AF - 45511s�e�ec� l P N -
� City of Fridley � 1557 �
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"��"�'°�°��"��w�'"s BUILDING PERMI� �
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�y______ COMMUNI7Y DEVELOPMENT �IV. C�7G�T�
� r � PROTECTIVE INSPECTION SEC.
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1 �
�"'"1 � CITY HALL FRIDLE� 55432 NUMaER aEV DnTE vnGE oF qve ovEO Bv
� """"� � ,'� 612-571-3450 910-F15
11/21/79 � �
�oanooaess 1601 Gardena Avenue N.E.
1 LEGAL ��TNO. BLOCK TRACTORADDITION SEEATTACHEO
oesca. S. 110' o Lot 23, E. W 30' & S 30', Auditor's Sub. #92 s"EET
2 PROPERTVOWNER MAILA�ORESS ZIP ��� PHONE
Allan J. Fehn 1601 Gardena Avenue (2b be changed to � Benjamin Street)
3 CONTRACTOR MAILADORESS ZIP PHONE LICENSENO.
Same 574-1736
4 ARCHITECT DR DESIGNEP MAIL ADDRE55 ZIP PHONE LICENSE NO.
5 ENGINEER MAILA�DP , �a�10�/,A�j(/(�6ENSENO.
� � t C�
6 USEOFBUILDING '
Residential
7 CLASS OF WORK
J NEW ❑ ADDITION C ALTERATION C REPAIR C MOV REMOVE
X
8 DESGRIBE WORK .
Con t t 24' x 20' Gar e and a 40' x 26' Dwellin Before digging cafl IoC ''� �;i�g
NE - Ei.EC?It;;' - G,�� tr.
9 CHANGEOFUSEFROM T� . ��� n����
STIPULATIONS provide a hard surface driveway. Provide sod in the front and side
yaxds. Provide City with copy of verifying survey before capping. We will
change existir�g house nwnber £rom 16Q1 Gardena Avenue to 1521 Benjamin St,
upon completion of this new home and notified by owner/builder.
Driveway nepression Escrow Paid: 20' + 6' = 26' x$15.75 =$409.50 for new
depression off Benjamin Street for existing home.
Paid $400 Park Fee�and $800 Envimnmental Impact Fee
Sewer & Water Locations; Services to existing house will be used by new
dwelling and existing house will have to have new servioes off from
Benjamin Street.
TVPEOFGONST. OCCUPANCVGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REOUIFED FOR ELECTRICAL, PWMBING, HEATING,
VEN7ILATING OR AIR CONDITIONING. WOOCl FTdID2
THIS PERMIT BECOMES NULL AND VOID IF WORH OP CONSTRUC710N ZpNING SO. FT. CLL FT.
AUTHORI2ED IS NOi COMMENCEO WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WOPK IS SUSPENDED OR ABANDONED FOA A PERIOD OF 120 OAYS AT .�LO4O �' �IBO ZS� %OO TOtdl
ANV TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
I HEflEBV CERTIFY THAT I HAVE READ AND E%AMWED THIS APPLICATION ], STALLS GARAGES
ANDKNOWTHESAMETOBETRl1EANOCORRECT.ALIPROVISIONSOFLAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIRED HEREIN OR NOL THE GFANTING OF A PERMIT $3H�OSS $19.03
DOES NDT PRESUME TO GNE AUTHORITV TO VIOLATE DF CANCEL THE pERMITFEE SACCHAPGE
PROVISIONS OF ANV OTHEP STATE OR IOCAL LAW REGULATING CON-
STRUCTION OR THE PEFFORMANCE OF CONSTRUCTION. $�.OZ.HO 5425.��
PLANCHECKFEE TOTALFEE
� 25.70 $572.53
�' ��iJPeoFLC�uia4CTOaOPnulNOa�¢/eonG�ENr ��niEi yNHEN PFOPERLV V LI�ATED THIS IS'/011fl PEPMIT
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CITY OF FRIDLEY
ARPLICATIOiJ FGR RESiDE�dTIAL 13UILDIPJG PERt•1TTS
(P!evr, Alterations, Fluditione, or Repair�s)
Qtd�dER: , ,LLAn/ J- ���`/n/ _
.5�'ra� �.JSF�m �Al .�� 2��
ADDRESS: —�'�E`� �=
TEL iVO: .3 ��— /� 3�
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sT-in;�� r�o: � s2�.�.T:
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BUILDER: - Sf�-/V1_�__ _.
