AF - 43442� � � . �
. ,£
BUII..DING PER:MIT
Village of Fridley, Minn. N� 2 7 6 7
Date �l% � ��. . . S� . . . . . . . . . . . . . . . . . . . . . . .
Owner. . . ... .�!... . Builder ...........................................
Address p.�Q�..... ... . ............... Address .........................................
LOCATION OF BUILDING
No. ����......... Street ���Pi��l.'....-.�f%8 . .......... .. ... Part of Lot ... ............. .... .. .
,�'/r e
Lot ...��......... Block ... .. ... . . Addition or Sub-Divisio� ���•�.�T•��'�!r�....
Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ........:.................
DES+CRIPTfON OF BUILDING
To Used as:
............... Front ........ Depth ........Fieight ......... Sq. Ft. ........ Cu. Ft. ........
.................... Front ........ Depth ....... Height ......... Sq. Ft. ........ Cu. Ft. ........
��^ �
'2'ype of Construction�,!��'A'.'s!'�Q . . Est �l� �� . . . . . . . . . . . . . . . . . To be Completed . . . . . . . . . . . . . . . . . . .
In conaideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in cw�npliance with all provitions of
ordinances �f the v�illa�e of Fridley. . /�
� %�( /%�:f�..�•�./..... .w ................
In corisideration the payment of a fee of $�:�'. ., permit i� hereby granted to
8
� . r.. to construct the building or addition as described above. This permit is granted upon
the •.ress condition that f.he person to whom it is granted and his agents, employees anc� worlQnen, in all work
done.in, around and upon said building, or any part thereof, shall canform in all respects to the ordinanees—ot"
Fridley, Minnesota regarding loCgtion, construction, alteration, maintena�ce, repai� and moving of buildings with-
in the village limits and this permit may be r�t►oked at any time y�On violar,iQn of any of the provisions of said
ordinances. 1/ l \ �
,�',�.'.'... Building Inspectc�r
NOTICE:
This pe�mit does not cover the consEruotion, inttallation or aiteration fo� wiring, plumbin�, pas heatin��
aewer or water. Be wre to aee the Buildln� Inspmator fo� separate permita for these itoms.
-
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
;,
� �
� ; L ___.__ COMMUNITY DEVELOPMENT DIV.
r � � PROTECT�VE INSPECTION SEC.
1 . �
�` � �"'1 � CITY HALL FRIDLEV 55432 NUro�BER REV. DATE
L""� � ,�� 612-560-3450
910-F15 10
JOB ADDRESS 5901 Central Avenue N. E.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION
DESCFI. ].4 1 Meloland Lakeview
2 PROPERTY OWNER MAIL ADDRESS
Carl Page 1049 Gardena Avenue
3 CONTRACTOH MAILADDRESS
Sussel Ca�pany 1850 Com� Avenue
4 ARCHITECT OR DESIGNER MAIL ADDRESS
PAGE OF
� �
ZIP PHONf
645-(
ZIP PHONE
PERM .
. 1441'7
R PT NO.
�t��S�
APPHOVED BY
SEE ATTACHED
SHEET
IICENSE NO.
331
LICENSE NO.
5 ENCaINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residenti.al
7 CLASS OF WOHK
X NEW � ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
! .. �e �
9 CHANGE OF USE FROM
TO
STIPULATIONS provide a hard surface driveway. Garage must be set back 25 feet fra�a
side yard right of way ].ine on Gardena and 4� feet fraan conamon line without
survey, and over 8 feet froon the exi.sting house.
S��'�RAT� �ERMIT� REQUiRED fOR WtRING,
W�ATIN�, PL.U1��31f�� AND SlGNS.
TYPE OF CONST.
