AF - 45370, sus�recr PE
�ity of Fridley . 1452
AT THE TOP OF THE TV�tINS � U I L D I N� �� R M I T
�
, � CEIPT NO.
COMMUNtFY' DEVECOFMEN7 DIV.
r i YT- -_-� PROTECTH/E 1N&PECTION SEC. f��8�/,�
1 ., � _. 0
il ��� Y"�+1 ��� CITY HRIL .. FRIDLE� SS432 'NUM$ER " REV. OATE ����� PAGE OF APPROVED BV - .
L���.lt..i `•� 812-360•3450 � �
910-f 15 12/ 14/7 7
�os AnoRess 1494 Gazd,�na Avenue N. E. <
1- LEGAL ��TNO. BiO�K TRACTONADDITION SEEATTACHED
DESCR.;- P�i'e81 III Fdi� Of 't Zsi Audi:tor's Stlb. #92 SHEET
2 pF►ppgt�Ty p�fy�R MAfL ADDRESS ZIP PHONE
' M�rris L,t�ng�rbone 1494 Gardena Avernue N.E.
3'CONTR�ICTOR ' MA4L ADDRESS ZIP PHONE UCENSE NO.
B�att-Palen Builders Route #3 Box 197A . Zsari�a. Mn. 742-9371
4 ARCHITEGT�R DESIGNER MAIL:ADDRESS ZIP PHONE LICENSE NO.
S ENGINEER MAIL ADDRESS PHONE LICENSE NO.
8. USE OF `BUII W NG
D0 NOT PLAN7 OR PLACE ANY•
Resi entiaT �
� Gu►ssOFwOAK � NEW ` ❑ ADDITION O ALTERATIC�NR����F ���A�Y ��' ��j'�1�E ❑ REMOVE
X ,.
.8 DESCFi1�EVMQRK
Cons et a 25' x 3' Dw li and a 36' x 24' Ga�a e
;
SE#�ERATE PERt�11TS �E tREU` F tN
9 CHANGf OF USE FROM HEAT�1 �1ri, P1..t1M81NG AND SIGNS.
STlPUL,ATtON:S provide a hard �urface driveway. Provide sod in the front and side
-_ -.° yasds. Provide a verifying survey befor� capping. Provide 2 x 8 inch
.floor joist minitnum or provide alternate approved design by 12/30/77.
W�� SZ'OP BOX 38. 6' from the N.W. corner esf hou�e; 40. 7' N.E.of power pole,
53.6', east af hydrant. -
;SEWER 11' south of stop box.
, °Y" El�vati.on: 966.11 .����
SOUTIi iNVERT OF MAt3HOLE 966, 09
�o� oF,F�oa43r'c�r;u +a�r� s69.ii Before digging cail locai utilities
�'�� ���� r�et�t Gua�t:,t�'� t: �; rr� tELEPHONE - EL�CTRIC - GAS Etc.
, ,ti�:;U1ZAC;Y CiF UTILliY �:'C4CA'�tONS AND ELEYATiGr..��
r�ss oArA ts rort w�o�u� �v�os�s or,tY �uvo REC,?U � R� �J BY �A�W
�r�s usu� a s� v�r � �o�,,n�
Ot�! Ttt� SITE
SEPARATE PERMITS AREREQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF.GONST: OCCUPANGY GROUP OCCUPANCY LOAD
Y€N7�LATING. OA AIH CONDITIONING. WOOC� E�1'dIC4@
THt� RERMIT. BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZdN�NG $Q. FT. CU. FT.
