AF - 46192BUILDING PERMIT
Village of Fridley, Minn. x� 21 ��
Date •�!•�T:��%�a�. [P• ............ ...............
! / �
Owner 4L:kv.r'tf•(�..�,.4`r�7'!!!...... Builder� ...........................................
Address tt ri.�� ... .��l:t'�/.k.':�1.... 2.tf� . Address .. . . ...... .. . . ... . ...... .. .. . ....... . . ...
LOCATION OF BUILDING
No. ...�. •S•a��..... Street ..�r�.�a-ss::s-it1....�4�'..... Part of Lot .......................
Lot ........ �..... Block ....� ......... Addition or SuMDivision �?�?!6.'✓..�(��...C6y(��!y.......
Corner Lot ............ Inside Lot ............ Setback 3��!��fy� 5ideyard . fQ.�.�ff .............
DESCRIPTfON OF BUILDWG
To be Used as:
�!!'rzL-i�i-ff.,�'�... Front .,.�.ij�. DePth .,;,'-.��..Height .��:;� Sq. Ft. ........ Cu. Ft. ........
¢ �r:.� { ,7
.................... Front ........ Depth ... r.... Height ......... 5q. Ft. ........ Cii. F[. ........
�.0 -:'
Type ofConstruction :�:4tC�-�..-�,(. Est. Cost .fly�C�/._,)... .r.:....... To be Completed .•�rt'f.C�%�#:�.�.�
In consideration of the issuance to me of a permit to construct the building descri6ed above, I agree to do
the proposed work in accordanee witti the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
...........................�........................
/ 7n consideration of the payment of a fee of $ �C �permit is hereby.:granted to ..�9�?'!�. ,f.' r�..
,,,�rj��r�t�61�,,...... to construct the buildin�r/r addition as described above. This permit is granted �upon
'f $ie express c$n�ion that the person to whom it is granted and his agents, employees and worlm�en, in all work
done in, amund and upon said building, or any part thereof, shall conform in all respecfs to the ordinances of
Fridley, Minnesota regarding locarion, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. , f ...
InspeMOr
NOTICE: � �.
This permit does not caver the construction, instzliatlon or alteration for wiring, plumbing; gas heating,
sewer or water. Be sure to see tha Building Inspector for separate permits for tfiese items. .
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SUB�ECT
City of Fridley � � 5 � �
AT�METOPOFTHETWINS gUILDING.� PERMIT
' � IPT NO
� � ��_ _ C�MMUNITV DEYELOPMENT OIV. � �� � �
r � �'� PROTECTIVE INSPECTION SEC. � 99 �/9
1
� ���""t � CITY MALL FRIDLE� 55432 �+umeer+ aEV. onrE o>ce oF nocqoveo er
�'""� � ,'' 612-571-3450 970-F�5 5/12/80 � /
JOB ADDRESS 5821 Hackmann Avenue N.E.
LOT NO. BLOCK TRACT OR ADDITION
i LEGAL SEEATTALHED
DESCR. 7 3 Paiwiew Mamr SHEET
2 PfiOPERTYOWNER MAILADDRESS ZIP PMONE
Hernard P. Demarais 5821 Hackmann Avenue N.E. 571-9178
3 CONTqACTOR MAILADDRESS ZIP PHONE LICENSENO.
Sussel Company 1850 C�o Avenue, St. Paul 645-0331
d ARCHITECTORDESIGNER MAILADDRESS ZIP VMONE LICENSENO.
5 ENGINEEP MAILADDRE55 ZIP PHONE LICENSENO.
8 USEOFBUILDING
Residential
7 ClAS50FWORK
� NEW ❑ ADDITION qd ALTEPATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 24' x 30' Detached Garage and convert existing garage to livinq
area.
9 CHANGEOFUSEFROM TO
STIPULATIONS
SEPERATE PfRMiTS REQUtRED FOR OYiRtfl1£�,
WEATING, PLUA7IBING ANQ SIGI�S.
WAR�IG
8elae digging caN bcel util�ies
TELEPHONE • ELECTItIC-6A$ Etc,
REQUtitED BY LAW
SEPARATEPERMITSAREPEQUtREDFORELECTRICAI,PIUMBING,HEATING, tYPEOFCONST. OCCUPANCVGROUP OCWPANCYLOAD
VENTIIATING OR AIR CONDITIONING. �
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRLICTION ZONING � S�.FT. CU.FT.
