AF - 42787/�~1
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Caty of Fridley, Minn.
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LA ON BUILDING
No. " � e Street � r _�_ � Part of Lot
Lot _ Slock � ddition or Sub-Div3taion . � _��
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Grner Lotr Inside Lot Setback �_� Sideyard ,�r�. ��
sewer IIevation �'�'_ ' 8 � _� Elevation b� �l a . � �
'j'OP oF �'oa71N6
DESCRIPTION OF BUILDING
Front �� Depth .���� Height �� &1. Ft ��� Cu. Ft�
Depth I� ght Sq. Ft Cu. Ft,
Type of Constru �� F�t.�C'o�t �[ �o be Completed
In ew�sideratfon of the issuaace to me of a permit to construct the building descxlbed above, I agree to do
the proposed work in acc�rda.nce with the description above set Porth and in compliance with all proviaions of
ordtnances of the dty oP Fridley. _
�--e--�-� .
In consideration of the payment of a fee oP $_�`� , perrnft is hereby granted to
to �onatruct the buflding or addition as descrYb� above. Thisp�� t ie granted upon
the express crondition that the person to whom it is granted and hia agenta, employees and workmen, in all work
8one in, around and upon said building, or anypa� thereof, ahall conPorm in all respecta to the ordinaac� of
FridleY� M3nnesota g la:ation, construct�on, alteration, maiatenance, repair and movin� of buildiuga
witbin 'the dt3► ]imfts��a d�this pernnft may be revoked at any time upon violat3on of aay of the provisiona ot esid
or�inanc�s. � _ �-�
Building Inspector
NOTICEs
iW peneh dea eof eo+rar 4hs eo�erueH�, leshlla�im hr wWeB. P�+�B. 6a 6�9, �ru er wafer. B� a�n fo as
tlw BniWiuB lesp�eto� tor pp�raf� parm6s /or th�a it�nn,
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(,�t��` Vl.�d �SSOC�.IAtGs� ��C• Telephone 421-6340
LA6�lD SUR1/EYORS .
Anoka, Mirenesota
CL=RYiE9CATE OF StlRiiElf: •
cJOSEPH MACIA8ZEIC �OB����0��9�70
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LoTS 14-1�, B�ocK I,
OAK GROVE ADDITION,
ANOKA COURITY� MiNP1ES07A
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I HEREBY CERTIFY THAT TH15 IS A TkUE AND CORRECT REPRESBJTATION OP A SURVEY OF THE BOUNpAR1E5 OF THE ABOVE
DESCWBED LAND, AND THE LOCATIOPI OF AL! BUILDiNGS, THEREdN, AND ALL VISlBLE EWCROACHMENTS, IF ANY, FROM OR ON SAID
LAND.
AS SURVEYED BY ME THIS....I GTH DAY OP ..... ......MARCIi .......AD. 19.FiI�:....
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_ P!. C. HOIUM A�r'AS��I��ES, INC. �Np SURVEYO�S
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Caty of Fr�dley, M�nn.
� BIJILDING PER:MIT No 7 0 7�
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AdBress - Address
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�O ION BUILD NG
No. _G�..��� Street .� Part of Lot
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Lot __ 81ock ddition or 5ub-D4 on �
Corner Lot �� Inside Lot — " �b�ck Sideyard � � � �
Sewer IIevation ........_ — Fo dal3on IIevation
DESCRIPTION OF BUILDING
To as: �
F�nt ��"... Depth .�Q� Height � S4. Ft��'-�–f�- Cu. Ft�.��
t Depth �Tefght � Sci. Ft. Cu. F�
Type of Conatruction ��_._._ Faat�C'osil ��_��_ � To be Completed
In conaideratton oP the issuaace to me of a permft to construct the ding described above I agree to do
the proposed work in acc�or�dance with the descrlption above set fo�th�3n c�mPliance with ons of
orrlinances of the dty oP Frldley. `) /
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In conafderatton of the payment of a fee of ���� , permit fs hereby granted to
to conatruct the buflding or addition as described above. Thts permit fs granted uPon
fihe express c�ndition that the person to whom it is granted and hia agents, employees and worl�en, in all work
done in, around and upon eaid building, or anypart thereof, shall �nform fn all reapects to the or�inances of
Fridley, Minaesota g location, construct�on, alteration, maiatensace, repair and moving of bufldiugs
within the dty limfts��s d�thia permit may be revoked at any tlme upon violation of aay of the provi�lons oF eaild
n Nonce=
'Ihis parmtf does net eorar t6s comhveHo�, �oa �er wUteg, plumbtnA, en 6�attnA, rar�r er wal�r. B� aRS to se�
th� Buildie� IespKter for ap�rd� parmha for fh�a hxea.