AUTHORIZEO IS NOT COMMENCED WITHIN 60 DAYS, ORiF CONSTRUCTION j.$�� -j� 864 35, 424 Total
OR WORK-IS SU$PENDED OR ABANDONEO FOR A PEFiKiD QP 1ZO DAYS AT
ANY TIME AFT�R WORK IS COMMENCED. NO. ` DWLG. UNFTS - OFFSTREET PARKING
I HEA6BY CERTIF'Y THAT I HAVE READ AND EXAM{NED THIS APPLICATION �- STAiL,S GARAGES
ANO KNOW THESAME TO BE TRUE AND CORRECT, qLL PROVISIONS OF LAWS VACUA7fON ' SURTAX
AND ORi�INANCES GOYERNING THIS TYPE OF W�RK WILL 6E COMPLIED $.r�•l ��19 $28.96
1NITH WHETHER S�'�CIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DpES Np7'PR�SUME TO GfVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE' SAC CHARGE
PROYtStONS�OF ANY., OTHER STATE OR LOCAL LAW REGUI.ATING CON- $1��� 7Q $3'�5.00 Cr. fr. Wre king
$T}ql9GTION; Fi THE'PERFORMANCE OF CONSTRUCTION. '
PLAN CNECK FE� TO �8, r
� 35.42 $246.08
Sl(iNA7UR�'4f�GIINi.fiACTOfiOFAUTHOHIZEDAGENT (DATEI �1F/j�{EJ�J i!iiCiF�FLY�VACIOATED THIS IS VOUR PERMIT'� '�
— _������� c
�a -ia'-� 7 �
516NATURE-0FOWNERU:OWNERBUILDERI � IDAT �4 ' � ��
BIDG �NSP� DATE
- . . . ... _ . . . _ . . .. . . ,!
. . . . . . . � . . � . � � . . . .. . . .. . . � � � �'�
\
CITY 01= F(ZIllLEY
APPLICATIOt'J FOR RESID�NTIAL BUILDING PCRMITS .
ii�EW, nLTLR�TIONS, �iUllITIO(�5, Of2 REPAIRS)
OWt��R: I3UILU�R: �� — ��"5^- ��
Address: Address: � � ( /� �
Tel. No. : %�f�- � `% 37/ .
No.: 7 Street: -�
�� � � �- � - 4� �
LOT: �IACY.: f ADDITION:
CO22NER LOT: INSID� IAT: S;:TBIICK: SIDEYnRD5:
Applica'r.t at�ach 'to this form �ao Certi�icates of Survey of Lot and proposed
building location drawn on these Certificates. �
DESCRI PTI Ofd OF BUI LDI fJG
To sed As: �
� �l x ��°
Front: �� ' Depth: �� Height: ��
Square Feet: I�j� Cubic Feet: �8,5 /�
_.+�C.� ` ' r
I'ront: ��� Depth: ai Height: � �
� Square Feet: S� 7 Cubic Feet: �`1 ��'
�eype of Construction: ���� ����-}-�ri� J Estimatea cost: S �S `7, �9�9
Rb Be Completed:
Alt. A Alt. B
Proposed Drive�vay Wid� If New Opening Is Desired $ $
(SE� REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work lierein
specified, agreeing to do all cvork in strict accardance with the City of
Fae'idley Ordinances and rulings af the Deoartment o� Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. See reverse side far additional information.
DAT�: _ f����� SIGNATUTtE: aG�`�� I`1 -`��iC
Stipulations: . �,
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HE�1T LpSS CALCYLATIONS DEPARTMER� Of BUILDINQrS VILLAGE OF CHAMPLIN
Weatherstrips �� Construction No. Insulation
Windows I Doon ^ Refereau Out. WaU Int, Wall Ceilin� Roof Floor Kind HoM► APpGed
Yes—IVo �Ro 19
Fl.� Room Len`th '�C' Rlie�h � He�ht Fl.� Room Len`th Width Hei�ht
Windowa and Doors---Crrckase aad Area Wiodows and Doors--Craeka�e and Area
�viacn H•ishe No. ot tra.a� r. wr.• IAtA x.�see rra ec e.ai t�. wn.
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Coef. &a
In6ltntion �7 � a 4 9 �
CJass 3 S2 �� / 7 � �
F�p. wall j S%
Net e:p. wal) � o S O
Int. wall
Ceiling �o ° S O Q �
Floor � C� /C1 'j $ !�
Total Btu.
Required aq. h. E.D.R. or q. ins. W.A. Leader area
Fl.� Rcom l.en�th Widch
Qliadows and Doocs--Cr�cka�e and Ares
Wld b Hsltbt No. ot Lla�al tt. ArN
Na of wns ot wn� Ilr,t� ot cracic �a. tt.
�
1n61tration
Glass
E:p. wall
Net up. wsll
Int. wall
Ceiling
Floor
Total Btu.
CoKf.l Ben
Required sq. ft. E.D.R. or �q. ins. W.A. Leader ana
FI. Room � Length Q/idth
WindoNn and Doors--Cracltage and Area
wlaeh x•t�hc No. ot tle.�l «. wrea
No. ot yan� ot p�e� II�At� ot crsek p. tt.
�
In6ltration
Cdaa
----_..
