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AF - 45644Vzllage of Fridley, Niimz. BUILDING PERMIT Da�e: . �r% .a�r.-,�f�..tf�...'.. �7�.......... � /' Cwner�%� .�': i�il";1-1F'. . . f.� t9{ . x.��:YE.JI. . . . . Address ...............:. Suilde: �:�.�';'� Address �o 1421 .................... ..�,..� ............. ` C.�. � � �oc�,a�r�io�v o a�,u.,,JiLj DII�IG ' No. ..I. ). °?.... Street . . � �YU..�J.UC.(�....�L .`�. �'. Part of Lot ....... n �}.,� 1 S /� Lot ...:..��.i.... Block 11N�i-'�...'.��.+:�X , ( ...................... i7 /� ddition or Sub-Division .... n.:.. ,:... .. 1.. y�t , � ................. Corner Lot ........... Inside Lot ........... Setback�F. V. �%�./. Sideyard/�:..�:���/;!�°�* .............. C?�SCF2fPTlOI�! OF 6U{LDING To be lised as: i i C-`..... ; `��� p � ". ' -g ��.tF , 9 ,. '. .,t,.•F �`.- Front'� De tn..::Y:.... T3ei ht s�. S Ft.;�:�. �s,. Cu. Ft. ........ li..C�.,....`....... Front .":�-.... De N� ���� Ize'eht << :f��� a Ft. ' �i..�.. , , P d�..:L:.. .m "q. :� ... Cu. Ft. ........ Type of Construction , ,.:,-:;:s.,.•.... �sf. Cost . � � � �� �-���° '�- �� �` ` ... , To be Completed •:��„d, � ('" .,.,-. .. . . . u:'!.:.; . [`" : i ` }— ��' � . __..... - . «.t .�.e..,ry�i� /'�y �'e+- 1,wP t::..ye.t¢ LE.r� � "-, k� �� ',h;,t.�r.�rw' . ' :.1_ p�. � `j - � � In consideration of the issuance tn me of a pernut to construct the building described above, I agree to do the proposed work in accordance with the description above set ",th and in compli e with all provisIons of ordinances of the village of Fridley. � �� r t � ..:� ..� .:.. . . i..�� � x..��. ,,. . . �,: = �, 4 � //. �"� i , � Tm m�sideration of the payment of a fee of $!.-,\}..—T;--�, „ permit;i's hereby granted to 7.�� .i7-- .�� .. . .. ........... � � �' : 9..r....., to construct the building or addition as�described above. This permit is granted upon the eacpress condition that the.person to whom it is granted and his agents, employees and worlm�en, in all work done in, around and upon said building, or any part thereof, shail conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, �repair and moving of buildings with_ in the village limits and this permit may be revoked at any timz upon violation of any of the provisions of said ordinances. � !! �j�Ff�� x' . �C � ' �• . . . . .�.�: � � � 3!'-. ��:f7�I,.-Building Inspector IVOTICE: i� 7his permit does noY cover the construction, installafion or alteration for wiring, glumbing, gas heating, sewer or water. Be sure to see th^ Building Inspector Sor separate yermifs for t`^se items. �� � . m 0 � � �� C � �� � � � = O . � � 0 �a O d � � d � � � � a � LS J � 0 W _ U N W a � J g � a ��ro F q y x�ov 0 3 � �a ^� ~ m "o���.