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AF - 45993City of Fridley, Minn. BUILDING PERMIT Date: �_�ri� 16, 1970 ---- � 5��33 �- x. �oso� p�r: __Tri-Co Buildera____ _ B„��r _ Same __. Addieaa ...__...7561 Van Buren St. N.S. p�� _ S� -- -- LOCATION OF BUILDING Na _..._616 _ Srieet —Glencce --- —..---._..... Part of Lot _ � _ 51 � 52-- �O� —T ---------- Addition or Sub-Divlsi� $iverviev Hei,�hts _ Corner Lot ----- Inmde Lot _.._....,�........__ Setbnck _�_� _....-- 3ideyazd -- Sewer IIevati� Foimdat3m Elevation DESCRIPTION OF BUILDING To be Uaed as: �. e� � GaraQe Flroat __4L._._ DePih -- Heig6t --20�._ Sq. Ft -1028_ Cti. FL 2p�56Q -'------ �t _20� ..__ Depth 22�— xeie,�t _.._l�� _ Sq. Ft 440 �� 4400 Type of Constiucti� Frame___ _.__. ���16,000..._..._.._...._ To be Completed — J�e 1970 1 E Verify lxati� of basement bafore c�tiauinQ fram� coaslruction above foundation, Sign agreement for REC chargea. 7n consideratton of the issuance W me of a permit to c�struM the bullding described aUove, I agree to do the psopoeed work in acooxdsnce wittt the description abave aet fg�h and in oompliance tviffi all provlsfona of aidinances of the Cit,y of Fridley. i_1 � /' n 7n emetderatioa of the payment of a fee of E��--�--., permit ia h�eby �anted *a T.x�i -C.o Buildera tp ���et the building or additlon as �cribed above. 1t�ia permit is granted upon the expreas c�ditlon that t6epe rson to whom it Is �ented end his agenta, �npbyeea end worl�en, fn ell mork dame in, aramd and upaa said buildinB. rn' aav Pert thenrof. shall aomform In all reepecta to tLe ordinan�.�es of F+'itIIeY� Min�eota regarding loeatron, constructim, siteratim, maiatenance, repair a� moving of buildings wit6in the dty limits and thia P�t may be revaked at aqy tlme uPm vtolatloa ot any of the Pro�� of saW orclinanoea NOTICE nds vMaN ae.. .a �w.. Ih. eee�s�. iqldw.n fe. �Nsr. v�a re hwYeO, w`r.r «...�... M... a.» 11r MiWiY �MWx� for wpvM� P�b fer 1b br�. . � e . � � � _ .. is.> --� � , \ • i , --__� , AGREEMENT ' � //G[xh��J /3, / 9 7 O /,J ��p�� DATE �7 � - (. G r�?���'/ . �_ �P ` v,, %J the owner of the . follo ing descri6ed property ��i �� d� � " ' ���� ��.,TP1-ei �T %� �— � �� . ,,3 :/ , Hereby agree to pay in cash $;;;,.�_-,�.-`�(f� -. ����� to the city of Fridley to cover my proporti����� � � , share of the utility system, or in lieu thereof agree to have the City levy an assessment against the property described above to-cover the cost of my proportionate share of the utility system as pro- , vided in Section 2 of Ordinance No. 113, passed - by the Council of the City of Pridley on December _ - 11, 1455. /l`y���-, �.7�'c<<{�v t �'-z �- ��;��- .� . � �-�, , _ OWNER$ SIGNATURE Tapping Permit No. � . . � "� � � , � . � ~ . � _ � L�l a � / � �� � n � a. W � 4 � � � � (; V 6 "�� � � ,1 � a � _ �� APYLICATION FOR BUILDING PIIiMIT CITY OF FRIDLEY, t�IINNESOTA 6 3 8- a?a� OWNF,R 'S NAME .it'i7i1 �.. �,;, .��� BIIILDER � - �,,,_, �r��c,y nnnxESS �SG/ Il�� I.�-�,�,,, � ,�.� AnD�ss �.-...�- LOCATION OF SIIILDING �A,..,�, �3 3' � % �' NO.��STREET � h P y/ � U ^P LOT b'% �-S �BLOCK� BDDITION OR SIIBDIV'ISION GWt�'"c� �,"�c,i-�i�%tLL, CORNER LOT INSIDE LOT�SETBACK �� SIDEY9RD SEWER F,LEVATION TOP OF FOOTING ApplicarAt attach to thie form Two Certificates of Survey o£ Lot and propoeed building location drawn on these Certificates. DFSCRIPTION OF S[TILDING To Be IIeed �e: / %��^'�ti`".s' 'CZ�'��� �`-� a2 t/ . Front �/ Depth � Height ��% Square feet Q� Cubic Feet Zp , S�t a ��Front aa Depth � '�,� Height � � Squase feet yyd` Cubic Feet G�L�c� Type of ConstructK� �ix�y,-,�,z Eatimated Coat /(e, p-pt�• W/� .