E:p. waU
�,
Net �p. w
Int. w�p
Ceiling
f loor
Tetal &u.
Required aq, ft. E.D.R or �q. uu.'�/A. Leader arc�
Bhl
B�Y
In6laation
Glau
��
Net �p. wall
In� waU
Ceiling
Floor
Total &u.
Rcquired w. k. E.D.R. or p. ins. W.A. Leader area
Fl.I Ro� I Lensch Width
Windows and Doon--Cra�kaie aad Area
Wldte 1I�ISnt No. ot Lln�al [t. Ana
No. o[ v��� et own� Iltev ot er�elc q. tt.
Infiltratioe
G{au
Fsp. wall
Net esp. wall
Iat. wall
Ceiling
Floor
Total &u.
Requued sq. k. E.D.R. or sq. ioi. Q/A. l.tadet ues
Fl.� Room I I.en�th Widch
Wiadown aad Door}-�raelca�e aad Ares
T WIdtA R�I�At Na o! Lln��l It. T Ar��
Ne. e[ o�n� e[ we� Ilrst� OI Cf\CI[ �u. tt.
Coef. Btu
Infiltratioa
Glass
fsp. wall
Net e:p. waq
Int. wall
Ceiling
Floor
Toeal &u.
Required q. h. ED.R o� �q, i�s. WA. Leade� a�ea
6ROOKlYN ►RINTING i AOV. CO.
�
0
� CITY (�l� f-fZIl)L�Y , 1���
' 1►PF'LIC/',TIU11 f"Uft (;I:SIIJ(=tJTi/1L L'iJli_DIi��G ('!_f�(•1ITS
' if'�LW, �LT�Lfi/1TIUI;�, j11)llITIUf��, OR RL=P/�I(25�
� �����
�t;t?L•'R: �d�P1{/S z.o�✓GG n �oIV�' r.UZLllJ.Ii: .
r�aaz���•:, : �9 � G�R���A A✓L naar���s : '
0
Tcl. i�ia.: �7�`09�b 4`y –� /f.
No..
LOT:
Street:
I3I�JCY,: ADf�IT70'i�:
CO}tl�l}_'R LOT: INSIDP LC?T: SLTPIICY.: SIDEY�'�I:DS:
Applzcai.t a'�tach L-o Lhis fonn 7`•�o Cer±:ificat��s of_ Survey of Lot and pro��osed
buildir�g location dra�r�n on these Certificates. .
Ta ]:e Us ed I:s :
DFSC�IPTIGfd OF BUILDI(�G
Frent: Depth: � Height:
Square I'ee�; Cub?_c Fee,t.:
�ront: Depth: Heiqht:
Squaie I'eet: �1bic Feet:
Typa of Construction:
Esti..-naL-ed Cost: $
ib I3e Completed:
— Alt. A Alt. B
6°
Prciposed Driveway Zti'idth �f l�e.�a Op�ning Is Desired �� $,37% $
(S�� 1Z�VERSE SIDE OF SHEET)
The uriclersig:zed ,�ereby makc.s akr�lication for a ge. r,iit €or the work lierein
specificd, agreeing t.o do all �.ork in stiict �3ccordance wit_h the City of
Fxidl.ey Oi-dii:a�lces and rti]i�lgs of tiie Dcl?a.rt;;ietit of }�tiildings, ai�d licreby
deelares that all the fac+�s and represcntations si:ated i�i tilis ap�licai:ion
aa:e Lrue and cozrect. See reverse side for acltiitional ii�forn�ai:ion.
.
DAT�: '7' ' � � ' � � STGI�'ATUP.I::
Stipulations:
0
0
:9
,��.. ..
CITY' OF FRIC�LEY
8431 tINIVERSITY AVENUE N.E., FRIDLEY, . MINNESOTA 55A32
' TELEPHONE ( 812)571-3450
11, 1978
Don Bratt
Hill Wind I�ad N.E.
iley, IMIl�T 55432
Re: Final Inspection at 1494 Gardena Avenue N.E.
Dear.Mr. Bratt:
A final inspection was made on May 2, 1978 of the above address and
the following iteqns were noted which must be campleted before the
canstruction can be finaled aut;
1. Install house nianbers on structure by May 15, 1978.
2. Install separation wall in garage by Ma.y 15, 1978.
3. Protect plumbing stack from impact i�nediately.
4. Cbmpletely fiserock all c�bustible surfaces in garage by
May 15, 1978,
5. Provide sod in the front and side yards by October ld, 1978.
6. Provide a hard surface driveway by October 10, 1978.
7. Complete pl�uabing final by May 15, 1978.
We will expect the above it�ns to be completed by the scheduled dates
when reingpections will be made to determine campliance. If you have
any questi.ons on these items, please contact me at 571-3450.