ADDRESS:
TEL fd0:
Construction Locatio
Loi P�2CE'L
LOT: . —�_� �' � �
�»o' oF io%a3,�,eee�r Tft� ur. 3p� �
Corner Lot: � // Inside Lot:
��
ADDITION: (�[, � � . � �qa �
TrF� S.3o�
Setback: Sideyards: __
App].icant attach to this form Lwo Certiiicates o£ Survey of lot and
prop�sed building location dra�an on certificates to scale.
DESCRIPTIOIJ 0� CONSTRUCTIOPI
(r+ R1T �:�(ts � Front: �'.. C� Ih;pth: 'c„ i.a Heigi7t: �,�
Squane S'eete ��'�j �bic I'cet: _ ys_ �,.?
�
���'j(��'�' Front: �{Q DePth: _rZ.G Height: /(�
Square� I'eet: ./�0 YO Cubic Feet: ���y�_ $ y, �a
Tgpe o£ Consiruction: �,�-ME �st:=mated Costc �G�o
7b Ee 6�mplete2: ��,E� 1 5 , � 9�O
, � j�� -j-��� Al�'r�4. SO att. II
Proposed Driveway .iati Si New Oyening Is Desired: _�_ $.�� $
0`��_ �, iG IS�7S -�tv l- �U SPE REV��� SHEF.T ,
�� 1�.,.. a .�.,.. �Q
�9ze undersiqned hereUy inakes appiication for a permit for the wvrk herein sp�ciiied,
agr.eeiny to c� all work in strict accordance with the City of Fridley Ordinanoes ancl
rulivgs oi the Department of Tluildinys, zr.3 hereby declares that a11 the facts and
representations stated in this application are true and correct.
DATE: I�— � /Z � �� SIGNF�TUItF.: V f�v_ �!�%!! �, _ -. ���*s
stipulations: ��-�.r�q� ,�.�..� M,�.✓,,,,,Qya�-_ IbISJ
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- .�,�,.;RGY CONSERVA'iip.i 3UP6'�,..;.:::.�: Sv .. .��CLNG PERul1' APYi.�:
pI,ANNING AND INSPECTION DEPARTMENT
� CITY OF FRIDLEY, MINNESOTA
?I
This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE
AVEFtAGE "U" FACTOR INFORMATION. This information is required so the BUILDING
OFFICSAL can determine that submitted plans camply with the ENERGY CONSERVATION
DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). It is the APPLICANT'S
responsibility to accurately compute the data; reflect the proper DESIGtd CRITERIR
in the plans; submit product specifications, if needed to support the "R" and "U"
factors used; and to assure construction is per approved plans.
JOB LACATTON:
A
ADDRESS:
�
�/� oS/�
A. Determine the Total FScposed iJall Area as follows:
i.
2.
3.
4.
5.
6.
7.
