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Ciiy of Fridle�, N�a.nn.
�UII.DING PE '�
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Owner � . �. . . . . � Builder
Addr�s . . . ��.� ! . . . . . . . . . . . . . . . . . . . . . . ddress
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N° 3107
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LO�CATt0�11 OF' �U[LDIdo�C
No. .�� ��Street ���,n��. . . . .. . . . Part of I.flt . . . . . . . .. .. . . . . . . . . . . . . . .
. �.
Lot . ....� . ... Blo .. .�1.. .. ... Addition or Sub-Division . ..�. . . . ;����% . . . .
Carner Lot ............ Inside Lot ............ Setback ..�'�� ... Sideyard��.�':�^: ���,�'%t�e���
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DES�CRIP'd'IONf OF �Ui�DII�G
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. . Front . Depth°Z . Height��i:�G� Sq. F`t. �O'� Cu. F't. . . . . . . . .
. . Fr nt . /. �� Depth �� .� • . H igh . . . a� Sq. Ft. . °�. 9� Cta. F't. . . . . . . . .
�structio . . . . . . . . . . . . Est. Cq�t. f. �r1.'.! .b .'.'-"'10 �be Completed . . . .� . . . . . . . . . . . . .
���� �� �.- S�' .. �
/ � � C�'�/��°�t�*�e� %� � °
In consideration of the issuance to me of a germit to construct the build'ang desribed above, I agree to do
the proposed work in accordance with the description above set forih compliance v+�ith all provisions of
ordinances of the city of Fridley. `°�
A�f.
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In consideration of tlae payment of a fee of $. �� p. ...�, ermit is hereby granted to . ......
. . . . . . . . . . . . . . . . . . . . . . . . . to construct the building or addition as described above. This permit is graated upon
the express condition that the person to whom it is granted and his agents, employees and worl�nen, ia all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota. rega.rding location, construction, alteration, maintenance, repair and moving of buildings with-
ia the city limits and ihis permit may be revoked at any tiane upon violation of imv�e# the provisions of said
ordinances. /I � �� /
NOTICE:
Thls permlt does not cover the const�uetlon, inetallation o� alteration fo� wiring,
sewe� or water. Be sure to see the Building Inspector fo� separate permtts for the�
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gas heating,
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INDUSTpIAL C. E. C O.0 L T E R
BUBINE88
ciTV �oTa LAND SURVEYOR
TOPOORAPHIC MAPPING REGISTERED UNDER LAWS OF STATE OF MINIVESOTA
LICENBED BY ORDINANC6 OP C17Y OF MINNBAPOLIB
3300 LYNDALE AVE. 50. MINNEAPOLIS 6, MINN.
TAYLOR 4-0370
SUk'I/EY FO�' �i6'4/D E. �'.�ePl�s�;1�' � SO/►/ �/Yl,'
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LAKEBHORE
JUDICIAL
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I hereby certify that the abqve is a true and corzect plat of e
a survey of : ��
Lot Seven (7 ), Block Two ( 2). PAI�KVIEU� I�sANOR, Anoka County,
Minnesota, except the Northeasterly Ten (10) Feet thereof, as
measured at right angles to the Northeasterly line thereof.
As surveyed by me this 20th day of June 1958, A. D.
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,� S3gned � �a��
f�tinnesota ..�qistratson Noo :'_
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Caty of Fridley, Minn.
BUILDING PERMIT
Da�; June 8�1967
� �����
N� 9298
p�r• Gi1 Ro��enbuck g�� A. B. C. Blacktop Co.
�� 5 889 Haclanan Ave . N' . E. Ad�� 1308 Main St . 1V. E.
LOCATION OF BUILDING
No. 5 889 5�t Sacl�an Ave . lQ'. E_ ____ Part of Lot
Lot � __ Block 2 Addition or Sub-Division . Parkview Ma.nor
Coraer Lot — Inside Lot Setback ._.__ Sideyard .—..
Sewer Elevatian �— — Foundation IIevation
DESCRIPTION OF BUILDING
To be Used as:
Front � Depth Height 84. F't. Cu. Ft
Front Depth I�eight Sq. Ft. — Cu. Ft
Blacktop Drive $134.00 Ju1y 5 1967
7�pe of Construction � Es� C�t — ...�__ _ To be Completed .�
In consideration of the fssuance to me of a permit to construct the building d�cribed above, I agiee to do
the proposed work in accordance with the description above set forth anc� in compliance wlth all Proviaions oP
oidinances of ti►e dtq of FricIIey. ,� ,� ✓
In consfderation of the payment of a fee of $ 5• � , pern�it is hereby granted to A. B. C.
Blacktop Cp. to construct the buiiding or addition as d�cribed above. This �ermit ia granted upon
the expr�s condition that theperson to whom it ia greated and hia agents, employees snd worl�nen, fn all work
daae in, around end u�n said build9ng, or any part thereof, alzall cwnPorm in all respects to the ordinances oE
Fridley, Minnesota location, conatruction, alteration, ma3ntenance, repair and moving of buildinge
within the dty ]innits� permit may be revoked at any time u�n violation of any oE the provisions oP eaid
ordinanc.�.
cT_ARENCE BELISLE g�� �
NOTICE:
'Ihis penait doss nM eersr �6s eoestendioe, inshllatioe }er wieine, plvmbing, en 6eaHeg, mr�r er rrtltr. B� surs to su
t6o ButldMp lespseto� toe ssparat� p�rmits Por thas h�ns.