Sincerely,
FIUN HOLDEN
Building Inspector
RH/mh
CC: Mr. Morris Longerbone
3 f� � Y
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�`� �
;�� � � x� June 7 19 78
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8431 UNIVERSITY AVEt�UE N.E.,. FRIDL[Y, MINNESOTA 55432
��• Mr. Don Bratt
� Bratt-Palen Builders
�:.
x Route #3, Box 197A
Isanti, MN
Re: Final Inspection on 1494 Gardena Avenue N.E.
Dear P4r. Bratt:
TELEPHONE ( 612)571-3450
A final reinspection was made on June 6, 1978 of the above address
tA check on the separation wall. It was noted that the owner will
install the separation wall by September 1, 1978. It was also
noted that a handrail on the front step.had not been installe.d. We
wi.11 expect this to be done by you on or before July 15, 1978.
Our files also indicate that you have not submitted a copy of a
verifying survey of this address. We will expect this to be
submitted on or before July 15, 1978.
If you have any questions on these items, please contact me at
571-3450.
Sincerely,
RON HOLLlEN
Building Inspector
RH/mh
CC: Mr. Morris Longerbone
i
sua�ecT PER
� +�ity of Fridley 14952
AT THE TOP Of THE TWINS B U I L D�� G P E R M I T
� � RECE .
r ; L_ .__ GO�tMUN4TY DEVEEOPMfNT DIV. ����O
� � PROTEG7IVE INSP@CTION SEC.
t = .
�, /"'�1 � CITY HALL �� FRIpLEV . 55432 �NUMeER REV. DATE PAGE � OF APPROVED BV
���•h � ,•J g13�60-3450
910-F15 10/6%78 � �
�os nooRess 1494 Gardena Avenue N.E.
1 LEGAL LOT NO. BLOCK TRAC'� OR ADDITION SEE ATTACHED
DESCR. PdPG@�. � Pd,i� �� 't. ZS A11C�. SLlU. ��i SHEET
2 PROPERTY OWNEH MAICAQDRESS ZIP PHONE
Morris Longerbone 1494 Gardex:a Avenue �T.E.
3 GONTRACTOR MA1l ADDRESS ZIP PHONE UCENSE NO.
aa�ue
4 ARCHtTEGTORDESIGNER MAtLADDRESS Z�P PHONE LICENSENO.
5 ENGINEER MAILADDRESS 21P PH4NE LICENSENO.
6 USE OF BUILDlN(i
R��1..G�Atldl
7 CLASSbF WpAK
❑ NEW ❑ ApDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 36' x 8' Deck
9 CHANGE OF USEfROM. TO
STIPULATFONS
SEPARATE PERMITS ARE REQUtRED FOR ELECTRICAL, PLUMBIN(i, HEATING, TYPE OF GON3T. OCCUPANCY GROUP OCCUPANCY LqAD
VENTILATING OR Atq COTiDITI�WING. T���
THIS PERMIT BECOMES NULL"AND VOID IF WORK OA GONSTRUCTION ZpNING SQ. FT. CU. Fi:
AUTHORI2ED IS-NpT COMMENCEO WITHIN 60 DAYS, OFilF CONS7RUCTION
OR WORK IS-SUSPENDED OR ABANDONED FOR A PERIaO OF 120 DAYS AT
ANY TIME AfTER WORK IS GOMMENCE0. NO. DWL{'r. UNITS OFFSTREET PARK�NG ;
I HEREBY CERTIFY THAT I HAVE READ AN� EXAMINED iHIS APPLICATION �' STALLS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF I.AWS VA�UATION SURTAX
AND OROINANCES GOVEi;NINCa THIS TYPE OF WORK W1LL BE COMPUED.