Total wall window area
Total door area
Zbtal sliding glass door area
7.bta1 fireplace wall area
Zbtal wall framing area(average.l0�)
Total net wall area ahove floor(average 90�)
2btal rim joist area
Subtotal: Total exposed wall area above floor
8. Total foundation window area
9. Rbtal net foundation area above grade
Subtotal: Total exposed foundation area
GRAND TOTAL EXPOSED WALL AREA
e
PxoNE: s- �+� 1 7.? c
,�. / 7
7 S'
�� J
/�/(,
i � ��,
����
I,�O
B. Multiply.the GRAND TOTAL EXPOSED WALL AREA X.17 =
C. Determine the 1bta1 Exposed Roof/Ceiling Area as.follows:
10. Total skylight area —
11. Total roof/ceiling framing area (lOb) /� z
12. Total net insulated roof/ceiling area / OQ f
GRAND TOTAL EXPOSED ROOF/CEILING 1�REA //� 7
D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X.OS =
�0,� �
�.: G
Item I ,? �/ G
Item II S �
L�. J@�@:L . Ct1C . �_.�. . .... . . _. , ..j ..,1 �..0 u . .
+ IOZZOWS: � -
. . ' l. d- � % $ nUn � J,• S' c / �� ' � . . .
i. � � }[ nUri � r _ r � � � � ' .
3. �! � g ��U�� -S - _ .: �
4. __ g ��U,� .._ ` 4
5. 1 Ll �' g,�U.� ( �' �;i = v
� / . 1� 1� .r� ^ I _ . 4i i . . ' . ..
6. / ' /:o, X � U , :,� 7 r - i . � � � ' . ...
� %. �' '�� ( . ii nU�� . I % j �J`� _ � l :% . . . . ' _ : .
$. _'. � � x nUn . . �.. � _ '_' . .. . . .. .. ..
I� � � r ., . '. . . �.. - ' � � ' . . .
g, j.;' c� g ��U�� , ur 4. _ ;�;' ,/
. , }: ;.
ADD 1-9 FOR TOTAL WALL SEGMENTS � �` � _ � ITEM III ��.� C' �
- F. Detemtine the "U" value of each segment (10-12) and multiply by the area as
fallows:
10. X �.U�� � _ - .
�Y. 11. /l Z. g ��U�� �� t�_ _ <^
�I...: � 12. �OpS^ g� ��Un i CJ�/ i'-- _�• L% r � .
�_ -: ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS ±""�� _ - ITEM IV �_
G. If Item III is the same as, or less than Item i, you have met the intent
of State Building Code 6006 (c) 2.
A. If Item IV is the same as, or less than Item Z2, you have met the intent
" of State Building Code 6006 (c) L ".
I. Add Item I� . � �/ G + Item II S G . . . _ � ,} ,^`
J. aaa xt� zrx _�' .� 9 + it� zv � 7 �_ .�' >' t'
K. If the sum of Items�I2I�and IV are less than Items T and II, you have met the
I intent of the Code for total envelope system.
The undersigned, as applicant £or a building permit, hereby affirms the above
infoxnation has been urepared and submitted by himself or under his direction,
hereby acknowledges the information to be correct and accurate; and hereby
presents the information with required plans in support of the building pernit
application.
�
DATE:
9
AGREEMENT
This Agreement made and entered into this 27th day of August , 1979 by
and between Allan J. Fehn and Pamela M. Fehn, husband and wife, the fee owners
of the South 222 feet of Lot 23, Auditors 5ubdivision No. 92 �Parcel 1240),
except the West 30 feet and the South 30 feet, according to the recorded plat
therof, h�einafter referred to as the subject property and William H. Costello
and Anna May Costello, husband and wife, the fee owners of Lot 24, Auditors
Subdivision No. 92 (parcel 1280), except that part described as follows:
beginning at the Southeast corner thereof; thence North along the East line of
said I,ot 24, a distance of 150 feet; thence West and parallel with the South
line of said lot a distance of 80 feet; thence South and parallel with the East
line of said lot a distance of 150 feet; thence East to the point of beginning.