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OWN��lt ° S
ADI3RES5
APPLfCATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MTNNESOTA
LOCATTON OF BUILDII�
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No. �� Stre�t Part of Lot
Lot Block Addit3on or Subdivision
Coraer Lot s—llnaide Lot _�tbac Side Yard�_
SEWER ELEVATION UNDATION ELEVATION
Applicant attach to thia form Two Certificates af Survey of Lot and proposed build-
ing location drawn on theae Certificates.
DESCRIPTION OF BUII�DING
To b use as •
Front Depth Height�
Sq. Ft . , Cu . Ft . ��, ��
Froht Depth Height
Sq. Ft. Cu. Ft.
. / �
�ype of ConsCructioa Estimated Cost
Tc� be Completed
The undersigned hereby makes applicat3on for a permit for the work herein specifiAd,
agreeing to do all work in etrict accordaace with the CiCq of Fridley Ordinances an�
rulings of the Department of Buildings, and hereby declares that all the facts aacl
repreaent�t3ons aCated ia this application are true and correct.
DA� � °— ..�
(Schedule of Fee CosCS can be found oa Che Reverse Side).
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BUILD7IVG PER�T F�E SCHEDULE
Section 2. The Inspector of Bu3ldinge shall, before iesuing anq permit for
�he erection of anq building or structure, or for any addition ta aay exiee-
ing building or struceure, or for aay alterationa or repaire to any existing
building or s�ructure, upon application therefor, reqaire the gayrment by ehe
applicant� for auch permit of feea ee the amount herein below aet forth and
in the manner hereia provided to-wie:
2.1. For any such permit for the erection o,f any fire-proof building, other
than a garage� warehouse, factory or grain elevator, or for the erecCioa of
aay fire-proof addition� for similar occupancq, to aay exiating building
ahall be at the rate of $1.40 for each ona thousand cubic feet, or fraction
tt�ereof, in such cubical contenta.
2.2. For any such permit for the erectioa of anq fire-proof garage, warehause,
faetory or graia elevator, os for the erection of any fire-proof edditiea,
for similar occupancy, to any existing buildiag siaall be at the sate of $1.25
for eacb one thousand cubic feet, clasaified as "fireproof" bq Se�tiaa 502 of
the �tnneapo,'�ie Building Code.
�QUSES
' 2.3. Eor asy auch permit for the erection o� any non-fireproof buildiag other
_ � thaa a garage, wareho�ae, factorq or �rain elevator, or an�nan-fireproof
-' a�tditton; io ar occupancy;�o any existin� building - permit $1.00 fos
each one thousand cubic feet.
GA.RAGES
2.4. For anq such permit for the erectioa of aay aon-fireproof garage,
warehouse, factory or grain elevator, or.for the ereetion of any non-£i.reg�a�.f
add3t�.ou, £or s.imilar accupaacy, to aoy ex3ating building or for each such
bu�t.lding or add3xion - niaety ceats ($0.90) for each one thousand cubic feet
or fractioa thereof, in the cubical caateata thereo� w3th a minimum of $4.OQ.