� � a . ��E �3v"d �aa°' �-�i �..0 � a �'�� �W� u ��+� a y �, �w a S'� a �x�" ���� ���[ a ��0 �b am s % aN �FVo � ��oq � �� M p F�7a�i F M � U v�'i m �"N � h M M �885° � OD b u! LV g g o O � � �. � w •4 � T. � m � � � � . � Q ° � � °� o m w � ,�G C C �i a m " ,� ,� 3 � W � .� � W „ p� a a a � W P�i �. R'. d � .;. �� ;.,..," t � Iw � o v O C� 'J�' 0 �� � 0000� ���;�;� � o $ : S �e+ � : :o� N � Y�:s� agd7� � � m a o 0 Fl ro W � � �� � � � � v u C � � �m � �a��a u �, �, � � . 3 ay a aa� � C. Y. 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S ! i � � .t «t �ssgg � � a a m � » _ .��: � . � .. �. � N � � 8� �� � � � � � 4 � �� ��,� : ����� < � ; �! � �� �� � � � S � � 9 � e���� � . � 3 � . $A �� �� s � a� � ��� � y4�� � W � � � s� �� � I � � � � � � o Qi z � � ��9y � ~ 'O o � � � E z �, i� o , s 1 ` N N � N g8a8 ���� M � a � � �� �� � Y � m x�ffi � � s �x �� �� p�7 Il � � $ � � �� �� �y � 3 Y � o p M � � � � � � s� �8�� � � � M � � � � � � I I } � Y � w : : � � � �� �� 3� � ' �. � � � � ����a� ��. ������ ��� � �� � � �� �.�, � u'1 �.� W � � B S :.J K � .�.� i� .:_ ! � � 9- (�Y OF FRIDLEY � � Applics�os for Instsllation oi �Vater and Bewer Bervice This form to be completed before a tsp is made to any eacisting water or sewer line. /� � �/ Lot ..��...... Block ......:........_._...... Addition C..C.GC�!..J�1X`.__ .%.2 . -' Address .�.L..3.......:.._ ./...1l�---G_<.---.._--�'J._�.•v.�..f.re:e.�fS_../_ ) Owner ..__ _.. _�..t-.t_��.:G�/�...t_?.1....----_...�..r-_z.� Piumber � ..�.._..YG�t.l�. �r_..__�.C...Q:. z.: /L. e �S -. (thia pm�tion of form to be completed by person reguesting tap) � CHARC:F,S TO BE PAID BEFOR.E TAP LS MADE — WHERE ASSF.�SMENT HAS NOT BEEN LEVIED AGAII�TTST FROPERTY Sewer ��Connect{on fee . . . wStreet patch _. � Water . Connect3on fee � Meter depo�it Msterials uaed •Btreet patch _... ' Where applicable The abwe applies fa� all regular residential Ri�p mateltiate for �wster service rwer, not to essceed $3.W a f� AS3E6SP�RV'TS TO BE LEVIEP D R �ae�'S. �O'!J� — ' Ta� ,+O-v . o O S fi- G Q 7F , 4�4-tc� h. ��X9� 4O 613' ]ae p1tt�Rbet' a maxfmtm� BSd..30 � Credit for material ..__............_..........._.._.... - � . Total assessment $......._ .............__.._............. . Sewer Lateral $ ....................................._..... ` � � Credit for material 60.00 - � . . � Total assea�nent $._../..g�S.a2..3Q Clerk's signature �Q/L1l1lrJ._i:..�tl�fp.�) I hereby authorize the a ve tap � _._..___..._—.._.....__......_.._..._......_.....:__ __........._...........---__..:.._._........_..... lst cop�—Public W�ks Director aP Public Works ` � � -� � � � � � � 1Y^' � • 1 � � � � �. �+ o�� � � � U � �y Qs O i �� �� O� � � g � ���� �� �'� ���� ��9 q � & .