Whereas, Allan J. Fehn, fee owner of subject property has petitioned the
City of Fridley to approve a lot split, splitting the subject property into a
legal building site; and noted as Parcel A on attached Exhibit A; and;
Whereas, the City Council of the City of Fridley at the regular meeting of
May 7, 1979, did approve the lot split contingent on an agreement with the
fee owners of Lot 24, (parcel 1280) Auditors Subdivision No. 92 pertaining to
the location o£ a future single family dwelling on the newly established. '
building site noted as Parcel A on attached Exhibit A. Q./'���✓
�P,�.�.a�� / � �ri,c 6wJ �
Therefore, it is mutually agreed that the si e family dwelling or�
garage on the newly established Parcel A shal not be further East than the
single family dwelling existing on Parcel B s noted on attached Exhibit A.
It is further agreed that a storage structure, if any, shall be constructed
as near the North line of Parcel A as the City of Fridley Building Code allows.
FURTHER, IT IS MUTUALLY AGREED that the provisions of this agreement shall
be binding upon and enforceable against the parties hereto, their successor.s
and assigns and all subsequent owners of the property here� described. An
executed copy of this agreement shall be filed with Anoka County Recorder's
Office and made a part of and be binding upon the above described property.
IN WITNESS WHEREOF, the parties have hereunto set their hands this
27th day of _ Au�ust , 1979•
This instrument drafted by:
City of Fridley
6431 University Avenue
Fridley, MN 55�32
//����!,' %i � ,
Allan J. FeYAn - Husband
Fee Owner �
���./�% , �' :
�/Cl��, ,;i�? %; i. ,���= �,��
Pamela M. Fehn - Wife
Fee Owner
-- RGREEMENT
Fehn/Costello
State of biinnesota)
) ss
County of Anoka )
On this .i`�! �day of vG�✓ c�=-�� , 1979, before me, a Notary Public
within and £or the County of Anok and the State of hfinnesota, personally
appeared Allan J. Eehn and Pamela M. Fehn, husband and wife, to me known to
be the same person described in and who executed the foregoing instrument,
and acknowledged that they executed the same as their free act and deed.
_��__... _T
� �� a,�met �. �if�cz
-�(� Hp1An NEIIC-MihNESOiA
�`�, qNOKA COUNtY
µy mmmission ezpae= IOct. 24, 19A5
�-
1���� G' /C��
N�ia Public
���/��;:� �, %�'-���r-
William H." Costello - Husband
Fee Owner
� ,
��>> �
� � � � �= ; /i �� � (� ��.;i/�"l� �
' Anna hfay Costello:= Wife
Fee Qwner
State of hfinnesota)
) ss
County of Anoka )
On this �? �day of ���ci�L�a�� , 1979, before me, a Notary Public
within and for the County of Moca and the State of Minnesota, personally
appeared William H. Costello and Anna May Costello, husban3 wife, to me knowii to
be the same person described in and who executed the foregoing instrument,
and acknowledged that they executed the same as their £ree act and deed.
�
,�-, aa,�e, E ��t<<z ���"�<<���� c= �� ,,
,�...
NOiA0.T D�GIIC - MINNF SOiA
�" ANOKA COUNIY N�T PUU'Z1C
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N_ 583
� CITY OF FRI�LEY �.19?9
Da te
PUBLIC WORKS DEPARTMENT
TAPPING APPLICATION AND PERNIIT
FOR INSTALLATION OF WATER & SEWER SERVICE
I) This form to be completed before a tap is made to any existing water or
sewer line. „
Address /l n � �R.�4FiVA ' To �� G-FA.�`� To �� �+✓�
Owner F �1 �/
Plumber ��T� �-1� `` ���'Q—
CHARGES TO BE PAID BEFOKE TAP IS MADE — WHERE
ASSESSMENT HAS NOT BEEN LEVIED AGAINST PROPERTY
II) Water & sewer connection permit must be registered before this Tapping
Permit can be issued.
City supplies all material and labor for 1" or under water tap. Con-
tractor supplies all material and labor for water tap over 1", and all
sewer taps.
WATEft TAP: Materials Used:
Street Patch: * .