SEPARATE PERMITS AFE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OFi AIR CONDITIONING. j�ppd Frdl�
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTqUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWiG. UNITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPIICATION 1
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF IAWS VALUATION
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT ySL� ].%O
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL lAW REGULATING CON-
STRU TION OR THE PERFORMANCE OF CONSTRUCTION. � 23 , Q[j
PIAN CHECK FEE
� '
SIGNATUREOFCON7RACT R UTH RIZ GENT �DATEI WHEN PR(
ER BUILDERI 1
WARNING
Before digging cail I�caf utilities
TELEPNONE - Ef.�C�I�;C - GAS Et�.
REQU�RE� �Y LAW
SQ.
STALLS
V
NCYGROUP OCCUPANCYLOAD
CU. FT.
OFFSTFEET PARKING
�GARAGES
SURTAX
�`i.os
SAC CHARGE
TOTALFEE
$25.12
IDATED THIS IS YOUR PERMIT
�s� �4 ��3—'� 7
DATE
� CITY OF FfZIULEY . � C��...�-T
APPLICATIOid FOR RESIDCNTIA� BUILDIN6 PERMITS �.�
�NEW, ALTERATIONS, ADDITION.�, OR REPAIRS) C1,�,�,,a,�
OWNER: BUILDER: . o+ �i s a� LQ .
'-..
Address : d� .SQ,�c� Address : / g.$�a ellntl /Q�f�
S90/ �r3L t}J � �%�[,Te1. t�o. :.____i24�s - d �:3 /
. �, .
No. : _ �! Q� Street: �i�H���O N� � - ,��_
___.__. __. ,_ -
LOT: l ��: BLOCY.: � ADDITION: ��p.�,d ,
CORNER LOT: INSIDE IAT: SLTBACK: SIDEYARDS:
Applicant attach to this form �ao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRI PTIOfJ OF BUI LDI NG
2b Be Used As : !�J 2�+�LX.,�, ��,t.,
_ � � Front: _�� Depth: � J'�M Height:
Square Feet: � Cubic Feet: �%� Q"
Front: Depth: Height:
, Squara Feet: GZibic Feet:
Type of Construction: _ �1^ �w�. Estimated Cost: $ y / - ��� �y
Q ��'-
7.b Be Compl.eted: < l� s_ Alt. 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 all work in strict accor.dance with the City of
Fridley Ordinances and rulinqs 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: (YLC� %- ? 7 SIGNATURE: .-
Stipulations: /
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BUILDING PERt�IT FEt SCHEDULE
SECTIOH 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 s.uch 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 Curb Streets Only)
Alternate A: Removal and replacement of conerete curb and
� gutte'r only; Driveway width plus 6 ieet 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$15.40
�11 �l:_ ► �' : •\
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 or the cellar to the
average heights of the upper surface or to the average height of the roof surface
of the �ain 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 $.50 state surcharge. �
VcRIFICATION OF FOUNDATION '
NOTE: Permits ior construction will be issued a minim�n of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceedir.g with the framing.
; � � 1 ':1
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building pe nnit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
�
w
WORKORDER
HOME PHONE: �?� d?�'
I ' SUSSEL � . = --
� NAME BUS. PHONE:
��� C���C� A DIVISION OF TME � '� '
i a u SUSSEL COMPANY, INC
� ` JOB ADDRESS �d�� �� �� ��'
' Permi� b� -
�
Legal Description BLDG CODE AREA 1
Lot
I Bik �'1-,��� ��=P�
Add'n SALESMAN CONTRACT DAT IZE
� Value FOR OFFICE USE ONLY �
Type Const. �•Q � ��_! • �
SLAB: CONTRACTOR JOB #
�$y SUSSEL '
❑ By Owner Approx.
❑In • �
2-STARTINGS POINTS ONLY ' . , '
S. P: L
S. S. P. L.
R.P.L. , . .
;
Alley � . , ... ,.
� House �
�
I F. Street �.
' Other � _
,
.
$'Sq�d'f�'With
�-FieeFs� . : .
Mesh ' ' :
- By � . �
, C�.�.��rc��X, � � i J
6-Bag Mix � . �� '' , .
9
(��ia �mpin Y ' � '
❑ A.B.U.�
' �Grade Point • ': �
� Conduit , , _ . .