WITH WHETHER SPE6IFIED HEREIN OR NOT. THE GRANTING OF A PEFMIT Sl� SQQ S• 7�'
DOES N07'PRESUME TO GIVE AUTHORITY TO VIOlA7E Of± CANCEL THE pERMIT FEF SAC CHARGE
PROVI310NS OF ANY OTHER STATE OR LpCAL LAW REGULATING CON-
STRUCTION' OR. THE PERFORMANCE OF CONSTRUCTION. $9. OU
PIAN CHECK FEE TOTAL FEE
$9.75
SIGMASUREDFCONTRACTORp � UTHORIZEDAGENT � (DATEI � EN PROPE LY VALIDAT D THIS IS.YOUR PERMIT�
s � l �j�.¢•,�
. �o�„c.. d � - ,7 � . 1 d
� f6NA.�U OfOWNER�iFQ NER� DER) IDATEI- � � �.BLDG.INSP � � � DA E �
.
... . . . . � � l . . .
CiTY or- r-�z�»�cY
, 1 .����.
��: -
' AP�PLI C/1TI Oli FOft iZLS I ll(:tdT I11L IIU I LD1 riG PEI�I�i1 TS .
' (�1�[:W, �LTL"Rl1TIOfdS, �llUIlIO(JS, OR REPA1(2S)
• . . . �, ���! .
. OWt2�R: 4�?.u.�J ?3UILU�R: � �` �, - -'��—
�aar�ss : �7� �'1 � o / G - Address : �
. • Tel• N0. /�� /n / / �� •
No. f Street: ��Qif1CL � .
� R-�c.�.+.. �cQ - � , '�E.9��
�ax; � r�r.,ocr,: r�nDZTZOra:
/�`i .' oT CD'ra�
C012NER LOT: I2JSIDT•.' LOT: S;:T}311CY.: SIDiYRRDS:
0
Applicart attach �to i;his fonn �oo Certificates of Surv�y of Lot and proposed
bui.lding locat�an dra��n on these Certificates. •
DESCRI PTI Oi�d OF BUI LDI hG
To }3e Used 1�s :
�t G �
�►J�:.lJ—� Front: �� Depth : • C� ' Height: � �� ��-u�
Squ�re Feet: Cubic Feet:
-- _ _ rront: � Depth: . Height:
' 5quare Feet: Cubic Feet: �
Type of Construction: ��'� ' Estimated Cost: $/�-���
�b Be Completed: �� �°/7� Alt. A Alt. B
�
Proposed Driveway Width If New Opening Is Desired $ $ '
(S�� T2�l�ERSE SIDE OF SHLET)
The unciersigned hereby makes application for a permit for the work herein
speeified, agreeing to do all e.ork in strict accorc�ance with the City of
Fxidley Ordinances and rulings of the Department ai Fuildings, and hereby
decl.ares L•hat all tlze facts and representatians stated i�i i:3�is applicatian
are true and correct. See revcrse side for aclditional iniorniation,
DATE: �(/ l i i�� SIGNATURE: '�-'�'o`-'
Stipulai:ions :
6 �
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-+
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� TMS CITY O� ,
DIAECTORATE o0
a •�
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. ��,
MEMORANDUM
�` PUBLIC WORKS �� ' .���.
� � �� �'
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� OATE �.� � ���-
�t p 4
FROM 'QP.1AI John G. Flora TO
SUBJECT Repair of La�ra at 1494 Gardena Nasim M. Qureshi, City Manager
�
v
�
Councilman Schneider rec}uested information on #he above in his memo
dated June 9, 1983
The property is owned by Merle Longerbone's brother. This winter we
made an emergency repair to a sewer blockage at this location. A
permanent fix is still required.
Our backhoe has either been non-operational or required for emergency
work. This work order is next scheduled for completion and should be
accomplished within the next two weeks.
When we make the permanent repair, We will complete the entire project
iacluding landscaping.
JGF/mc
cc : Ralph Yoll�an
Attachment
s� -��.
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::��� }� �.
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����;4k.� �
ACTION I INFO.
CIZY OF FRID�EY
MBI�lORAPDDIYi
'1�:
JOHN FIDRA, P[�LIC �ARRS DIRDClOR
FI�M: DENr1IS 9C�i�EIDER
SUBJFX.T: REPAIR OF I�AWN AT 1494 GAItDII�1
L1ATE: JOI� 9, 1983
Nasim, I have just received a call from Mr. Longerbone at 1494 Gardena Avenue
regarding the repair of his lawn. It ap�ears that sometime last winter the
City came out to repair a sewer blockage and had to dig up a portion of the
yard at Mr. Longerbone's home. He indicates that the problem was a City
probleqn and that the City did, in fact, repair it and agreed to fix his lawn.