X�;`�,XX7�XxXXxXXXXXXXXx
a-
SEWERTAP: StreetPatch: S x�% �; $ �00 00
III) If this property haz not paid a full Lateral Charge for its share of the
water and sewer system, additional charges will be placed against it.
This will be in addition to the normal connection and tapping permits, �
meterdeposits,etc. 2�OTxt $ a��-p�
Water
ASSESSMENTS TO BE LEVIED: Lateral:
Clerks
Supt. a
M/P 3/�6
Sewer Lateral: S
TOTAL ASSESSMENT: S — � �
White P.W. Canary Finance Pink Prop. Owner Goltlenrod Plumber
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643Y UNIVERSITY AVENIIr N.E., FRIDLEY, MINNESOTA 5543�2
TEIEPHONE ( 672jSTf-3450
March 4, 1980
t9r. Allan J. Fehn
1601 Gardena Avenue N,E.
Fridley, MN 55432
Re: Final Inspection at 1601 Gardena Avenue t7.E.
Dear Mr. Fehn:
A final inspection was made on t4arch 4, 1980 of the above address
and the following items were noted which must be completed before
the structure can be finaled out;
1. Pmvide sod in the front and side yards by June 15, 1980.
2. Provide a hard surface driveway by June 15, 1980.
We will expect the above items to be completed by the scheduled
date when a reinspection will be made to determine c�¢pliance. IP
you have any questions on these items, please contact me at 571-3450.
Sincerely,
�
DARREL G. CL�RR �
Chief Building Of£icial
DGC/mh
soe�ccr � . � � PERMIT NO.
� City of Fridley , � ~
�
, ATTNETOPOFTNETWINS gUILDING PERMIT 3 �687
,.
� � _�� COMMUNITY DEVEIOPMENT OIV.
f � v � PROTECtIVE INSPECTION SEC /� � 3
�
� � �
� � �""� • CITY HALL FRIDLE� S51J2 HVM6EP AEV a�iE o�pE O% �VnNOVED BY
�"'"�� ��' 612-571-3450 9t0-Fi5 3/19/Oi / /
100 ADDRESS 1601 Gardena Avenue NE
t LEGAL LOTNO. BLOCK TRACTONADDITION SEEATTALHED
oesca. S 110' of ot 23 Auditor's Sub. 1192 SHEET
7 PfiOPERTYOWNER MAiIADORES$ Z�P PNONE
Angelique Fredericksen 1601 Gardena Avenue NE 571-2851
7 CONTRACTOR MAIIADORE55 ZIP FMONE LICENSFNO
Same
a qRCNI7ECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAIL ADDRE55 ZIP PHONE LICENSE NO
6 USEOFBUILDING
Residential
7 CLA55OFWORK
R NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct a 10' x 12' Shed
9 CHANGE OF USE FROM TO
STIPULATIONS
Shed shall meet 80 mph wind load. Provide contrete slab with anchor
bolts or anchors. Construct per manufacturer's specifications.
TYPEOFCONST OCCUPANCYGROUP OCCUPANCVIOA�
SEPARAIE PERMITS ARE REOUIREO FOR ELECTNICAL. PLUMBING. MEATING.