For the purpose of camputing feea for building permits, the cubical coatents
of �ay buildiag or addiCfpn to 8 uniform 6eight throughout by muLtiplying the
gsound area covered from a poiat sis (6) iaches below the floor line o£ the
basement or cellar to the average heighC of the uppar a�arface or to the
averege height of the roof surface of the main gable of a p�tched roof.
2.5. For repairs or alterations to an existiag structure, the fee aha11 be
at the rate of $3.00 per each Five H�mdred Dollars ($500.00) or fraction
thereof fa the coet of all progased work.
2.6. In ao case ��all the fep,chargad fnr anp pPrault �a set forth in
Sectioa 2 be leas than $4_00.
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SUBJECT F�ER � O�.
c�ty of Fr�aley . 13943 ,,
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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; � CEIPT .
� • COMMUNITY DEVELOPMENT DIV. �
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r � � PFOTECTIVE INSPECTION SEC. ����
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� /"�1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�----� • •'� s�2-58o-3a5o 910-F15 3/9/77 � �
JOB ADDRESS 6601 Fridley Street N.E.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oescR. 14,15 1 Oak Grove Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Da1e Brinkman 6601 Fridley Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICEIVSE NO.
T. M. Campion Co. 2139 Lowry Aeenue N.E. 827-5781
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE Of BUILDING
Residential
7 CLASS OF WORK
❑ NEW �7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 16' x 30' Addition onto dwelli.ng
9 CHANdE QF USE FROM TO
STIPULATIONS
Provide smoke detector in hall outside sleeping area. Provide proper
excape windows in all three bedrooms.
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S�pEy�p� PfR�AfTS REQUiREO F� ����G' TELEP�10r £� ELfCTRiCa�U{IS Et�
HEATING. PLU1�1BING AND SIGN�. �.�: REP,�U4RED �Y LA
TYPE OF CONST. OCCUPANCY GROUP OCCUPANGY LOAD
SEPAFiATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOC� Fl"3In2
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 48O �J%GO
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ], STALLS GAHAGES
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 y5`13 � OOS y�`G. SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OT R STATE OR LOCAL LAW REGUTATING CON-
S OR THE P R ORMANCE OF CQNSTRUCTION. �`3S.4O NONE
PLAN CHECK FEE TOTAL FEE
NONE $44.90
SIGNATUHEOFCOVTRACTORORAUTHOfl 7 IDA7E� - WHEN PROPERLY VALIDATED TH�S IS YOUR PERMIT
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- SIGNATUREOF OWNERIIF OWNER BUILDERI � IDATEI BLDG INSP �ATE
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CITY OF FKIDLEY
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APPLICATION FOR RESIDENTIAL BUILDING PERMITS
iNEW, ALTERATIONS, ADDITIONS, OR REPAIRS) .
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OWNER: �'`�• BUILDER:- Ts �` C� P� Z%'� c� .
Address : C�� C� � ��- e��i Address : � �,.3/ � , %�
Tel. No. : ^ ��' � ,� � � �
No.: c� � � a Street:�
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LOT: �I,OCK: ADDITION :
CORNER LOT: . INSIDE LOT: SLTBACK: SIDEYARDS:
Applicant attach to this form �ao Certificates of Survey of Lot and proposed
building location drawn on these Certificates. .
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DESCRIPTION OF BUILDING
To Be Used As:
� ,9 � ?�
��_ "� �'� �� `� ��l�. 'Front � �� Depth: � � Height: ,�
Square Feet: `�' � �`� Cubic Feet: � �� �
+ J : 3°?!�:S'°. �
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���: `" �,:.� � ,� , ` Front: �c�� Depth: �� �:� Height: "��"'s
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Square Feet: ,� �: _� Cubic Feet: �_' �-� -_
Type of Construction: ��(„� ��� Estimated Cost: $ .%� �,� �� �`y� `� �'
To Be Completed: ��� /A1t, A Alt. B
Proposed Driveway Width 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 a11 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 for additional information.