; cs OwnerOBySussel _' ~ .
; $Mei++teiw��-Total Walk�
1 Height inciuding Biocks .
'; ��8' Wali Height on •
; Top of Blocks . � • �
'8"6TfTET'^ , '
� O.H. Dr Offset l�' . � ' : _ •: :
:; S.D. Locationd'(,�� �' '
Windows � '
t �
� ❑ Att Gar Roof Tie-in '
� Drawn on attached pictures �
` Existing garage: No!��p► '
� ❑ Detached ❑Attached Yes U � --
� � . . .. / 'f • . .. �
� Size of existing: — x — . �
� Existing garage will be: ''N "
;
� ❑ Left as is � •
� ❑ Cc�yerted to L.S. - By owner -
❑ Removed By: Owner 1.1
� Sussel f l c„ � �/I.G�'y�,�
� .
Junk Musi Be Removed By Owne� �_(�,.+
�
❑ 5pecify removals by Sussel • � ��
,.
or owner - trees, bushes, etc. ' '
� O Show approx. dist. garage to �, t"`_ : f.; �
' house and all prop. lines ��t��
� S ta kes visi b le - C 1 Yes � 1 No � ��"" � d � C J��'' �•
7 Survey available - C7 Yes j�No
� � Special i.nstructions from
owner:
� � ,�?�r-� �
� • PURCHASER`S INITIALS� - oiaecr�oN
P-9
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J AGREEMENT '
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� I, �a�c.¢� `� ���1Liti ��ii:���J4% . owner of the propezty : .
located at �� Q 7- ��c�n�� �� i% �.,�ave no c+bj ection to th� ,•
City allowing the construction of a ,� to be
iocated a /D `{-�' - (..t.,�,�.� �'f without the required
� ��✓--,.-,__ _
� � i'Y�v �
certificate o ey that^th�C�ity ordinarily requires for all new •
construction. ��r �
• �'��i,�
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f � �'.I�ZJ � .
Signature � � �
: _ : . � o � _ s8�
• � • Address . �J .���� �J1'
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SUBJECT P
City of Fridley � 1610 2
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � �
r
� � RE .
� ; L �����_ COMMUNITY DEVELOPMENT DIV. /-� /�, f
r � � PROTECTIVE INSPECTION SEC. O� CY 's/
� �
i
�( � �'��1 � CITY HAL� FRIDLE� 55432 NUMBER REV. DATE VAGE OF APPROVED BY
.���� / �.J
612-571-3450 910-F15 4/3/81 / /
�oe AooRess 1049 ��i Gardena Avenue N. E.
1 LEGA� �OT NO. BLOCK TRACT OR AODITION SEE ATTACHED
DESCR. 14 M2�-O�-�Ild Gdla@IlS SHEET
2 PROPERTV OWNER MAIL ADDRESS 21P HO
Mary A. Petersen 1049 Gardena Avenue N. E. 57�.-�197
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO.
Saane
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 C7x ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOFK
Reroof Structure
9 CHANGE OF USE FROM TO
STIPULA71oNS �of can be second k�ut not third roof. Ins.tall ridged galvani.zed
valleys.
SEPARATE PEfiMITS ARE REOUIRED FOR EIECTRICA�, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTI�ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OF ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEiiEBV CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATtON 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIEO $6OQ $. SO
WITH WHETHEF SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $7� 5O
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
�$•�0
Si N TUFEOFCON'RACTORO T RIZEDAGENT IDATEi WHEN PROPERLY VA DATED THIS IS YOUR PERMIT
� � � � �
Si ATURE O OWN IIF O NEH BU�IDEAI IDATEI BIOG iNSP ATE
� Ot�JtdER:
ADORCS
�
CITY pF' FRIDLCY •
APPLIC/1'fIO,�d F'OR RESI[)L"f�ITI/Fi_ QUILDI�IG PEE��IITS
(IJc��r, All:er��tions, /ldditions, or Rcpairs)
TEL nIO: _ c ]��/— �,�;%
��.�.