�'d+�C To Be Completed_� / �%O � 3'� � f The undereigned hereby makee application £or a permit £or the work herein epeoifi�d, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declarea that all the facts and representations etated in thia application are true and correct. 19?. (Schedule of Fee Costs can be found on � . ��Z �f y�°i'�/ � the E verse Side.) ,-.P � _�u�1 � ' / � d1� � �`"'�' � � y � :� e � �'°"�, � �0 5 4 , � c� � f-, _-� /� �' � � ��F � i % I � � L � � � �, f �. ,, �' c �` ", , ry �, � _,. -r� � � Z7 �/ �� ya.. � Z � 1����� � ��,i � � � � /" G; � �f �/ 3�` es�" �! C` *� 2�,i �ez %l k9 • ��� ��° � , . 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G � �E� o �■` � Ul 5� �a � � � � � � � pp � i(ylOp � r� O W y � 3 r '`I O Aq p g � U '� q Y $ � .� t � L � � E ap B °' � o � � o � m FY $ F � ��� � N ; < .. • . 571�N3ID � �, � � sv� �iSVM OUIv swisv� ban sN�v�a sr�ws u✓ia amaa L.wa MSVM arus .�.�. � �av� �� a.,00 rurw. Tdj.�D7Sj q �. I rt!I rv` O 1 O � � � � I 7 C� 8 p C � $ . c .9. � � 7 O U p 0�0 y o v 3 O iC u n .x � v � E ! iC D F ui O 0 0 � � g� �Yo a C s� : i � i il I r i• s 1 W � 0 W U N W Q Q' J � � a Z pe W � C � \ � � � � � z °a C o° . � i � F t+1 M M N M N N» M � g$�'� g'c�, 8 t g i�°, g �' w w w °� � � i�► �" � �► �ii % % x % x x M M 7t K =11111i1�11�1 : : : : � : ' : . : . . � � si 9 . . . � • • m . 5 . . . � °0 � � � . : : � G �G i7 . . a. . 9 . . � : � g : ° o� : - � a d c` z: 7� :�$ � o O . tc � ^' °`� x �s �;;; ��s � �M �� K� S ° g w x a � � ' 3 ` a � Y � � � a = z� z u° 3 zp H� e c� O �+ � � 0 � � . 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W J � 0 W U N W H � J a � a a H � N N N M M N N t g�� c� g v�i g� 8 n g °G « w .► °ri :g � Fi °C « » :i M K X i1 M K M N 71 N � I � � � � �(°z � � � � �. � � �. : : : O 4 W : .ra' � . � •p , �� O W R t °' �' g ° ° � � � a „ o v 4 � � a' �r ����qx�g��o" : � � � �i � o M n � a �� s � M� a x z� z" u B z q� � S tl �,7 � 0. d � � � ^ �� � 1.� � n �F F � � � � � ° e � � � - SUBJECi � �� ;� City of Fridley "'T"ET°°°FT"E�'"s gUiLDING: PERMIT � � ' � ' COMMUNITY OEXEIOPMENT ON. ' � v'-"'", r � PROTECT4VE INSPECTION SEC. f � � i,.__-� �"'�,� GTY HALL FRIDLE� 55432 NUMBEfl- t � 812-580.3�50 910-F15 JOB qDORESS _�,16 le coe Street N E. 7 LEGAL L6TN0. BIOCK � - TRACTORADDITION � a fl�. DESCR. SZ�SL T Riverview Heighta Addition USE OF OFUSEFROM Garage � NEW 616 Glencoe Street N.E. MAIL AODRESS MAII ADDRESS 55432 21P P�GE OF � � ° 12061 NO. (o�! 9�a. APGROVEO BY SEEATTACHED SHEE7' LICENSE NO. PHONE LICENSE NO. ❑ ADDITION D ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE TO STIPULATIONS - � � � Stipulationa; Provide a hard aurface driveway..Get a latter from N.S.P. approving building garage 3 feet fzom back property line. SEPERATE PERMITS REQUfRED FOR WIRING, HEATING, PLUMBlNG AND SlGNS. SEPAPATE PERMITS ARE RE�UIRED FOF ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL ANO VOID IF WO(iK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 OAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PEHIOD OF /20 DAYS AT ANV TIME AFTER WORK IS COMMENCED. 