DATE:
Stipulations:
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BUILDING PERt�IIT FEt SCNEDULE
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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 exis ting 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:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee. �
DRIVEWAY DEPRESSION: (Concrete C�rb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x$11.75
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$15.75
' 11 � � � �' � 1
For the pur,pose 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 or the cellar to the
average heights of the upper surface or to 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 permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
VERIFICATION OF FOUNDATION
NOTE: Pern►its �or construction will be issued a minimtun of 24 hours from the time
of application to allow for proper review of the proposed structu,re and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
► : � � '��
_ �
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
saa.d structure shall not be used or occupied until a Certificate of Occupancy has
been issued. .
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'° LAI�dC SUR�f�I'ORS
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1 HERE6Y tERTIF'f THAT TH!5 IS A TRU: AND CORR[CT iiEfR'c5E1:T�TICr� OF A SUR�'EY OF THF BOU."�D,4KtF5 GF THE ABOYE
p'c5; ^t3cD LAND, AND THr LOCATION Of ALL BUi! DtNGS, THE�:FGN, ANC� ALL VISIELE F.P:C�GACHr,tENTS, I` A�J'!, FROM OR ON S:.I�
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AS SUR�'EY;D 9Y !�: TNIS �`^ TH. DAY OP
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N. C. HOiU;.I AlyD AS�OCIATES, INC. jlAND SUR'JtYG'S
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SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i �
� �
� ; L _.___ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1 � �
� �"'1 � CITY HALL FRIDLEY 55432 NUMBER AEV.
�'""'� � ,�� 612-571-3450 910-F15
JOB ADDRESS 6601 Fridley Street N.E.
7 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. ]_-15 1 Oak Grove Addition
2 PROPERTYOWNER MAILADDRESS
Dale Srinkman 6601 Fridtey Street N.E.
3 CONTRACTOR MAILADDRESS
Ariel Rc�aod.elinq 5744 �ntest Moore Lake L
4 ARCHITECT OH DESIGNER MAIL ADDRESS
5 ENGINEER MAILADDRESS
8 USE OF BUILDING
DATE PAGE OF
6/16/81 / /
ZIP PHONE
571-3619
ZIP PHONE
\
PE .
16240
RECE O.
�� � �
APPROVED BV
SEE ATTACHED
SHEET
LICENSE NO.
LICENSE NO.
21P PHONE LICENSE NO.
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Canstruct a 12" x 25�' Addition
9 CHANGE OF USE FROM TO
STIPULATIONS �n.�actor to verify that there d,rill be 18' betFreen addi.tion and
side lot line.
������
Bafae diggirtg c�ti local utiiities
TELEPHQNE - EL+'�C; k�C • 6AS Etc.
REC�UIRL�"f ".�'r' �-�W
S�PERaTE PERMiTS REQuIRED FoR i�'Ri�G,
HEAtIf��, PLUI�BING AWD SIGW�.
TYPE OF CONST.
SEPARATE PERMITS ARE REQUIHED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. W-�Od Fr�IG
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. N0. DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1
1ND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
'D� �RHETHER SPECIF EDNHEREINIOR NOTOTHE GRANTING OF AOPERMIDT +��-Oi2rJO
NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE
� 'ONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
� `I�OR THE PERFORMANCE OF C STRUCTION. S63.00
\ e� PLAN CHECK FEE
� � �� � $15.75
�F CONTRACT R OR AUTM RIZ D AGENT IDATEI WHEN PRi
� � �
OWNERIIFOWNERBUILDERI _ _ IDATEI BLDG WS
OCCUPANCY GROUP OCCUPANCY LOAD
SO.FT. CU.FT.