E3UI LDER : _^��y��-�1��'LQ� -
-_______..
�' IIDqRESS: - � ,
7EL I��O: •
� Consl:ruction Location '
• STRi�T NO: � STItEET:
L07.': _ / � BLOCK: ADDITION �''i%��(G��
�
Corner Lot: Insii3e Lot: Setback: Sideyards:
Ap�lic3nt attach to this form two Certificates of S'�trvey of lot and
. proposed building location drawn on certificates to scale.
. � DESCRIPTIOid OF COtdSTR�JCi'IOP� •
y �— I'ront: � Depth: Height: .
.�
Square. �'eets . Qzbic Feet:
, Front: DePth: Height:
Squar.e� I'eet: C�,ibic I'eet: �
Type af Construction : Estimated Cosi: _�� �Q
�._
Zb Be Oor,�pleted: . �
' . . Alt. A Alt. B
Proposed Driver�ay Width If New Opening Is Desired: $� $
, . .. S�� R�VERSE SIDE OF SHEET
7.5ie undersigned hereby m�ke� applicaticn for a permit icr the �;�ork� herein specified,
agreeing to c� .all wozk ir� strxct accordance �•�itii tlze Ci�y of I'ridle�r Ordi��ances and
rulings of L-he DeZklrtmei�t of Bui.Idings, and hez:eby declares that all tl�e iact� and
rcprescn E�Zti.ons stated ;n this applica
D�'lTE; G SIGNIITUF.E:
�
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� • �u��t}�i�1G 1'Cft�11�r r-er: sr.tir:nut_�� � .
:;)aC't`x01�� 2. �'�'1iL 7n�:��eetc�r. of 13u3.1c',ir�cJ ;::liril.t, befor.c: i.:;suing ��cnnits for t:he crc:cL•i.on
uf: .���y )�ui.J.�l:in�J az :�i:ruct:urc, or. �a�: tin}� ��dc�i.i:ic�n !:o auy cr,i.;:Ci_r�c� l�tiilcli.nc1 �r :stzucLura,
i�r.' l:a�' tu��y a1.L•eraL•io�i or. r.cl�t�ir.:; L•o •��ny c.:.i.::t:i»c� )nii.).di.�u� or. sLr.ucturc, u}��n ar����i.c:ata.on
't1i�:r.�f.or.c, r.cqu.i�-c th� l�aymc��t: ?�y U�c ar,pl.i.c:anl: xoi- such }?cr.mi.t of.� fees to tlie arn�unt-
hcrc:in bea.cn•i sc:L• f•or.th anQ i.i� t-hc mannci: hcrca.n p�:ovidccl L•�-t:a.L•: •
r7}:l•] CONS�PI:UCxIOI�: aingJ.e 3.'amil.y tJomes and Gar.ac{es: Y4.00/J.�O�Q cubiC tec:t:. .
P7..At� Clll:Ci:: ?.5 I�cr.ccr�t: oL• hui.lc3iiicJ J�c�-miL fce.
Ult]:VI:I'111' llL•'L'P.c:5SI0I•:: (ConcrcLc, �irb atzeets On�.y) ' � ”
' A).i-ern�-�t:e A: ltc:moval and re��laccment oi concxete cuzb and
qutter only; t�riveway i•�idth pl.us 6 ieeL• x$13. �0
R].tcrnate i3: Removal and rep�acemcnt of concrete curb and
.� guL•ter and i�lstall a 3 foot Y�ide approach �aith ='
' ,• 6 inch c�epth; Dra.vc��ay �•�idth �plus 6 feet x-515...75
• � . .gn�1 �� onn� t r��or�;�nT i oN
Ibr the purl�se of computzng tees for. bui].ding Permits,. L-he cubica3. coi:tents af any
k�uildi.ng or. addition, is dctcr.mi.ned by rnulL-iptyir�g L-he ground area covered tro:n a
poa.n'� sir. (G} inches belor� Lhe tloor ]_ine oi L-]le bas�-nent or th� cellar to thc
�verage heights of the �upper surface or L-o ihe average heiyht of the roaf. surf:ace
of the nain gab2e of a pitched rooi. • �.