He indicates that he has called City Hall at least three times since Spring
and each time has been pranised that his lawn would be f ixed at "the beginning
of the week". He says he called last week and spoke with Russ in Public Works
and was again told that the lawn would be f ixed at "the beginning of the
W�k n
It is now wednesday night and no one has been out to do anything with regard
to his lawn. He argues with justification that when he built his hame, he was
required to complete his landscaping within a specif ied period and that the
City should honor their conunitments also.
Please look into the matter and as you know, I will be on vacation for the
next week and one-half so I would hope that by the time I return there will
have been two more beginning of the w�eeks and that the lawn will be repa ired.
If there is a problem and the City is not about to repair it, Mr. Longerbone
should be told about the reasoning and I would, also, like to have any kind of
background inforn�ation you have.
Thank you for your help. I trust you will handle this matter in my absence.
DS/bd
2/1/1/2
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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 OIV.
r � v � PROTECTIVE INSPECTION SEC. �O�
� �
� , /"'1 � CITY H A�� FRIDLE� 55432 NUMBER REV DATE PAGE O: APPROVED BY
�'""'� � ,�J 612-571-3450 910-F15 9/3/96 � �
JOB ADDRESS 1494 Gardena Avenue NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. Pt 28 Auditor's $tlb. ��92 SHEE7
2 PROPERTY OWNER MAI� AOORESS ZIP PHONE
William Simms 1494 Gardena Avenue NE
3 CONTRACTOF MAIL ADDRESS Z�P PHONE UCENSE NO
Westphal Roofin 686 141 Ln NW, Andover MN 55304 786-7000 3739
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PNONE UCENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION p ALTERATION � REPAIfi ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Gara e(24 sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED FOF ELECTRICAL, PLUMBING, HEATING, TY�E OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTILATING OR AIF CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. FT.
AUTHOFI2ED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WOfiK IS SUSGENDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCEO. NO. DWLG. UNITS OFFSTqEET PARKING
I HEREBY CERTIFV THAT I HAVE READ ANO EXAMINED THIS APPLICATION 1 STALLS GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VALUATION SURTAX
WI H WHENHER SPECIF{ED HEREINIOR t�OTOTHE GRANTING OF AO ERMIDT �1f98O �.99
DOES NOT PRESUME TO G�VE AUTHORITV TO VIOLATE OR CANCEL THE pERMiT FEE SAC CHARGE
PqOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $62 � 25 Fire SC ��.. 9H
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTAIFEE
License SC $5.00 $70.22
GNaruaEOFCO � nCTOa RAUTHO AGENT IDATEi WHEN PAOPER �ALIDATED THIS IS YOUR PERMI�
� �
SiGNATUFlEOFOWNEF�IFOWNERBU�LDE�71 iD�TE� �g�p p �IiTE
NEW � ] Effective 3/1/96
ADDN [ ] CITY OF FRIDLEY
ALTER [� SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2 O
Building Pernut Application r C'� �
�,�
ConstructionAddress: �� � � � �- C��� �--
Legal Description:
Owner Name & Address:
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECS AItEA:
OTHER:
0
m
Tel. #
MN LICENSE #� 7 _� �
Tel.# 7�(�-'�oO�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
Length Width Height
Length Width Height
Length Width HgtJGround
��l,n.� .e.��_ non� ( 0['7 � � 1 �L�1 U
Corner Lot j) Inside Lot j]
T�p�e of Construction:
Approx. Completion Date: _
Sq. Ft.
Sq. Ft.
Sq. Ft.
� � (
Ft. Yd Setback Side Yard Setbacks
' Fstimated Cost: $ _ %���iC� s -
(Cost on Back)
Driveway Curb Girt Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �- 3- Q� APPLICANT: Tel. #� � jy ---�o o C�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
� ��, a�
$ ����g
$ � �'/ I
$
� �. ov
$
$
$
$
$ �i .