306
STALLS
�GARAGES
JRTAX
�5s 13
�C CHARGE
NONE
)TAL FEE
$83. 88
CITY Of� �ttIDL.CY •
��r��.ic:nria� r�orz r,�str�rr�i-rzn�_ r�u���»�iG near�rrs
(Idc��l, 111 �cr�tions, /ldditiuns, or Rcpairs)
� 01dIdF:R: �`a �2 �`e �i �� � � �a
ADDRES S : � � D � �� • �a�� a ; � �
TEL �l0:
�UILQER: �r i.� � �� ��-� .
/1UDRESS: S 7 �{�" (�,cs� ����� ��.
TEL (d0:
. ��I'��/� �`'
� Cons�;ruction Location
smz�c�e r2o : � � 0 , s��r T: � o' �� �� �—
� i .
�
� �
LO'!.': - ' � BLOC%: � 71UAITIOP3: � ^sa. �s � Y 0 ��. � � �e e � .
Corner Lo�: ��'"� Insicle Lot: SetbacY.: Sideyards:
l�p�la.cant at�ach to t�}iis form L`LJO Certificates af Suxvey of lot and
proposed building �ocation drawn on certificates to scale. .
� DESCRIPTIOfd OF COPISTRUCTIOPd - �
��1 i rl0 � I�'ront: ��-•� Depttz : �S�/ Iieight: `o� �
Sc�ua3^_e. k'eets^�_ Cxibic Fcet:
�'ront: Depth: � Heiglit:
Square• I'eAt: � Cubic I'eet:
� �,i` Ic ��. � : /U,?�'/.S�t - /(� 2�'u t10
Type af Consicruction : OB� ��C, Es�:imai�ed Cos�: $ ��
xb $e Oor.�pleted: I �� � ��t � , .
� � Alt. A Al.t. B
Proposed Arive�•�a�J Width If New Opening Is Desired: $� $
' S�E k��tTERSE SIDE OF SHEET
�Sle undez signed hereby m�};e� applica�ion for a permit icr the �:nrk� herein speci.fied,
agreeing to c� ,all work iri strict accardance t•�ith the City o€ �'ridle}� Ordiiiances and
rulings ot i�he Department of I3ui.ldings, and hereby deelares that all the iacts and
rc�resen t�ztiens stat�ed ;si t.iiis applicatian re true and corxect.
A.:TF:: �/ �� �� � SiGNATUF.�:: �
St:1j�U11t1O11S : •
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• P.�.. 1�.7�.
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vJ: any )�u.;,].cl.i.i►�� ar. :,t.::11Ci:UL'C'.� �r. ta�: tin�� �xc1Q�.i:ir>11 !.o �u►y c�:i:�i_S.u�� l�uilclinr,� �r stx.-�icLur.r_,
. ci�' i'ar t���y til.t:c•r.�t�i�,n ar. r.cl,�ii.r.:, t:a �at7y c.:S. :t:i.ri�J )�u�.:i.di.�i<1 or. :,t�:ucttirc, t�J,wi ar�pli.cat.i.or�
�tli�r.:f.or.c, r.cqu.i.rc t�Jic pciymci�t: }�y t]ic a1,J�].S.caiit: f:a�: ;;t�cli ��cr.rnS.t• ut: fc;c:, ta tljc arnount-
hcr�iri bcJ.o�•� sr.t- fnr.th �inc1 i.0 t:lic ���annez hczcin r�zov�.cic_cl L•o-�•:.i.t:; .
I:l:1�J CON�;�l7'tUC'.CIOIJ: �ingJ.c ).'�1mi1.y llotr,e:; and Gar.�Zqcs;: ;:4.00/J.,G�O cuLi.c tec.t.. .
P7,7:;�2 C:I11:C1:: 25 I�r.xcc��t: a.L bui.lcli_nc1 }�er.miL fce.