For reF�zixs or a].terations L-o an existing structure, the fee shall be at the xate
of $3 .00 rcr. each fivc hundred dollars �� ($500.00) ar fracL-ion '�:ll�erc:of in fihe cost
ai al.l proposec� wor.k. . , '
In •no case sha�.l the fee cliarged fdr any penni.t as set torth i.n Section 2 be less �
tiian $7.50 plus $.50 state suxcliarge. � ' �
� . VERIFICATIO�! QF FOUr�DlITIO��
_ �
NOTE: Permits �or constructi.on evill be issued a minimum ai 24 hours fr.om t:he time
�f application to alJ.ota for proper rcview of the proposed si:ructure and oi the
construction site. �
I� Ceri:ificatc � of Surv�y of the lot, shoc,=ing the locati.on of the £oundation once a.t
has beei2 cons�nicted t.*a.11 be required k�ef_ore pr.ocecdi�lc� with the iram3.ng.
.�:13LI F I G/1TE OF �C�UP1II��Cti' � '
' ApplS.cation ior a Certificate of Oceuf�ancy shall be mad:� ten (10) days prior to the
u; e or oc�ir�ncy of any sti-ucture for :�hich a laui.lcii_ng perr,iit l:as been issu�d; and
sz�icl st•ru t_urc : hall. i�ot be uscd oz- occupied i:iztil a Ccrt�.iicate oi' Occuj�zncy has
bcen i,�sued.
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' April 3, 1981
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CITY QF FRiDLEY
6431 UNIVERSITY AVENUE N.E.� FRIDLEY, MINNESOTA 55432
Ms. Mary A. Petersen
1049 Cardena Avenue N.E.
Fridley, NIN 55432
Re: Address Change For Residence
Dear Ms. Petersen:
TEIEPHONE ( 612)571-3450
Per your request of April 3, 1981, we are listing the following change
of address for your residence; '
NAME: Maxy A. Petersen
FROM: 5901 Central Avenue N.E., Fridley, 1�II�T 55432
TO: 1049 Garde�a Avenue N.E., Fridley, NIld 55432
LEGAL: Lot 14, Meloland Gardens Addition
We have notified the following companies of this change and also various,
departznents in the City Hall. If you have any questions on this change,
please contact me at 571-3450.
Sincerely,
DARREL G. CLARK
Chief i3uilding Official
DGC/mh
CC: Minnesota Gas Company
Northwestern Bell Telephone
Northezn States Power Company
City Water Billing Department
City Assessing Department
City Police Department
City Fire Department
Minneapolis Post Office Department
Mpls. Star & Tribune
Voters Registration
/ ' ,, , �
;�, .-.... ��°
� �
l
� April 3, 1981
CITY t3� '�RIDLEY`
8431 UNIVERSITY AVENUE N.E., FRIQLEY, MINNESOTA 55432
TElEPHONE ( 812)571-3450
Minneapolis Post Office Department
Superintendent of Delivery
lst & Marquette Avenue
Minneapolis, MTJ 55402
Re: Change of Address
Dear Sirs:
We are listing the following change of address in the Ci.ty of Fridley:
NAME: Mary A. Petersen
FROM: 5901 Central Avenue N.E., Fridley, 1MIN 55432
TO: 1049 Garden Avenue N.E., Fridley, MN 55432
LEGAL: Lot 14, Meloland Gardens Additi.on
We have notified the homeowner of this change and we w.ould appreciate
it very mueh if you would change your records accordingly.
Sincerely,
DARREL G. CLARK
Chief Building Official _
DGC/mh
SUBJECT � P � ,--
c�ty of Fr�aley o _ _
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i � R .