VENTILATING OR Alq CONOITIONING
THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION zONING SO.FT CU FT
AUTMOAIZED IS NOi �OMMENCED W�THIN 60 DAYS. OR IF CONSTRVCTION
OA WORI( IS SUSPENDED OR ABANDONEO FON A PEA100 OF 120 DAVS AT
ANV TIME AFTER WORK IS COMMENCED. NO DWLG. VNITS OfFSTREET PARNING
� MEREBV LERTIFV TMAT I MAVE AEAD AND E%AMINED TNI$ APP�ICATION 1 STALLS GAPAGES
ANDKNOWTHE54METOBETRl1EANOCOFRECT.ALIPROVISION50f�AWS yp�UATION $VRTA%
nN� ORDINnNCES GOVEFNING TMIS iYPE OF WOAK WILL eE COMP�IED @
WIiH WMEiMER SPECIFIEO HEREIN OR NOT. THE GRAN7ING OF A CERMIT W$OO � �.SO
DOES NOT PRESUME TO G�VE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE $ACCMARGE @
PAOVISION$ OF 4NY OiMEF $TATE OA IOCAL LAW REGUUTING cor+. �32.65 . Fire .S(�i y.8�
$TRUCT�ON OP iHE PEAFOFMANCE OF CONSTRUCTION
PLAN CHECK FEE ipT4L FEE
$33.95
5� •ruAeO�C cp � pq� n¢ED• Ea* i��tE HEN OPEAIY V4LIDAtED TMiS IS VOU �PEAMiT
, , d
S�Gm�i�aEO�Owu ���pµpEUBWLOEA�. ��D��1 p Sp i��i
NEW [ ]
ADDN
ALTER
Effective 5/10/99
[ ] CITY OF FRIDLEY
[] SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address:
Contractor: ��
v'rr� e v�o. ��, r_ N L �v �c�( ( e
err ksP.2.
Owvte�
Tel. N (o!Z-S�I-Z�S %
MN LICENSE !{
Address; Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVI.riG AREA: Length
DESCRIPTION OF IMPROVEMENT
Width Height 3q. Ft.
GARAGE AREA: I.ength Width Height Sq. Ft.
DECK AREA: I.ength Width HgtJGround _ Sq. Ft.
OTHET2: JO X 12 CT a!o i¢. S�ieo�
Construction Type:__ W oo /� �-/Z� L-� Estimated Cost: $ ���(�
Driveway Curb C�t Width Needed: _Ft. + 6 Ft =
DA'I'E: � ��7��! �7
Pennit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
Ft x $
_$
1� �
�, � Y
1� � +
1�
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Pemut Valuation (i/lOth%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$ $5.00 (State Licensed Residentia.l Contractors)
$ Alt. "A" or Alt. "B" Above
TeL # ��Z-S7�-Z�-.��
$
$
$
�-�--II -
$450.00 Conservation Plan Review
Fee Deternuned by Engineering
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS:���n cy�
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City of Fridley ''
ATTMETOPOFTHETWINS g�ILDiNG PERMIT ��32os5
r
i +
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LOMMUNITY DE�ELOP�ENT DIV. � „LL»��_��o� � n/�
r � V PROTEC7IVE INSPECTION SEC. �t% � L
I
� � �°'� � LITV HALL FRIOLE� 55�3: MlI4BEM NEV D�TE o�GE 0� �FOpOVED Bv
�""'"�" �'� 61�-571-3450 9�0-Fi5 8/16/O1 / /
J00 ADDRE55 1601 Gerdena Avenue NE �
f LEG�L LOTNO. BLOCK TPACTOR�DDITION SEEATT�CHED
oESCA. pt 23 Auditor's Sub. 1192 SNEET
2 PROPERTVOWNER MAILADDAES$ 21P PHONE
Angelique Frederiksen 1601 Gardena Ave NE 763-571-2851
J LONTRACTOR MAILADDFESS IIP GHONE UCENSENO
Suburban Home Improvement 32 Maple Lane, Little Canada, MN 55117 651-787-0974
� ARCHITECTOADES16NER M�ILADDRE55 ' 21P PMONE �ICENSENO.
20267333
c cur.wocn uule�ORE55 . ZIP PMONE LICENSENO
6 USEOFBUILOING �
Residential
1 CLRSS OF WORK
� NEW O ADDITION ❑ ALTERATION � REPAIR
8 DESCRIBEWORK
Reroof House & Garage (24 Sqs) Tear-off
9 CHANGEOFVSEFROM
ro
STIPULATIONS .
Underlayment must comply with the State Building Code.
TYPE OF CO
SEPARATE PERMITS/.RE REOUIREO FpR ELECTNILAL GLUMBING. MEATING.