Ulil\'1;S•'111' llL•'L�P.L•'557GI•:: (Conczetq C1irb �Lrcets On1y) � �
' A?.t-crnli:e �: ]ta�noval �znd repl.ricatr�ent oi' concxetie cur.b and
guLL-er anly; l�rivecaay �•riclth p7.us 6 feet r. $13. �0 �
7�li.crnate l3: };�Inoval and r_e;,��.acement o£ concrete cur�, ancl
• guL-ter ar,d ins���ll.� a 3 f-oot e�ide anPzoach taii:h ''
. � 6 �nch ae�th; Uri.vc;•�ay �•�ic:th �plus G �'er.t r. $15..75
• � �nD 1 T j �nn►�r .,�-, - OiZ��1/1T r or
I'or the purlvse of compuL�_ng tees for. building permits,. t-l�e cubicaJ_ coi;t.ents of any
kiuildi_ng or. a,ddition, i.s dci.er.:nined by rnultiptying L-he gr�und area covcred from a
p�in'� sis: (G) inchcs belo:� i:Yze floor ]_ine of tlie basemeni� or the cellar to 'tiie
average iicights of fihe •upl�er sw-facc or L-o ihe average hei�ht of the roof �urf:ac�
oi i:he raain gab�.e af a pa.tched roof . '
Fox re�ai.rs or a�t�r�eti.ons to an eYisting s�ructure, tiie fee shall be at the xate
of, $3 . 00 Pc� each five l�undred do�lars °($500.00) or iraction '�lier�of i.n the cost
of all proPosed wor.Y.
. . • . - �
in •no case sha;.1 the fee cliarged foz any p�nni.t as set iorth i_n Section 2 be less �
tiian $7.5p plus $.50� sta'r.e surcliarge. ' - , -
� , -RIFIC�TIO��! oF r-ou; nn -lo � �
� NOTE: Permits ; oz cons.L-rucL•ion �•�ill be issued a minimum oi 24 hours from tiie tizne
vt �pplication ta a]locv for pxoper revie�v of ihe proposed structure and of the
canstruction site. . .
; ,
I� Certificate � of Sui-vef of the l�t, sho�,ring the location o� the faundation once it
has been consunic�ed t.�ill be required before pr.oceeditlq �•�ith the �rami.ng.
, .�RTIFICl�TE OF ���UPAI��CI' ' � ��
� I►PP�i�atzon for a Certiiicate of OceuZ�aiicy sh?11 k�e mad:� ten (1p} d1 S
�t�:e or aecurailcy ot an}• structure for �,rllic}i a buil�iiiiq �ermit Las bee'n Pssuedi�andc
stii.d struci_u�-c :�.tialx liot be used oi- occupied t.ritil a Cert�j.tic�Z�e oi Occul�Znc}► has
�1GGJ7 xssued.
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Sue�ECr
Cit� of Fridley
AT tHE TOP OF TME TWINS g U I L D I N G P E R M I T
i �
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� `y �_�___w COMMUNITY DEVELOPMENT DIV.
f � ' PROTECTIVE INSPECTION SEC.
� � �"'1 i CITY MALL FRIOLE� SS032 NuMBER REv
�----� • •'� 612-571-3450 9/0-Ft5
10B ADDRESS 601 Fridley Street NE
1 LEGAL �OT NO BLOCK TRACT Oq ADDITION
oESCA. 14,15 1 Oak Grove Addition
2 PROPERTY OWNER MAIL ADDRES$
Dale B�rinkman 6601 Fridlev St NE
3 CONTRACTOR
Midwes�t
4 ARCHITECT OR OESIG
5 ENGINEER
8 USE OF BUILDING
MAIL ADORESS
Roofing & Siding
NER MAIL ADDRESS
MAII ADDRESS
7 CLASS OF WORK '
❑ NEW
8 DESCRIBE WORK
Reroof'IHouse &
9 CHAN(iE OF USE F IOM
❑ ADDITION O ALTEAATION
33 Sa) Tear-off
TO
OATE PA
5/14/98 /
�26053
NO.
c�� % �
OF APPpOVEO BY
/
SEE ATTACMED
SNEET
571-8374
21P PHONE LICENSE NO.