� �
; ; y ._._._ COMMUNITY OEVELOPMENT DIV. �� ���
r � � PfiOTECTIVE INSPECTION SEC.
� �
i
l--•.� �����,,� CITY HALL FRIDLEV SB4$2 NUMBER REV. bATE �PAGE OF APPqOVEO BY
i 612-571-3450 9t0-F15 11/28/89 / �
10B ADDRESS 1049 Gardena Avenue N.E.
1 LEGAI LOT NO. BLOCK TRACT OR ADOITION SEE ATTACHED
DESCR. 1[� jy�2101d,riC� SHEET
2 PROPERTY OWNER MAIL ADORESS ZIP PHONE
Ma.ry Peterson 1Q49! Gardena Avenue N,E, 571�-0797
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO.
North Central Bui,ldezs 74Q1 � 42nd Avenue North., New Hope 55427 533-6168
4 ARCHITECT OR DESIGNER MAIL ADDRESS IIP PHONE UCENSE NO.
5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO.
B USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOHK
Reside Dwelling (steel siding--Alumi�tun trim)
9 CHANGEpFUSEFROM TO
STIPULATIONS
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING Ofi AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. fT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONED fOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION �- STALLS GARAGES
AND KNOW THE SAME TO 8E TRUE AND CORRECT. ALL PROVISIONS OF IAWS VALUATION SUHTAX
ANO,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OF± NOT. THE GRANTING OF A PERMIT $6 r 4aQ . $3. 2Q.
DOES N T PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHAqGE
PROVISI N Of ANY OTHER STATE OR IOCAL LAW REGULATING CON-
STRUCT ON OR THE PERP RMANCE OF CONSTRUCTION. SgQ � QQ
PLAN CHECKPEE 70TALFEE
�--� � ' ` � `r $23 , 2 0
IGNATUREOFCONTRACTORORAUTHORIZEDAGENT IDATEI WHEN PROPER�Y V DATED THIS IS VOUR PEFMIT
- �" _` l l eZ
SiGNATURE OF OWNERiIF OWNER BUILDERI IDATEI �.r BLDG WSP OATE
� ��
ADDN [ ]
ALTII2 � �
I�1 AND �2
Building Piermit Application
Effective 5/1/88
cbnstruction Aadre.ss: � ° - l r5 yq �'�+RM�.�/� � � � �� �.� � � r
Legal Descriptio�:
owner rr�e & Adar�s: �/I��r � 7�2 s o� �e1. #__�7 /- d 7 9 7
aoaztrac.-tor: _/Cj D C�w7'k A c. QL-D �el .#:533-�/6 �
p,ddress: 7 Y6 l �/� AV /►� d� �(i �G� �Fa O�. l+9,ru SSy- �-7
Attach to this applicati�, a Certificat8 of Survey of the
lat, with the px�q�osed c�.i� drawn on it to scale.
E� s: w; ��M •;, •i' ��i.: �.'�c•�i:�,�
LIVII�IG ARE�i: I�ength Width Height Sq. Ft.
c�R� ARE�,: Le�ngth Width Height Sq. Ft.
DDCK AREA: Leix,�th Width Hgt/Gra�nd Sq. Ft.
art�: �rs�oc s r��� .� � �,u T�e�,�.!
Corner Lat [] Inside Iat [] Ft. Yd Setback Side Yard Setbac�s
Z�pe of O�nstruction: Estimated Cost: $ �� �/a a�
Ap�rox. c:c�letion Date: ,�..� �� g�
Proposed Driveway Width If New Qpei.ung Is Desired: Ft. $ $
Width + 6' See Back Page
n�: 1 � ��c�,rrr: G� �. # ,� 533-6f��
P�ermit Fee $ �D • O d
State SuYrhar9e $ �.a b
SAC charge $
Driveway Escx�w $
Park Fee $
sew�er rtain Criarge S
TOR'AL $ �.