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50!$1,000 Valuation
$900 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:
-- - _ �
Building
Inspections
763-572-3604
763-502-4977 FAX
DATE�
r
SITE ADDRESS 1
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSURANCE
PROPEItTY TYPE
PERMIT TYPE
TYPE OF WORK:
DESCRiBE WORK BEING
SIZE OF IMPROVEMENT
ROOFIlVG
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
O Vinyl
❑ Aluminum
❑ Other
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTNE 1-1-09
YOUR E-MAIL ADDRESS
❑ OWNER
PHONE:
CITY
STATE LICENSE #�� v�v� L� EXP DATE
�.-c��
�INGLE FAMILYMEW CONSTRUCTION
❑ TWO FAMILYMEW CONSTRUCTION
O ADDITION 0 GARAGE/SHED
❑ BASEMENT FINISH �OOF
0 DECK ❑ SIDING
❑ SW[MMING POOL
❑ NEW HOME CONSTRUCTION ❑ ADDITi
❑ MAINTENANCEIREPAIR C'a'S2EMOI
❑ HOUSE ONLY
❑ HOUSE & GARP.GE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
❑ Trim
❑ Fascia
WINDOWS
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
NUMBER OF
FAX !(OS' [��
SIZE
STORIES _
WIDTH
❑ DRAIN TILE
❑ OTHER
Permit No.:
Received $y:
Date Rec'd:
STATE ZIP,
0
STATEIMAJ ZIP�
r
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor ptan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
and proposed project.
2. Two sets of consWction plans
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
SI�TG THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ S OCCUPANCY TYPE
Permit Fee $ C�� ,�� See Back Page for Fee Schedule
Plan Review $ 65°/a of Building Permit Fee
Fire Surcharge $ � .001 times the total job valuation
Surcharge $ .0005 x Permit Valuation Minimum $.50
License Surcharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $20Q0 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft+ 6 ft= ft x$22 =$
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary () Non Necessary ()
� Total Due $ p,�— Make checks aavable to: Citv of Fridlev Attach
THIS IS AN APPL[CAT10N FOR A PERMIT-NOT VALID UNTIL PROCESSED
lations
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that 1 understand this is not a
permit but only an application a permit and ork is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of ich eq ir s review and approval of plans.
SIGNATURE OF APPL[CANT PRINT NAME�L� <<�c� DATE � t �
Building
Inspections
763-572-3b04
763-502-4977 FAX
DATE �P/ ( / U"�
SITE ADDRESS j'i
THIS APPLICANT [S:
PROPERTY OWNER/
I TENANT
I
; CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
' AND CERTIFICATE OF
INSURANCE
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORI�:
DESCRIBE WORK BEING D(
SIZE OF IMPROVEMENT
ROOFIlVG
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
O V�y1
❑ Aluminum
❑ Other '
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTNE 1-1-09
YOUR E-MAIL ADDRESS
❑ OWNER
ADDRESS: !`Z Y `�_(,���,rLy. b'`iy'C CITY
PHONE:
STATE LICENSE # OC��2 a(v� L� EXP DATE
ADDRESS: [-lJ��__ ��-.�- �"� CITY �
rs-.-��
�SINGLE FAMILYMEW CONSTRUCTION
❑ TWO FAMILY/NEW CONSTRUCTION
❑ ADDITION ❑ GARAGE/SHED
O BASEMENT FINiSH �OOF
❑ DECK ❑ S[DING
❑ SWIMMING POOL
❑ NEW HOME CONSTRUCTION ❑ ADDIT�
❑ MAINTENANCE/REPAIR f'H�EMOI
WINDOWS
IN EXISTING OPENINGS ❑Yes ONo
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF, WINDOW TO BE MSTALLED__
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
FAx l(oS' lt�'
SIZE
STORIES
❑ WINDOWS
❑ DRAfN TILE
❑ OTHER
HEIGHT
Permit No.:
Received By:�E
Date Rec' d: f a I
ATE Z1P,
0
ATELr1iU ZIP�
F'I'
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
OSoffit ADDITIONS. & PORCHES SUBMIT:
O Trim 1. Site Plan/Survey showing the existing structures
❑ Fascia and proposed project.
2. Two sets of construction plans
3. Energy Calcutations
LOCATION OF WINDOWS
OF
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
SI�iG THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ S OCCUPANCY TYPE
Permit Fee $ C�,� ,��b See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Fire Surcharge $ � .001 times the total job valuation
Surchazge $ .0005 x Permit Valuation Minimum $.50
__ _
License Surcharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft+ 6 ft= ft x$22 =$
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary O Non Necessary O
� Total Due $ D+ Make checks aavable to: Citv of Fridlev Attach
THIS IS AN APPL[CATION FOR A PERMIT-NOT VALfD UAfTIL PROCESSED
lations
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application a permit and ork is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of ich eq ir s review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME_ .J/CG� l�>rid'y� DATE � l��