�. � i y p � � O �� �� � �°°� �� Y A ���� � $��� � � � � M ^ ����� x�� � � N � u • s • . �ny.o 3smva 'lW svn �11VM Dl11Y SNIM Mi117 snmia swws t :ura� �NIW uwi NSYM CY115 � � �av� ��w � .... ��s I � � o � �� �� �� O � �� . r. x 'o s. nI ."i�l • � � � ��p M C « ^ d o �3 a U p E � � g 5 � � F r� O W J � � W U � W � � � � � � � d �� � � � I` � \ � � � c O� � m p N N M M N N M M � 8 « � °.d IY Ei i�i �' `�i » '�2 ft K x +e x re M H K H �� I I � I� � I I • � . • PFC . : • : Q a � • m . S � : • . � a � pq : • � . � .� . F : � $ : ° °� ' � � � � � Q � � a � ' w �r � 3 d . � 3 � x "a 5 � � � � � � M.. �� pj S Q g w� a F.. w C7 V � � � a � � $ � � � � �.' � 7. U B Z p� i, h„ � Ci � � 6 � �� n � � `� �I �,v : � w ca a � . < ¢ x : � .� N J � • : • � • �y O ` a � � � o� �� � _ GTYOF FRIDLEY �� �-e FR]DLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (6I2) 571-1287 January 17, 1990 Mr. Norman Aerzog 115 Glen Creek Road Fridley, MN 55432 SUBJECT: Plat Map Dear Mr. Herzog: PW90-18 Enclosed are two copies of a portion of the half section plat showing your property. The scale of the map is approximately 1"=200'. Sincerely, % / � , i '���. . _ � �l � , � Mark A. 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FLOOH CITY 3UBURB OCCUPANT .� ,�DJ' OWNEfl HEATLOSS L[�'DA�_TE HTGJNBL Q) � � � SOLDBY ,� w��*^^��� T�- INSTALLEDBY Jlq� Etactrica� Work By O/n �� �- Q�-� _ _ Gas Llna By �( J I a� TYPE OF HEqT GA FA / HW STEAM SPACE HTR. UNR HTH. OTHEH R GAS DESIGN CONVERSION MAKE� *� MAKEOFBUqNEH Model Cal- McdN Serial �/ 3 a / Max. BTU Raling iNPUT '$ ...OLZ� pAKE OF FUqNACE �1 CONTHOL9 THERMOSTAT T. ' HeatPlug Valve _� Limll Llmll Setting _ Fan Sotting _ Pilol Typa _ Pila Maw— Modal �// VaM Siu K1ND OF LINEA (� �I SI� NONE Dreft Hood � Repula�or Fllten SISa�X x� Numbar / Chimnay Location Insldo Outalda ChlmnayCOnalructlon .i�(yG Pilol Modal 7` Smok� Bomb Wiriny' PllotTlminp �Z_ C� U.PLI - Drafl T�stTag L. W. Cut Off � � Dcor Prossun r Llghting Pressuro Paro�nICO� J Det�Ta1W � � InputCFH P�rwMO� ��� CompanYTMinO 9�i '- StackT�mp. }��_ PoroanlCO d Nam�ot7�Na � f Form 23S . �.. �5 �pF FiQ�_ � � �� PUBUC WORKS MEMORANDUM TO: John Flora, Director of Public Works FROM: Paul Lawrence, Superintendent of Public Works DATE: July 9, 1998 SUBJECT: 115 Glen Creek Road Outside Services and I met with Mrs. Herzog at 115 Glen Creek Road regarding clearing the Gten Creek channel behind the Herzog home. Outside Services will contact Mrs. Herzog a couple of days before they begin work, to aliow her time to remove the plants she wants to save from her flower garden. Tentatively the work is scheduled for early August, and will take about one day to complete. Outside Services' hourty rate for labor and equipment is $225 per hour (log skidder and four personnel) for total estimated cost of $1,500-$2,000. The cost of this work may be covered by FEMA