-AUTHORI2ED IS NOT COMMENCED WITHIN 60 �AVS, QR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABAN�ONED FOR A PERIOD OF 120 DAVS AT �
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMWED THIS APPLICATION 1 �STqLLS GARAGES
ANDKNOWTHESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAWS yqLUATION SURTA%
AND OHDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO $6 343.24 $3.1%
.WITM WHETNER SVECIFIED MEPEIN OP NOT. TNE GRANTING OF A PERMIT �
DOES NOT PHESUME TO GIVE AUTHORITV 70 VIOLATE OR CANCEL TME pERMITfEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCiION Ofi THE PERFORMANCE OF CONSTRUCTION. $ZS.HO
. PLANCHELKFEE TOTALFEE
$31.47
�/ A*uAeOF-COr�iAnCroeoa ur RIZEDNGENi �o iEi WHEN PROPERLY VALIDATED THIS i5 VOUF PERMR
/ \ ' � �Y
IGNATUREOFOWNERiIfOWNERBmLDER1 0 9LOG iNSa n E
�...
CI7Y Ot' FRIDL[Y
Af?PLIC11'CION FOR RFSIDE[ylIlil_ fiU.LUTPJG PGRP4ITS �
� . (He�•r, Alteratiuns, Additicns, or Repairs)
04lN[R: ,�P.S�?�. �' �rn�(�a i �_ eui.LD[R: , �USSe�.,
ADDRESS: �E�a\ �p�,�m'�..�J "AU�. T�. �, ADDR[SS: Ia�O CO� A-V� �T Qa�.Q.
1[L rd0: �7�— �17�• TEL t90: l�ys- a��d �
Construction Location
sTRrn;� iao: S8a1 sTi�rr: k�'AC�rn�,.,,� �v�. N. F„
LOT: I RLOCY.: � AUDITION: ��!/�GJ 1 C.vJ 1��%�A%O R.
Corner Lot: • Iriside Lot: � Setbacl;: Sideyards:
Applicant attach to this form tcvo Certificat��s oi 5urvey o£ lot and
proposed building location dra:an on certificates to scale.
DFSCRIPTIOir' OF COivSTRUCTIOid
�r0.���9 , Ga.,,, =ay � -- — ,
�jE.Front_ --. ,�.__ �P� � _ t3U
I, I
lieight: 'v
Squane.Teet: Cl�bic Feet:
'WNU� �I�fI�A - —
6
1�U^'a'W Gd"�'�C Front: Depih: ]3eight:
�U �'���� �"'F'�' S uare Peet: Cubic Feet:
���. �5-��✓r1I.xG�. '
.�i
7j>pe o£ Construction:w�tJR ���CS(�G�V� , ' Estimated Cost: ;
_—�_ �
7U Be Cbmpleted: �JO.t.t.L ay � 7�l.
� n���L � �
� �7�y�.�1 �P
Froposed Driveway S4idth If New Opening Is Desired:
I�lt. R
�n3y3, ao
Ali-. B
$ $
.. - S�E 12EVER5� SIDE OI' Sf3�ET
'1°iie undersigned hereby makes apr�lication �or a pe.'mit for thz 4o.rk herein specified,
agreein�7 to do al.]. work ir� strict accordcu,c� �oith the City of Pridley Ordinanees and
rulings oL t}le De1�arUnent oi Builclings, aiid ]iereb}� dcclares tliat all the iacts ano
represen4ztions stateci i�i i:hi� application are true and correct.
D)1TE: I— Of S� Q lJ SIGNATU.RE :
Stipulations:
tl'�znw��•'� o��• $�
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� � � � � suuctr �- -. � � RMIT NO.
c�ty of Fridley 2 9 817
.