.e Grove, MN 55311
21P PNONE LICENSE NO.
416-4804 20010277
ZIP PMONE LICENSE NO.
� REPAIR ❑ MOVE O REMOVE
STIPULATIONS '
'�Underlayment must comply with the State Building Code.
SEPARATE PERMITS AR� REQUIREO FOR ELECTRICAL, PLUMBING, HEATING, '' r� �r �••v•.
VENTILATING OR AIFi CONDITIONING.
THIS PERMIT BECOME NULL AND VOIO IF WORK OR CONSTRUCTION ZONING
AUTHORI2ED IS NOT C MMENCED WITHIN 80 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPEND D OR ABANOONEO fOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WOR IS COMMENCED. NO. DWLG. UNITS
I HEREBV CERTIfV THAI I HAVE READ AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME T BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOV RNING THIS TVPE OF WORK WI�L BE COMPLIED
WITH WHETHER SPECIf ED HEREIN OFi NOT. THE GRANTING OF A PERMIT �2 f 752
DOES NOT PRESUME T GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEf1MI7fEE
PROVISIONS OF ANY THER STATE OR LOCAL LAW REGULATING CON- $74.75
ST TION OR TNE PE FORMANCE OF CONSTRUCTION.
� '-�� `''� ` ��/� �� P LiCNECK FEE
SIGNATURE OF CONi ACiOR OR AUTHORIZED AGENT IDATEi �N �
� �DATEi
GROUP �OCCUPANCVLOAD
CU. FT.
OFFSTREET PARKING
STALLS GAFAGES
SURTAX
$1.38
SAC CHARGE
Fir SC $2.75
TO L FEE
$5. $83.88
ALID THIS IS VOUR PERA
i►/__ /_• � ._ .
�w
ADDN
ALTER
[]
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CITY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/9�
�� a ��� �
ConstructionAddress: �i � C�� F/► ��G �f 5 f
�.egal Description: '
�wner Name & Address: ��/a �� �✓'� �,� ��►�,�cJ Tel. # S�%/— � 3� y
Contractor:� r G�G� S � , �v �i3� y ,� � � � 11�1 [� MN LICENSE # �U /OpZ � 7
,
Address: %� 9 T j (s iacQ�s l�o� f l� ld'� •,�l 4 D�< �rdve -/I/� /� Tel. #�irC� ' �%�0 �/
� �I s's"3 r/
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale. '
LIVING AREA: Length
GARAGE- AREA:
DECB AREA:
OTI�R:
DESCRIPTION OF IMPROVEMENT
Width
Length � Width
Length , Width
, ��.cs'� s;?
Height Sq. Ft.
Height Sq. Ft.
Hgt/Ground Sq. Ft.
9�� - %� -4,�
Construction Type: �4�• o�"� , i�c. " I�ao � Estimated Cost: $ �/,�a�
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: .S %`% ��f APPLICANT: L'�%2-% �- /���5� Tel, # g�'/" G G� 2
�ermit Fee
� ire Surcharge
itate Surcharge
�.AC Charge
�,icense Surcharge
��riveway Escrow
�;rosion Control
?ark Fee
oewer Main Charge
TOTAL
I$ ' ,i�,�
$ �. �S"
,$ o
$
$ ,.� -��
$
'$
$
$
� $ 3 .c`��
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1000 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 [ ]
��ULATIONS:
�.-°
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
$ i 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
$21 (Minimum Fee i� $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000 -
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, tm and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fracrion thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,Q00
$887.25 for first $100,000 plus $5.00 for each additional
$1,OQ0 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1, 000 or fraction thereof, to and including $1, 000, 000
$5012.25 for the fust $1,OOO,Q00 plus $2.75 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 $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 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of applicarion 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.
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