funds, as the tree fell into the channel during the May 15th storm and clearing channels is one of the items covered by the FEMA guidelines. I will have Brian take pictures to establish the extent of the prob(em for the FEMA claim, in case the tree is removed before the FEMA inspector has inspected the problem. sue�ecr � � PER IT '� City of Fridley o � g�� ATTNETOPOFTHETWINS BUILDING PERMIT � , � � RECEIPT NO. COMMUNITY DEVELOPMENT DIV. � . f � v �� PROTECTIVE INSPECTION SEC. �. ��p�. � i � `�-_-.� ����1,,� C�TY MALL FRIDIE� 55a32 NUM6ER PEV. DRTE PAGE OF 4PPqOVEO 8Y � L 612-571-3450 910-Fi5 5/31/89 � � lOB ADDRE55 115 Glen Creek Road N. E. 1 LEGAL ��TNO. BLOCK TRACtORADDITION SEEATTACHED DESCR. 38 Renised Aud, Sllb. #i�I . SHFET � 2 PROPERTVOWNER �MAILA�DRESS � 21P PHONE Norman Herzog 115 G1en Creek 12�ad N.E. 571-6303 3 bONTPAGTOR � MAILADDRESS . Z�P PHONE � IICEN5EN0, Same � ARCMtTECTOPDESIGNER MAILA�DRE55 ZIP PHONE� LICENSENO. 5 ENOINEER MAILADORESS Z�P PHONE� � UCENSENO. e USEOFBWLDING ' Residential 7 CUSS OF WORK � ❑ NEW f�1 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE S DESCRIBE WORK . � � Construct a 16' x 13.6' ThXee Season Porch and a 14' x 8' Deck Addition 9 6NANGEOFUSEFROM � TO STIPULATIONS � See notations on plan , Yg�YXiid[it3[8�67di�ffi�ii� Variance approved for rear yard setback - no stipulations. WI�Rk1MG Betote digBing �p lacai utAitieS SEPA�2ATE PERMI7S REQUIRED FOR t€EEPHpNE-E����•�5��. : WIRING, HEATING, PLUMBING ANU SIGNS. REQ���Ep 8y �qyy:• SEPARATE PEHMITS ARE REOUIRED FOA ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP qCCUPANCV LOAD �VENTII.ATING OR AIR CONDITIONING. � � TNIS PEPMIT BECOMES NULL AND VO10 IF WORK OR CONSTRUCTION ZONING SO.FT. CU.FT. AUTMORIZED IS NOT COMMENCED WITNIN 80 DAYS, OR IF CONSTRUCTION . OR WOHK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 720 DAYS AT - ANY TIME�AFTER WORK IS COMMENCED. � NO. DWLG. UNITS OFFSTREET PARKING I MEREBV CEPTIFY TMAT I HAVE fiEAO AND EXAMINED THI$ APPLICATION 1 STA��S GARAGES ANDNNOWTHESAMETOBETRUEANDCORREC7.ALLPPOVISIONSOFLAWS VALUARON SURTAk . ANO OPOINANCES GOVERNING THIS TYPE OF WORK WILI BE COMPLIED $5�4QO $z.%O WITH WMETMER SPECIFIED NEREIN ON NOT. THE GRANTING OF A PERMIT DOES NOT PqESUME TO GNE AUTMORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE � PROVISIONS OF ANY OTHER STATE OR LOCAL LAW RECULATING CON- $l.00 STRUCTIpN OR TME PE NCE OF CONSTRUCTION. �$ PLANCHE KFEE TOTALFEE 3! S $ss.�o 5� mn*uREO�corv'e oana* iZE nGEr+r iD TEi WHEN PROPER Y VAUDAT D THIS IS VOUR PERMIT S � SiGNAiUREOFOWNEA�60WNERBUILDEA� 10<}EI BLOG �NSP qLi � � � Effective 5/1/88 ADCN jxj I�1 AND R-2 ALTFR [ ] Building Pexmit ApQlication �fLS�Yll�l.