�s _
szz�TT�s: l�� .��
CITY � OI�bY
Fee Schedule on RevF.rse Side
$.50/$1, 000 Valt�atioa't
$575 p�x' SAC Unit
Alt. nAu or Alt. "B" Ai�ove
Fee Determined by E�ginaering
Agr+e�er�t xeoessazY [ J xot Neoessa�Y []
0
�, � �
I:���� � �, c ;:,�;�y�4 :�:w: : �:i:;��_��
"The Chief Building Officia]. st�all, before issuing permits for the ex�ection of ariy
buildir�q or structure, or fa� any additioaz to ariy existir�g buildii�g or structure, or
for ariy alteratioai or repair to any existing ?xiilding ar structure, upon applicatian
therefore, require the payment by the applicant for such permit of fees to the amo�uit
herein below set forth and in tt�e nanner herein provided to-wit:
TOTAL VAIIJE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 tA $100,000
$100,001 to $500,000
��.
$15 (Minim�a Fee i.s $15 Plus surd�arge)
$15 for first $500 plus $2 for eacii additional $100 or
frdcticn the.reof, to ar�d including $2, 000
$45 far first $2,000 plus $9 for each additior�al $1,000
or fractiw�► thereof, to ar�d including $25, 000
$252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to ar�d includiryg $50, o00
$414.50 for first $50,000 plus $4.50 for eac3i additional
$1, 000 or fractiar� thereof, to ar�d inclwdir�g $100, 000
$639.50 for first $100,000 plus $3.50 for each additional
$1, 000 or fraction ther�eof, to and incltuling $500, 000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1, 000 or fr<�ction thereof, to at�d incltld�ixig $1, 000, 000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each ad�ditional
$1,000 or fraction thereof
DRI�iF�iY �IaN EBG�OiW
(Oo�2�ete Curb Streets Only)
z
Altemate oA�� : R,�noval ar�d replac�ement of curb ar�d gutter ar�ly - Driveway width plus
6 feet times $13.50.
Alternate "B" : Reqaoval and r�laoement of curb ar�d gutter and install a 3 foot wide
approach with 6 inch depth - DrivEway width plus 6 feet tin�es $15.75.
�a• �.. a+� • •1' '�'il I��� •'�
P�e�mits for �on.structiari will be iss�ed 8 minitnnn of 24 hours frcm ttie time of
application to allaw for proper review of the prq�osed structure ar�d of the
ooa�structi� site.
A Oe,rtificate of S�vey of the lot, shawiryg the location of the fauxiatioaz onoe it has
it has be�n oonstnic�ted will be required before proeeedir�g with the framing.
.w.. .�..
�
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�
sue�ecr PER .-��
c�ty of Fridley 2 2 2 3 4
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� � .
� �
COMMUNITY DEVELOPMENT OIV. n
r �~ � PROTEC7IVE INSPECTION SEC. y��/
r �
� � �'�'1 � CITY HALL FRIDIEY 55a32 NUMBER REV. OATE PAGE OF APPROVED BY
�""� � ��� 612-571-3450 910-F15 11/12/93 � �
JOB AODRESS 1049 Gardena Avenue NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 14 N�eloland SHEET
2 PROPERTY OWNER MAIL ADDfiESS ZIP PHONE
Mary Petersen 1049 Gardena Ave NE
3 CONTRACTOR MAIL ADDRESS ZIP PNONE UCENSE NO.
North Centz'al Builders 7401 2 533--6168 3763
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAII AODiiESS ZIP PNONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW � ADDITION O ALTERATION C� REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reside Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REOUIRED FOR EIECTFlICAL, PLUMBING, HEATING, TYPE Of CONST. OCCUPANCY GFOUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK Oii CONSTRUCTION ZONING SQ. fT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OF WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
1 HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1' STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHEFi SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3 � OOO $1. SO
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $S4.00 Fire SC $3.00
PLAN CFiECK FEE TOTAL FEE
License SC $5, $63.50
SIGNATUFEOFCONiRACiOAOAAUTMOAIZEDAGENT IDATEI wN P VALIDATED THIS IS YOUR P�RMIT
k ( _� !