VENTILAiING OR AIFl CONDITIONING.
THIS PERMIT BECOMES NULL AND VOI� IF WORK OR CONSTRUCTION ZONING
AUTMORIZED I$ N07 COMMENCEO WITHIN 60 D/1Y5. OR IF CONSTRUCTION
OR WORK IS $USPENDEO OF7 ABANDONED FOR A PERIOD OF 110 DAYS AT �
RNY TIME AFTER WORH IS COMMENLED � NO OWLG.
I HEFEBY CERTIFY THAT I MAVE REAO AND E%AMINED TMIS APPUC�710N 1
AND KNOW THE SAME TO BE TRUE ANDCORRECT. A�L PROVISIONSOF �AW$ VALUATION
AND ORDIN4NCE5 GOVERNING �HIS TYPE OF WORK WILL BE COMPUED
WITN WHETHER SPECIFIEO MEAEIN OR NOT THE GRANTING OF A PERMIT �Z�S�3
�OES NOT PRESUME TO GIVE AUTMOAITV TO ��OLATE OR CANCEL TME pERMIiFEE
PFOVISION$ OF ANV OTHER $TATE OA LOCAL LAW REGULATING CON� 283.ZS
ST TION OR TME PERFORMANCE OF CONSTRVCTION w
X/^ v�AN CMEC
�1 -( QA�tn, i� �%Q.(,(,�,� c�—/� O/ Lice
6�GN�i�RE N" f,IOAOA�U*wOa�2ED�GEN! O�*E� y
0
$TALLS
❑ MOVE � O REMOVE
GROUP IOCGUPANGVLOAD
�GARAGES
IHTA%
�L.L9
C CMApGE
're Sr�_
u AL FEE
$92.1I
? 'f0( �
NEW [J
ADDN []
ALTER [ ]
Construction Address:
Legal Description: _
Owner Name & Address:
Contractor: S�bU d
Arlclress 3� YY1Q. n �
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
CITY OF FRIDLEY
SINGLE FAMILYAND DUPLEXES R-1 AND R-2
�UILDING PERMITAPPLICATION
AR D�,�6�
L l -�-�-�� ��;; �`�
Effective 1/1/2001
(763) 572-3604 Bldg Insp
' Se/� Te�. # 7b3' S/1— 2851
MN LICENSE# ��� 333
Tel. # ��� - 7�37-O�j��-j
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length
Length
Width
Width
Height _
HgVGround
Sq. Ft.
Sq. Ft.
Construction Type: 7'cq � a� —J2e �r� Estimated Cost: $ • �j :�5 �_3
Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x$ _$
DATE: 8–��'O% APPLICANT: /l(Lf�1M � �O.Q.(A✓� rei.# �0�1-787-�17�
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Pertnit Fees if mailing in application
$ �j o?.� Fee Schedule on Reverse Side
$ �. S% .001 of Permit Valuation (1/10th%)
$ 1,0?4 $.50/$1,006 Valuation
$ $1150 per SAC Unit
$ .S. d/� $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 [ }
$ ��
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
PERMI NO.: 2004-01587
�_. - -._
DATE ISSUED: 09/13/2004
(763)572-3604 FAX: (763)571-1287
ADDRESS : 1601GARDENAAVENE
PIN : 243024110050
LEGAL DESC : AUD SUB NO 092
: LOT 23 BLOCK 0
PERMIT TYPE : BUILDING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTTON TYPE : DECK
VALUATION : $ 4,760.00
NOTE: SEE NOTATIONS ON PLAN.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CONVERT 12' X 12' DECK TO SCREEN PORCH.
CONSTRUCT AN 8' X 5' DECK.
APPLICANT BUILDING PERMIT FEE 111.25
RAHMOUNE, DJAMAL PLAN CHECK FEE 7231
1601 GARDENA AVE NE FIRE SURCHARGE 4.76
FRIDLEY, MN 55432 STATE SURCHARGE, VALUE 238
TOTAL 190.70
OWNER
RAHMOUNE, DJAMAL
1601 GARDENA AVE NE
FffiDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or wnstruction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after wark is commenced.