1 HEFEBV CERTIFY THAT 1 HAVE HEAD AND E%AMINED THIS APPIICATION ANU KNOW THE SAME TO BE TRUE AND CORRECT. ALL PPOVISIONS OF LAWS � �AND OROINANCES GOVERNING TNIS TVPE OF WORK WILL BE COMGLIED WITM WHETHER SPECIFIEO HEREIN OH NOT. TNE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL THE PPOVISIONS OP ANY OTHER STATE OR LOCAL LAW REGUUTING CON- STRUCflON OR-THE PERFOHMANCE OF CONSTRUCTION. � :ONTRA i HORAUT OH�ENT �D�A/iEI �`- n. _ t 3 �'f/73 9.00 ;Y GROUP OCCUPANC CU. FT. 440 4400 OFiSTREET PARKING CaARAGES SURTAX .99 SACCHARGE TOTALFEE $9.99 AF.P�ICATION FpA RE$IAENTIA�� AbT�R�4TIQN, QR AAAITION BUILDING P&RMTT GITY OF FRID�EY, MINN�SOT� 9WNE8'S NA1lE:,SrEFR[Q �• S4Eiatia�st BUILABR nnn�tess: (, 1�, C<c 6N�o E s+. W, e. nn�ss �IOSs� (�a ST&EETt b�f; Lfdc o,� S i. r+/, �. IAT:, S' /___ ^____T.S �- gLOC&; T�F ADAITIONe, �.J Cle � i�E �✓ +f r: v l�ts T LORNBR LOT: �IAE Lf?T: � S$TBACRt SIDEY(fRD: �i.i4uqqt 8,t�:ac� *p f��,s �ps7�_ io Certificatea of Suivev of Lot aad proppaed bq�,idiag lacation sir�R oa tl�ese Cartificates, ��SCRIPTION OF BUIL�ING 9bo Se Wed As: GRQAq€. B� a a' �rn- �l ' ae�she• �o ' � square Baes; '%�O cub�c F�ets '�/�/00 Fropts Depth; Height• 6quaFe j�eet; Cubic 8eett 7j�{�e of �oaetrucCiaA; Weao ftq,y E Bstfa�ated Coat: $/��J�3. �U ',T4 �Di! QOI�i4tRd7 � M oN 7�� Z . Tba nmdespigned hereby �kes apPl�ca[irnt for,a peslait for the posk herein •peCLfied� agseeing fia do all Moik 1=t sttict accordance with Che Glty of Fll�dl� Qid�ASncee 8ad tttlis�gi 7i£ �►a Departmen* of Bu�idixt�a, epd he=eby i�wlareai i�at all the #+teu a�pd represertatione atated �t this application i�s �sue aa� correct, . ADZ9S; 3,,,�/ 3,17,3,_, BIGNATURE: r (Bp 1tsvK�e S�de Pos Add�ti,onsl Infosv�atian.) -k.� � ,+ � '� f� 1` � � �'`^� 1t -�� � g.00 �t� � �a��� .' � `� W �999 ���, l�/, �, , � � a r� c, � � � y li �� �j �` :� �-� � �, � � � I._ t �y ��c,. r Building Inspections 763-572-3604 - �: BUILDING RESIDENTIAL APPLICATION SITEADDRFSS (e!/s G-lYw�r 7% THIS APPLICANT IS: ❑ OWNER PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATfON PROPERTY TYPE CITY OF FRIDLEY YOUR E-MAIL ADDRESS o� PHONE: �Gt' �SD' RZ6p STATE LICENSE #_ ADDRESS:y��i PHONE S� � � INGLE FAMILY! ❑ TWO FAMILY/NE FAX PERMIT TYPE � �+DDITION ❑ GARAGFJSHED ❑ BASEMENT FMISH ❑ ROOF ❑ DECK ❑ SIDING TYPE OF WORK: DES(:RIBE WORK BEING DONE: SIZE OF NUMBEROFSQUARES_ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other /.t�7U1�hJJ LENGTH ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATIACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Tnm ❑ Fascia WINDOWS IN EXISTING OPENINGS �Yes �No LDCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF W INDOW TO BE INSTALLED NUMBER OF � i� ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ Z/U �°� OCCUPANC' Plan Review Fire Surcharge Surcharge License Surcharge SAC Chazge C�rb Clit Escrow Erosion Control Pazk Fee Sewer Main Charge Due 6DRAA1 TILE ❑ OTHER Received Date Rec'd: HEIGHT �i��Y 3Z BASEMEN'f REMODELAIG SUBMTT: l. ExisOmg Floor Plan 2. Proposed floor plan 3. List of sW cWnl members to be used FORNEW CONSTRUCTION INCLUDMG DECKS, ADDITIONS. & PORCHES SUBMIT: L Site Plan/Survey showing ihe ezisting swcNres and propose�projec� � 2. Two setwof construction plans 3. Energy Calculations TYPE See Back Page for Fee Schedule 65% of Building Pernut Fee .001 tvnes the total job valuation .0005 x Pennit Valuation Minunum $.50 TERIALS: $ S, p� $5.00 (State Licensed Residential Contracrors) $ $1550 per SAC Unit (Plans [o MWCC for determination) $ ft+6ft= ftx$20=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ (, (� Make checks payable to: City of Fridley _ Attac THIS IS AN APPLICATTON FOR A PERMTT-NOT VALID UNTIL PROCFSSED I hereby apply for a building pemrit and I aclmowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ciry of Fridley and with the Minnesota Construction Codes; that I understand this is not a permi[ but only an application for a pertnit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work wluch reqques review and approval of plans. � _ SIGNATURE OF APPLICANT Building BUILDING Permit No.�I3 $� Inspections RESIDENTIAL APPLICATION Received By:� 763-572-3604 CITY OF FRIDLEY Date�''� EP 2� 763-502-4977 FAX EFFECTIVES-19-09 DATE l��D'0 / YOURE-MAILADDRESS_ ��G I'Z3�IS ���M�cS%, I✓L° j SITE ADDRESS b l6 (!e r� Co C 5� !^-(� l d!< Y /''� � S�`!3 THIS APPLICAM IS: p OWNER OCON'IRACTOR PROPERTYOWNER/ Nq�: �V�{,�j �' �c�,f �1 C•r TENANT pDnttESS:_(� /� Ce[{niCoe Sr cmt F�� elCY STATFI"'��✓ZIP S�J �/'S Z PHONE: %� �- �$�O� 97l`7� CONTRACTOR Nq�„�: SUBMIT A COPY OF STATE LICENSE # EXP DA'I'E YOUR STATE LICENSE AND CER"[TF[CATE OF ADDRESS: CITY STATE ZIP INSURANCE pHONE FAX PROPER7'Y TYPE �SMGLE FAMILY/NEW CONSTRUC770N SIZE IWO FAMILYMEW CON57RUCTfON STORIES / PERMIT TYPE O ADDI770N ❑ GARAG&SHED ❑ WINDOWS ❑ BASEMENT FINISH �ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ S W IMMMG POOI. 1TPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDfIION ❑ MAINTENANCE/REPAIA ❑ REMODELMG DESCRIBE WORK BE[NG DONE: R� I�ODF - SIZEOFIMPROVEMENT LENGTH WIDTH HEIGHT S FI' NUO� OF SQUARES ��I ❑ HOUSE & GARAGE BASEMENT REMODELIN MIT L Ezis[ingFloorPlan GARAGES ❑ ATTACHED GARAGE 2. Proposcd Floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structu�al membcrs ta be used PROPOSED HEIGHT: gIDING FOR NEW CONSTRUC770N MCLUDING DECKS, ��'��Y� �Soffit ADD1770NS. & PORCHFS SUBMTI� � Aluminum ❑ Trim �� Site p�ar✓Sw'eY showing the existing strucWres ❑ Other ❑ Fascia � and proposed projecl. 2. Two sets af construction plens WINDOWS � � 3. ErwrgyCalculations INEXISTMGOPENINGS DYes ONo LOCA770NOF WINDOWS FORWINDOWS-PROVIDEU-VALUEAND OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WMDOW. OPENING CHANGES & TYPEOFW[NDOWTOBEINSTALLED NUMBEROFWINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE WST OF LABOR AND MATERIALS: YY�]I 1 Plan Review Fire Surcharge Surcharge License Surchazge SAC Charge Cur6 Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due [USLNG "fHE 1997 U.B.0 FEE SCHEDULE) See Back Page for Fee Schedule 65% of Building Permit Fee .001 times [he total job valuation .0005 x Pertni[ V aluazion Minimum 5.50 55.00 (State Licensed Residential Contracton) $2000 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftxS22=S 5450 Conservazion Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) checks THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED Atfach I hereby apply for a building permit and I aclmowledge that the infortnation above is complete and acwrate; that the work will be in conformance with the ordinances and wdes of the City of Fridley and with the Minnesota Construction Codes; [hat I understand this is not a permit but only an application for a permi[ and work is not to start without a permit on site; that [he work will be in accordance with the approved plan in the case o�f all �wor�yvjhich requires review and approval of plans. SIGNATURE OF APPLICANT T...,iC,C/ ��--� PR1NT NAME ��I/E ('E7'"r �„ {�7 e�DATE 'nl'1�G `0 F