SiGNATURE OF OWNER �IF OWNER BUILDER� �DATEI � G iNS� �)pTE
1vEV�r
ADDN
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Constii�ction Address:
I.egal DescriPtion:
CiTY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
- �2 ner�!� ��v� _-I�i_o C-
Effoctive S/26/93
�y0a�
Ovvner Name 8c A�: '(1� A Q Y �e r'� �c s o►U Tel. �� � _ p � q'J
Coahactor: o rZ t- � ��v t�r �t �- %1j v t� n� K-f MN LICENSE A��
Addtess: (O � n �' �u , w o - L/ �
1`� 1- � 2 {� l� NP /� Q'� �i n- Tel. #.5 3 3 l
IdVING AREA: Length
At�ach to this application, a Ce�tificate of Smvey of the
lot, with die proposed aon�tioa drawn at it to scale.
DESCRIPTION OF IMPROVEMENT
Widdt Height Sq. F�t.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: L�g�h,� Width Hgt/Ground Sq. Ft.
o�R: �l �-s � o� 6� �� � r� F
Corner Lot [] lnside Lot [] Ft. Yd Se�ack Side Yard S�backs
T�rpe of Constn�ction: E�ed Cost: � � c? C� �
Appro�c. Completion Date:
(Cost on Back)
Driveway (�rb G�tt width rteeded: F+ 6 Ft = Ft a S =�
DATE: , �- �- - a 3 APPLICANT• a��•f' �J � Tel. # y 6��i R� �
5
Permit Fee
Fu�e Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Fscrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
s ���`�
� �
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�
S
1{ M ' � . _
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.SO/$1,000 Valuation
�750 per SAC Unit
� S, �=' $s.0o (state Licensed Residential Cor�a�acta�s)
$
�
S
S
� S�
� �
Alt. "A" or Alt. "B" Above
Conservation Plan Review S4S0.00
F� ���a by ���;ug
Agreement Neces.sary [ j N� Necessary [)
STIPULATIONS:
,,,�.
1� "
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing pexmits for the erection of any buitding or sbructure,
or for azry addition to any eusting building or strucdire, or for any alteration or repair to any eaisting
building or structure, upon application ffie�+efore, require the payment by the applicant for suctt permit
of fees to the amamt herein below se� forth and in the manner herein provided to-wit:
TOTAL VALUE
�1 to $500
$501 to $2,000
�,00i �o azs,000
$25,001 to �50,000 �
$50,001 to �100,000
FEES
$15 (Minimum Fee is $15 plus surcharge)
S 15 for first 5500 plus S2 for each additional $100 or
fracrion thereof, to aad including �2,000
$45 for first �2,000 plus $9 for each additional $1;000
or fraction thereof, to and including $25,000
$252 �for first� $25,000 pl�s �6.50 �ar each additional $1,000
or ftaction the�reof, to and including $50,000
$414.50 for first SS0,000 plus $4.50 for each additional
$1,000 or frac�xoa the�reof, to and including $100,000
$100,001 to �S(10,000 $639.50 for first 5100,000 plus $3.50 for each additional
51,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000
$I,OOU,001 and t�
$2039.50 for the firsrt $500,000 plus $3 for each additional
$i,000 or fraction thereof, to and including $1,000,000
$3539.50 for the first 51,000,000 plus $2 for each addi6onal
$1,000 or fraction �thereof -
DRIVEWAY DEPRESSION ESCROW
(Concr�e (�rb Stre�s Only)
Alterna�e "A" : Removal and replacement of curb a�d guttea only - Driveway width plus 6 feet times
$13.50.
Alternate "B": Removal and replacement of curb and gubter aad install a 3 foot wide.
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for coastcuctioa will be issued a minimum of 24 6ours from the time of application to allow
for proper review of the proposed structure and of the coastruction site.
A Certificate of Sunrey of die lot, showing the location of the foundation once it has it has been
constructed will be required before proceeding with the framing.
. .�
_ �,