�l aa.a......... � �� l� � e. Yi t.., C'QC k V�• . IBJ31 DE4CI'1pt.1M: •�G't �$ � QeJtSecY i*U�'�'fbY,� o[Ll6AtJiSlori /`O, /7 Owner Name & Address: �prman }�ierzoq ° rCS �(en �re�k �• 'i1�1. # S7/�6�� Contractor: (�orm .. � �, � $7f -6jo3 tvtl 63� �f�SA Attad► to this applicatiar�, a Certificate of Stuvey of the lat, with the pmposed oonstruction drawn on it to scale. DF�[St2PTSAN OR+ II�AOVH�il' zsv���1� � n�,: �r,grr, /G wiar�, /3.6 ��,t �� sq. Fr.. a/6 C,pRi+I� A[�!►: Iength width Height Sq. Ft. DE7C1C ARE�: I.er�qth /y� Width S� Hgt/Grauri �� Sq. Ft. /� [:i�•ir� a� ��a �.vti z y,��u.T. ►� ��v� �. �a :'+�'p sc� z Sy �&z8 Corner Iat [] Insi� Iat [%(] Ft. Yd Setback Side Yaztl Setbacks Zype of oonstxuctio�: FY'a�xe Fstimated Cost: $ c��98 ��PDO Approx. �letion Date: H�qa� �S� ! 9 s 9 Pt�bsea nriveway wiatit Zf xew q�enirrq xs Il�siziea: Ft. S S �,jy1/J��� a'� CP�9 width + 6� see Back Page ��: / "-7 � APPLICANP: ll�a �'map �er Zc� Tel. # •S7/ -6303 --r—�— Petmit Fee $ �� State S��x+d�azge S � �'?O � � $ Driveway Escrow $ Fark Fee $ Sewer Main Chatge $ �. s ��� ���: ..� �._�- . � Fee Sci�edule m Reverse Side S.5o/Sl,000 vaivati«� $575 per SAC Unit Alt. "A" ar A].t. oBn p�OVe . F'ee DeteYmined by II�qinacrinq � �tY t ] � �s-�Y L l � P�,2,� A,� � �, �� �2 � � c� ' ,� d� /��s S�4 06 2dn6 - 4S 4� � - � �� ;.R�EV C�A7TNFiJHT ♦hO�G C VNT SUR�[15 '-LM1hCGih'GU Y SURVC�S M�NMCAp ll SURVCTS ,�,. oR�� FFCT N W SUn.n b]6SD Lnw[P �wousreu� - �uoicu� B�:EiHEfS - iO�OGRA►NICAL CITY LGif - ►L�TTING ;� _,. _..; re _ rcl� � � � f �� .< e �i ,:. ., ,� :., ,: ., _<- r � \ �� �:J \ C� , � ., ✓ � no��i, .,, y ,, 6; p. _ �a -���G� � O�O� �oE�,HILl.TC1Y0.EENGINEER [itlipLl�MCO \��� L A ND S UR I'� Fi }' URS C. F. SANDHOFF RE61fT[11[O YNDQ L�W� Oi /TAT[ Of MINN[50T� GVIL ENGINEER OT��L16ME0 IYOY ucch�[o •r OADINI.NC[ or uir or MINNEl1►OUf �qMES NELSON� 326 PLYMOUTH BUILDING FEO[w�� B�B727 SUR�G�R HENNEPIN AT SIXTH • MINNEAPOLIS 3. MINNESOTA i"`°����E° ��:a � METROPOLITAN LAND $�urbrpor's 6rrtificalc Suev[rons c��.oiic�m ���� �Ud' S�b R°� � j8� � . 0 l��� ` _ y13;``� , i; - ,� ; �.=i � ., 0 � t0 ii /—s• �RA.+.1� ' z_...�-� ° .c so�th �'- J99.B1'--- iVOi'/C Lof 3B. Rer. Au o/so /h /,:,e Os�f Cie�.�f- �k� I�D ' N•° 9� .. '�•�L d. svb. No 77, - - Ad�/. P/�f <. Znv, (/207E�97-.e3 - - / �,., I �� ";' � i �� ;`��' � i � i .;fQ. 4I�� �, � ; a� � � ��+ � � �I ; ��� ��aa \ E.seir�cnt � � Foi Oi:vcw,y�, I j � . ""_^- V e � ; lv O — N� .' 2 6 :�'— �>„! I:.e:c';�; ec.r;.ify th�t this is a true �ad correct repre�entation of � :, st:rvcy cS_L?�e bcw,dsrie� of �thct �art of Lot 3II., RevSsed Auditcr�s ! :.�:L.:iivisicn ":•�::_hcr 7i� Ano}:a County, i�:inr�eccLa.lyin�� Easttrly of thc, f cx�c :si.n 5ortherly cf t'ie na�t line of Lct 4� :'loek 1� Ciak Creek � 6d�i�ion Flat 2, and Aest of a line draun Horth at a right ar.