I hereby certify that I have read and examined this
application and Imow the same to be true and correct. All
provisions of laws and ordinances goveming this type of work
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of�y other state or local law
regulating conshvct' or the per rmanc of wnstruction.
Applicant Date
Bldg Insp Date � U . �
SEPARATE PERMITS Q D FOR WORK OTHER TIIAN DESCffiBED ABOVE.
NEW
ADDN
ALTER
I]
�)
[1
Construction Address:
CITY OF FRIDLEY Effective 4/1/2004
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDINGPERMITAPPLICATION r' " ��,
�.� ��� ���� � � " .
. \��
� _ .en . .�� �.� - i� \�.,
Legal Description:
Owner Name & Address: ��g,��a� � �, ev� Tel. # ���- `c�S�S—
Contractor: �^^�^--O ^ MN LICENSE #
ea.a.n��• Tel. # __
� Attach to this application, a Certificate of Survey of the �) % � f�. �_° � �
bt, with the proposed construction drawn on it to scale. ,� �`,'L` C
DESCRIPTION OF IMPROVEMENT
LMNG AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
+ r
DECKAREA: Length � Width � HgUGround� Sq. Ft. /
OTHER: ! o�.Jel�p����tu� �� �� � �� �l� �d �?o,-�_t.. � / '
J1 �
Construction Type: �p�� � ����� Estimated Cost: $ l���
Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x$ = S
DATE: � � APPLICANT: ��,�N� i� P��R 1-I wl � J�/ i. Te�. #��3 S�o 2� S� 8S ^
Call (763) 572-3604 for Permit Fees if mailing in appticalion. Fax to 763-571-1287 if using credit card and we wifl ca11
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ J, a Fee Schedule on Reverse Side
$ 0�2 • / 65% of Permit Fee
$ .001 of Permit Valuation (1/10th%)
$^ � . $.50/$1,000 Valuation
$ $1350 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 [ ]
TOTAL $ � 7� STIPULATIONS:
1\
tl; �1;
f �
N L
� i� .e
, ( fl Q
v "� F
: �
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' O 3 �
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,�sri�
in✓.=9¢�y� �
foy-975.5 ~
�
C�RTIFICATE OF SURVEY ��/ �/l�td)�°l�« f�
fOfl: � �- ����/i! �
/S�D/1%l �/i9E o So. //O P �
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8
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IN
E.Yis�in� Fov�
Tap af 6/0�� e%=
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34Bz- ,"'Z5,66
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LEGAL DESCRIPTION
_ 45•�7 __
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The south 110 feet of Lot 23, Auditor's
Subdiyision No. 92; according to the
recorded plat thereof, Anoka County,
Minnesota, EXCEPT Che west 30 feet of
said Lot 23, and EXCEPT the south 30
feet of said Lot 23.
o Denotesiron monument
❑ Denotes offset stake
x 000.o Denotes existing elev.
( 000.o ) Denotes Proposed elev.
—} Denotes surface drainage
Proposed garage floor elev.=
N�
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x 973.9 ---�
Proposed lowest floor elev. _
Proposed top of foundation elev. _
BENCH MARK:
I hereby certify that this is a true and correct representation of a survey o!
the bounJaries of the above described land and of the location of all buildings,
DEMARS -GABRIEL if any, thereon, and all visibie encroachments, if any, from or on said land.
LAND SURVEYORS� INC. �%l da
As surveye�e this y pf ecPm.fei', ,s�9
3030 Harbor Lane No. � . �
Plymouth MN 55441 � , � ��
Phone:�612)559-0908 i
, . � .906G
� Mir.n. Reg, No. ____
File No.
Zzo 3
Bnok — Payz
C�� !/
Scale
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