� �T'ME'°°°°'�Em'"S gUlLDIN� PERMIT No
,�
� � �� COMMUN�TY �EVE�OPMENT OIV. / � /�
f � y � PROTECTIVE IN578CTION SEC. ��
i
i
� � /'P1 . GTY NALL FqIOLE� 55�73 NuMlEa pEV O�TE ��GE O� �IVnOVEC !r
i..__�1.• ,,, e�2—s��—saso 910�F15 7/6/99 / /
,oa .00Aess 5821 Hackmann Avenue NE
t LEGAI �Ot NO. BIOCK . ��� TNACT OM1 AOOITION SEE ATiACNED
oescn. 7 3 Pdrkview Manor SMEET
2 PROPENTYOWNEii MAILADDAEg$ �P PMONE
Patrick Kni ht 4-
7 CONTqACTOR MAII ADDRE55 ZIP PXpNE IICENSE NO
Pennin ton Const. 4347 Centr T -
� ARCNITECTORDESIGNEH MAIIADORESS ZIP VMONE UCENSENO.
5 ENGINEER MAILADDPE55 . 21P PNONE UCENSENO
8 USEOFBWLDING
Residential
7 CLASSOiWOFN
p NEW D ADOITION ❑ ALTEFiAT10N S}C REPAIR ❑ MOVE p REMOVE
B DESCRIBE WORK
Reroof house and ara e 27 S T ar- ff
9 CHAN6E Of USE FROM TO
STIPULATIONS . �
Underlayment must comply with the State Building Code.
TYPEOFCONST. OCCU�ANCVGHOUP OCCUP�NCY�OAD
SEPARATE PENMIT$ ARE REOUIRED FOA ELECTNICAL, PIUMBING, MEATING.
VENTIUTING OR AIR CANOITIONIN4 � �
THI$ PERMIT BECOMES NULL ANO �OID IF WORK OR CONSTRUCTION ZpNIHG SO.fT CU FT
AUTMORIZE� IS NOT COMMENCEO WITMIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FON A PEFlIOD OF 720 DRYS �i
ANY TIME AFTER WORK IS COMMENCEO. NO DWLG. UNITS OFiSTREET PARKING
I HEREBV CER7IFY TMRT I MAYE AEAD AND E%AMINED THIS APPLICA710N STALlS GARAGES
RNONNOWTHESAMETOBETRUEANOCORRECT.�LIGROVI510N50f�AW5 yp�UATIpN SURT�%
AN� OROINANCES GOVERNING TMIS TVOE Oi WOi1K WLLl BE LOMPLIED .
WITM WHETMER SPECIFIE� MEREIN OP 110T. TME GRAN�ING Of A PERMR
DOES NOT PRESVME TO GIVE AUTHOAITV TO VIOLATE OF C�NCEL iME pEpMITfEE SACCMAAGE
PAO�ISIONS F 4NV OTHEN 5T OR LOCAL LAW FEGUL�TING CON�
STRU ON F TME �ER RMA Of CONSiqUCTION
P�AN �NECKFEE TOTA�FEE
se SC 5. 0 91.7
GN�+uaEO� '�Ci 0�u O ED�GE�+� �0�*0 {{E PERLV V IVD�TEO TMI IS YOUR GEAMIT
�P �
S�GNaiUAEO�OWNf4efOWNfABWLDfMi �04�Er BIDL�N50 r�alf
NEW. �[ ]
ADDN [ ]
ALTER [ l
C1TY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effec[ive 1/1/49
�pa 98i�
�o����o��ess:s�a� �Q���,Q�� ��e ,v� SSy3a
I.egal Description:
Owner Name & Address: �4'1'vi C.K �H �`q �t'f' SQ �"'� 2 Tel. # 6I �? 5`i � 9�yD
canc,�tor: Pe��; �g1-�� Co�x�r MNLICENSEl�o�01693�II
Aaaress: �43 �� �v1'%�4 / �4�e NE Te�. # 6`la? 7fr& �88-9
LIVING AREA:
GARAGE AREA:
DECK AREA:
Attach to this applicadon, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
I.ength
Length
Length
DESCRIPTION OF Il1�PROVEMIIYT
Width Height Sq. Ft.
Width Height Sq. Ft.
Width Hgt/Ground _ Sq. Ft.
° OTI�R:
,t Vo���
Construction Type:��_y(9�Fi� �f dit�✓ Estimated Cost: $?���� a�7 17�.B�a�
(Fee Schedule on Back) ��/ �
to
Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x$ _$
DATE: /^a qq APPLICANT: �o�� \-��M�' Tel. �f �/.��/P'�e/Q%
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
�
$ 3.�s
$ a3�
$ /, / �g
$
$ �do
$
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth°!o)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residendal Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary []
TOTAL
STIPULATIONS:
$ �'/ �9
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