�;lc frc� a point in t:,e tiorth li::e of aald Da� Cre.ek Addition Flat 2� distiint 216.0 Teet West �a;,ured en saiu :dcit;i line frcn ita intcrseeticr. srit:i ttie �{ecterly ;.L7e of East F�iver F.oad� • s �i � a:_:.e is cst;:blicacd acccruin� to the a£ore,aid record Flat of' Cril; Cre:ek i+dcitioa :;nt 2; to�•rther uitY. un ea:Er,ent for cirivavay pui•rc�e� ever t`ie Sauth 1;'.0 ieet c£ saiu Lot 3°� exi;endin� Easterly frota the r;a:t line of above de�cribec t:act to Lt:e We�t line c^ East P.iver ficad� all acaordin�• t,o the re�}ective plats t:,c:ec° cn iile anc oi reccrd in tP�e office o: the %e€ister df Deeds in u^d for __ i+a^ka Co,::.ty�_F:i.�neauta; aaa c.° tne looaticn of all t�uildings� if an� thernon� and a-ll-�isi�ie Pncrescts::er.ts� if any� ;ro:� or on said lard. TF:is survey ie r�:,ce cniy �:� .^::P.'f:�i,1C.^, �..:L:i i 7.1GtL�8�;P IOttG II[�1✓ Lflli€ F`l.;i�:v'i: OA ti�C :r!`�tf�.I'�j" iL'lil I10 Z1F1DlI1�J i> ;... �.._.: excej t to t::E hclucr e° esch r_ortga�e cr any ut,h��r ir.tere,t acq�ired by t,;c z�eaecn �f snoh nort�s�;e. It is undcrstood an3 a�reed no Taonursent� havo becr. :.lac-�� fcr the Fa:ro:,e of ostablishiag let lines or bou rf corne�s. As,�urve,�ned r;; .:c :: `s �Oth d&f c. July� 1959: s�c���' .. -^ - -�< �.l— ' �G�.R`:ti�l fRIGHT wwo 6L90N � �.{ ; , , ,\ �� �¢ . . . . ( . ; � i • � ; , . . . . � I i 1 , ; . ; I i I � I 1 � ! � i . . . � . . t i '. . 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I -I �--- ---�--,- � � ,- i ; � __ _ _ �_ ' I �_ �-- - � -�"'4 - , : ; - � i - - -- � � � - - f ; -' - _I-- - � _ -- - !- ,- ----- - , I : ' _ : ; � j f_ i -- . , , , _ � ` !--- �— �- -�- '- ' - I-- �--- - � _��- � I ' � � ' } , _� i I � I — -- ---- - � - -�- � � - — --- - 1 � j i � I � --- � - -_ . --- --- ( , � I- , � ; ' � }--1- -- -- _-- - - -- �-- -- - -._ -�-�--- - _ , ; :; , ,: � �- - - -- ----- - - � - � ; -- - � ,_ , ; --- � - - - 1 � ; . � - -- - -- -- __ -- -- -- - - - . .. , � . : . , _ - _-_ _ __ i _ -_ �-_ � _ � :►�--- E _��� , Ei� , �, . _ __ - _ , � _ .; ��� ;�� ;� � , ��� !I� --I_ I _► �.i . - _ _ _- - _i_ - -f_ � _.. _ _ -; _ . _�__�- _ __ . _-1 I _ _ � _ - -� -� - -- - --f-- �- � � _; i � F " �� .,!S r ' '^;�,.�� ;-':w, � .i' Y. �p: 5" _ a-:� @ ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 �i�-suu4 r.�: : 115 GLEN CREEK RD NE : 103024140008 : UNAVAILABLE : LOT BLOCK : BUILDING : RESIDENTIAL : ROOFING � ii-tza i PERMI O.: 2004-00888 DATE ISSUED: 06/10/2004 VALUATION : $ 3,357.00 NOTE: UNDERLAYMENT AS PER STATE BUILDING CODE. REROOF HOUSE & GARAGE (29 SQ) TEAR-OFF STATE LICENSED CONTRACTOR 1 APPLICANT HASTINGS RICHARD CONT (4051) 6331 RIVERVIEW TER NE FRIDLEY, MN 55432 OWNER HERZOG NORMAN J& MARY K 1 IS GLEN CREEK RD NE FRIDLEY, MN 55432 ACREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any tune after work is commenced. I hereby certify that I have read and examined this applicarion and know the same to be true and correct. All provisions of laws and ordinances governing this type of wor4 will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate ar cancel the provisions of any other state or local law regulating� c�tSuc 'on or e pe�n'e of constructiop. Annl' ��d Date ��Io/O+/ Bldg SF.PARATF. PF.RMITS REOUiRED FOR BUILDING PERMIT FEE FIRE SURCHARGE STATESURCHARGE,VALUE LICENSE SURCHARGE TOTAL �THF.R THAN TIF.SCRiRED ABOVE 9725 336 I .68 5.00 l OZ29 NEW ADDN ALTER [1 I1 I1 CITY OF FRIDLEY 6431 University Ave NE, Fridley, MN 55432 SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/2003 (763) 572-3604 Bldg Insp (763) 571-1287 Fax �op� aDB�� Construction Address: %�S 6LF,<l c�� F'1�' �Z.D _ Legal DescripUon: Owner Name & Address: No��KAN ��+ZZ o� Tel. # Contractor: f � � � � � p � ��� � � � S MN LICENSE # �p C / Address: �53 1 2� v�Z�7� �� T`�- (Z � Tel.# 57 U"5�.66 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Length Width Z.9 s� Height Sq. Ft. Hgt/Ground Sq. Ft. Construction Type: `t.�'A ���F � 2�� o o F Estimated Cost: S �S� Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x S = DATE: G � APPLICANT: �- � ���_ Tel. #'��y-� "/��� Call {763) 572-3604 for Pertnit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL I . a. �i . r ,, � ;, / Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th°�) $.50/$1,000 Valuation $1275 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 [ ] % � - _ .. 0 0 N .-� ` , � � R �., c �. � C ' \� ":. N .:. � > � U � W �'r z � � N � W Z � � � �a' ZN J � W U erA C9 H 2 � SO 0 r Q OZ F C1 Z � aa W Q Ti Z d0 �a �a Z t7 Q � V a J a .. . 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Si CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 a�z-sau4 raa: ADDRESS : I I S GLEN CREEK RD NE PIN : 103024140008 LEGALDESC : UNAVAILABLE �CiTi�e)�[�Z�1;� PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION . a ii-i�a i PE O.: 2004-0190�- �_ DATE ISSUED: 10/18/2004 NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. 100 AMP SERVICE UPGRADE. # NC UNITS 0 VALUE OF APPL OR WORK # FURNACES 0 # GAS DRYERS # GAS RANGES 0 VALUE (FOR MINIMUM CALC) APPLICANT PRACTICAL SYSTEMS 4342B SHADY OAK RD HOPKINS, MN 55343 OWNER HERZOG NORMAN J& MARY K 115 GLEN CREEK RD NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction 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 work is commenced. I hereby certify that I have read and examined this applicatiou and lmow the same to be true and correct. All pmvisions of laws and ordinances goveming this type of wor} wilJ 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 any othar