7 CIASS OF WOHK
nEV IO�TE
6/14/99
21P
vAGE OF
� �
PMONE
-4786
PHONE
PHONE
29680
CEIPT NO.
����
6vqpvEO Br
SEE ATTACIiED
SNEET
IICENSE NO
3354
UCENSENO
IICENSE NO
O NEW O ADDITION O ALTERATIQN � REPAIR p MOVE O REMOVE
B OESCRIBE WORK
9 CHANGE OF USE FROM
ST�PULATIONS
Underlayment must comply with the State Building Code.
0
SEPARATE PEFMITS ARE REOUIqED FOR ELECTRICAL, PIUMBING, MEATING. 'r� ve y�
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NUII AND VOID IF WORK OFi CONSTfiUCTION ZONING
AUTHORIZED IS NOT COMMENCEO WITHIN 60 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDEO OR ABANDONEO FOq A PERIOD Of 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO DWLG
I MEREBY CEi;TIfV THAT I MAVE REAO AND EXAMINEO TMIS APPLICATION
ANO KNOW TME SAME TO BE TRUE AND CORRECT_ ALL PROVISIONS OF �AWS VALUATION
AND OROINANCES GOVERNING THIS TVPE OF WORK WILI BE COMP�IEO
WITH WHETMER SPECIf1E0 MEREIN Ofi NOT TME GRANTING OF A PERMIT $1923
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEI THE pERM1T fEE
PROVISIONS OF ANV OTMER STATE OR LOCAL lAW REGU�ATING coN� �69 . ZJ
RUCTIpN O ME PERFORMANCE OF CONSTRUCTION
P�AN CHEC
Licens
S�GN�TUAE O� CON'aACTOA OQ �UTMOQ12ED �GENT IOATE�
S�GHnTUAE O� OwaEp��� OwHEQBw�OEA� iO�TE� m n
UN17S
P
OCCUPANCYGROUP OCCUPANCVLOAD
SQ. fT CU fT
OffSTREET PARKING
STALLS GARAGES
SURTAX
$.96
SAC CMARGE
Fire C $1.92
TOTA F E
.00 $7 .13
V/�IQ�1 MIS IS 1L�UR PFR . �
�A
. _
NEW L ]
ADDN
ALTER
Effective 5/10/99
( ] CITY OF FRIDLEY
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address
Legal Description:
`.s JC ��`, �2c-'s ;�J�- Q2
�O
�� �
�
Owner Name & Address: `�r �� c `i� •z� - ��' �4 �'� � �--�— Tel. # ��C�— ��-� l 2
Contractor: �' ; � ( � � w: yYr �t i jsc�,,,v ��o ,�,,- _5 i�Z � � � , c� , MN LICENSE # sns' �`/
Address: / � � 7 y / L �-T H � �; �� � �� � ,�� �rm.a� 55 3 3 0 Tel. # `��/ ��:��
LIVING 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.
Length
I.ength
Length
DESCRIPTION OF IlVIPROVEMENT
Width Height
Width Height
Width Hgt/Ground
0
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: T� -r+�z � f'�` �f /''�,�L�C;r (-f�� : sE-�- ���Estimated Cost: $ C - { `— � � ^ /���
Driveway Curb Cut Width Needed:
DATE:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STII'ULATIONS:
APPLICANT:
$
� ,�'
$
$
$
$__���
$
$
$
$
$ / • �
Ft. + 6 Ft = Ft x$ _$ .
Tel. #.
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Pernut Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 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 pemuts 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
$1,000,001 and up
FEES
$23.50
$23 .50 for first $500 plus $3 .OS 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 %rst $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
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the %rst $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.
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 minirnum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Cert�cate 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.
� �
n c�
� Q
C��
�� a
�
� �' �-
� �
N. -�
4 '�'
� n
� �
O �
3 0
� � T
? �
� o
� �
�' �
OC1 �
lD
�` � �
� � 7•
� � �
�•��a
o `°
� m
�
� Q
� �
�
S
O
� `.
D
�
'a
�
<
cD
a
�
�
�
0
c
�
�
v
�
�
�
� -
��
�-
_ y
�
�
V
lyl
'Z
�
n
n
�
d
Z
�'1
m
rn
<A
�
v
�
O
\
_
1
D y
x �
�
� �
� �
w
�
�
I�
��
�
O
P�7 ,
r �
�
�V �
�u �
� �
��,a
\ n
^�
�
�
•a
►-- o
`�e3
b� �
G �=
� �
� =a
O C
�
D _
a d
�
A
CC
O
�
O
�
� �
�
D i
r �
� �
m �
m �.
�
� _
� �
�
0
2 "� � u+ -I
D � C' � �
� A
� � � _ _
N � �
� �
CP fD
.�r�Q�
n � � � �
� a � � �
t=h m �. �
�S.�a
C � Q� �
� `p � O �
Q
� • � � `' �
��
� —�
, � i. c�
� � , O N
� � N
� � � �
�/1 �'G.�-�p
� � �
� 3 '
�
� v O � � �
rn � ',[ A �
(D d t!
� � (D � �
� c��—,��
� � � � e�
� � � � � �
� �S?.�
\ n � ^
..�
z L7 ,,,SF O'
� � ^ � C�D� ?
� l l �
iv �C• o
N o �
� Q �-
� �p rn
a � c_a
� _.
�
�-
a� O
O ?
��
<�
� �
\
� �
m
� 1�11
D y�
'�D_
Q°
e► D
� �
� �
� �
G Q
�
N
� r
!f)
-'i
O
Z
t�
a
C7
�
v
*
A
n
0
�
a
O
�
�•
aR
D
�
N
cD
N
�
�
N
�
�
cD
�
d n�i p c a
�n N o � c
�7 � � '� �1 �D
� � N� m �
� �m�cn�'
Q^ < m �
� (�p � m N
� a . � �
o �..,��a.
� C �
d �. O d �
S C •-r.
� � � � O
� '�d A s
' v
� C (�
v -t �
� �
� �
A
CD �
�
�
�A f� {Ya i� ff�
� O O O C7
o° °o °o °o c �'
�
ts� � � � � �
Q O 'f
c �
� �
� �
�
m
, �
�
a
�
Z
�
�
2
�
�
N
(D
Z
0
v
�
'*1 � --� 2
� -i � o
— C � =
0� �
� °'
� �
�
C
�
N
� �.
_
O � C�
a1 �
� wm
0
� c �
.n-r ^
ro �
a ��
C END �
� rn��
'a O
�o =
��
��
T
�
1/
O
1
� A
N _.
m
�
n
�
m
v
Ci
O
N
�i
�
�
`�
�
m
�
�
=i
z
0 '
�,'
�-t.
m �C
o m
Z
L�
� �
m �O
ID �
�
�t-] i'
r
r
�•
I�
�
r
n
�
�
•
..
�-
�
�
�.1�
O
`I
�
N
�
�
�
�
^ TI 4� n
Wai��
� � C O
V �
w�� �
d'ti v
� v' c m
W < -G
N � �
z�
m m
n
ti
Q
2
�
�
a �
ro
'9
=
'*t -�i
.� O
� z
� �
a°
��
o 'v- •
Z�- �
2�
v
Da
�
n y
O �
Za
gZ
�v
O=
zm
D
si Z
y0
m
O
N Z
D �
2 �
O�
vZ
C �
A �
N �
O
Z
m
«
e�
A
<
<D
�
�
`
�/
�
m
�
r
O
O
N