state or local law reguJat�ieg.constrpction or the performance of construction. HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIIt CONDITIOATING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 1861 f �� ^� � � �Zi� 1 � � r L;O ��_ ;�] � 0 10.00 0.00 0.00 0.00 0.00 0.00 0.50 10.50 � 1 � ��SL�� � ' ��-i�iZ1� SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Builaang Inspections 763-572-3G04 ��,� �,—.�r�• $1'I'H Al)UI(1iJ9 � 1'HI$ Al'PLI(;AIYI" IS. TC� NAIYT 1 `��� � $Ujj,bI1�TG Permit No.� RESIDENTIAL APPLICATI�N Received By;_ CITY OF FRIDLEY Uat� x��'a:--2 &MAIL AUUItkiAS CIUWNER .'�nNTR4CftM ADDRE5SJ..L..S.. _..._C�"GC�� PHONE; 7G�,— -S"7/ — _�Q�..... . _.. . ...�TATF !(jiW.,IP .tsy.3� l.:asPill[RI:IUK NAME:.,,�.c. - Lt.7 ✓ _____— _..........._. _. .......... SUBMI7A COPY OF STATC LIl'BNSE # XP D�1TE _.... , .., .'_.'_. YOURSTATELICENSE ADDRE59:_/�..GIGrr_.Cwpo� � CITY : ,. STAT��fN i�y�a WITH APFLIL'ATION pHpv�; /— FAX �' � � ' YROPERTY TYPE �7 S�NGL6 FAM[LY/NEW CONS'C2UCTION s�Lr: ❑ BASEMFN'I' NINISH O ROOF C] DLtC:K ❑ SmING DESGRIBE WORK BF.ING GA�lAQEB PRUPU4PA SIZE: PROPOSGU IiCi61�1T: _....� �YiQ]�L[ ❑ Vlnyl l7 Apiminum ❑ Other ❑ HCXI.YH �@ GAxAGB ❑ A7'I"ACH EU 4AItAGE ❑ vcrnci•sn ann.aa� f7Svffit ❑ Tcim a ra.+c+a W�DWC MP.XL9'�'INCUPE:NINGg qyp [1No LOCATIONOF WINDOWS OA POR NEW OPGN7NQ3-D�SCIkI�F SIZCi OF nPF?NINC CHANCiH5.4 Plan Rnviaw Fite Suroharge Surchaxge License Surcharge SAC Cherge Curb Cut Bscrow Eroeion Controt Park Fee Sewer Main Charge 1997 U.&C FEE SCHEUULE) c� „r..,........., DRAIN'fILH f71'HHR i, I �1Csi.YY pASEMENT REMO�BLSNG : 1HMf1': 1. Exia[uigPlonrPlan 2. Vnmunrdfluurpinn 3. L'ut ofsVUYUraI mzrMfets W be us�x) POR NEW CONSTRUCTION INL'LllD W C; UF(7KS, dD.A,lIL4l9,5..$.�RL}La SSfBbllT� 1. SiKPlan/$urveyshowingtheaciningsuuctures md pwp�sbd p%ja:l. 2. Twa xts of consauction pla��s 3. EnagyCalculatimis ANp MA See Bttck Page tor Fee Schedule 65°h of IIuiMing Permit Pee .001 times the wtal job valuation .0005 x Permit Valuation Minimum $.50 55.00 (State Licensed Residential Contractors) $ I55� per SAC Unit (Plans to MOVCC for determinatlon) 1�+bft= Rx$2l=$ $450 Conservatiai Pla�i Iieview Fee Determined hy EngineeYing AKreeement necessary { ) Non Necessery { } '1'HIS IS AN APPLSCATION POR A PERMR'-NOT VALlD IINTIL PROCESSRp I heroby apply for e builcimg permit and I conformanc� wirh the ordineneoa and c � pemtit btd only sn opplication a rm' a plan in the case ofall work � ' s[� s�pNanrne or• edge that tho infarmauon abowe is cumplate and accurate; that tiie work wil! be in y of Aridley and with the Muwesotn Conswotion Cod�s; lhut I understund this is not a is nat to start without a pe�luit; that the work will be in accordnnce with tho apprnved aPProval qf'plans. e i /7 ,