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APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME G I L � p G� E/� B C� G�i BUILDER _�•,Ba C•,�GA G�%d ���
ADDRESS J'�S l - �A�G1�C�J6� !!� �✓(J�� �•�� ADDRESS /� O �l - /�I �i/� S�• D� • � .
LOCATION OF BUILDING
N0. �� gcl STREET�/�G�`i1��/7� A��%��ART OF LOT
a
LOT '"% BLOCK o`�.o ADDITION OR SUBDIVISION � �� _
CORNER LOT INSIDE LOT SETBACK SIDE-YARD
SEWER ELEVATION TOP OF FOOTING
Applicant attach to this form two certificates of survey of lot and proposed
building location drawn on these two certificates.
DESCRIPTION OF BUILDING
�
To be Us ed as :
-- Front
Sq. Ft .
Depth
Front • Depth
Sq. Ft .
Height_
Cu. Ft.
Iieight
Cu. Ft.
Type of Construction ���Gi�%D1� //JEGcJa4 Estimated Cost �%3 L� �J
To Be Completed ��( �. � � � ��� 7
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridley Qrdinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are�true and correct.
DATE �1 u�vE �� I g� 7 SIGNATURE �' � C; . ��
(Schedule of Fee Costs can be found n the Reverse Side),
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BUILDING PERI�SIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erection of any bu�lding of structure, or for any addition to any existing
build3.ng:or structure, or for any alteration or repairs to any existing building
or structure, upon application therefore, require the payment by the applicant
for suc:� permit of fees to the amount herein below set forth and in the manner
herein provided to-wit:
Ur..iform Building Code: Type 1,2, & 4- $1.75 for each one thousand cubic feet, or
fraction thereof, in such cubical contentso Type 3& 5-$1.50 for each
one thousand cubic feet.
For the purpose of computing fees��for building permits, the cubical contents of
any building or addition to a uniform height throughout by multipluing the ground
area covered from a point six (6) inches below the floor line of the basement or
cellar to the average height of the upper surface or to the average height of the
roof surface of the main gable of a pitched roofo
For repairs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each Five Hundred Dollars ($5J0.00) or fraction thereof
in the cost of all proposed work.
In no case shall the fee charged for any�permit as set forth in Section 2 be
less than $5.00.
- . NSSSD Connection Charges based on location- Area 1 or 2.
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sue�ecT P E .
City of Fridley _- 15 4 3 9
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � ECEIPT NO.
• COMMUNITY DEVELOPMENT DIV. g�
� �t: ------� r/
r � � PROTECTIVE INSPECTION SEC. 9 �
1 i i
� /��'1 � CITY HALL FRIDLEY SS43Z NUMBEP REV. DATE PAGE OF APPROVED BY
�""""� � ,�� 612-571-3450 910-F15 9/10/79 � �
JOB ADDRESS 5889 Hacl�nann Avenue N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. % 2 PaYYItS�12W M3I101" SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Vernon Roggenbuck 5889 Hacknnann Avenue N.E.
3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO.
Viking Fia�e Improvement Co. 4832 - 2� Street N.E. 560-3794
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Residential
7 CLASS OF WOHK
❑ NEW � ADDITION C� ALTERATION 0 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
]'nsta.11 alwninum soffit and fascia
9 CHANCiE qF USE FROM TO
STIPULATIONS
S�A�RA1E PERI�ITS REpUlREB F�R 1�11�� �
HEATIt��. PLi�N1�INt� sNB �tGfi�S.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENT�LATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWIG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �. STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $9OO �`. SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGU�ATING CON-
STRUCTION OR THE P RFORMANCE OF C STRUCTION. %. SO
PLAN CHECK FEE TOTAL FEE
� - 0' $8.00
SiGIrATUREOFCONTRA TOHORAUTHORIZ DAGErvT IDATEi WHEN PROPERLY ALIDATED THIS IS YOUR PERMIT
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SIGNATUREOF OWNERIIF OWNER BUILDERI IDATEI I BLDG INSP �pTE
,
CITY OF FRIDLEY •
APPLTCATION FOR RESIDENTIAL BUILDIP�G PERMITS
(�Jew, Alterations, Additions, or Repairs)
� OWPIER: �`/�d�/ � �,T ��,,�uc��
ADDRESS : .���% tf �i.' CC����� � G�'�—
TEL �IO:
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BUILDER: �c'/� .�� � ��.�� ��1 � �, ' ��,
, . �� ' .
ADDRESS: �� a�—� �� �/�� - , _
TEL N0: .% � U — � � .
P
� � � ' Construction Location
. / �
_ STR�sT NO: s�T: �i� ��.��,�� d� U �.. ._
I,oT: � szocx: � ADDITION: ��2� �J �� rYl �u� U�.�
Corner Lot: � Insiiie Lot: Sefback: Sid�yaxds: „�;_�
Applicant attach to this form two Certi,ficates of Survey of lot and
proposed building location dra�,m Qn certificates to scale. �
DESCRIPTIOtJ OF CONSTRUCTION -
Front: - Depth: H eight:
' Squa�e. Feeta � Gtibic Feet: -
. Front: � Depth: � Seight: .
� � Square• Feet: - Cubic Feet:
�
n GU
Type of Construction : /�l�/l�� �rv yj J�J t-F� % � �i�v C � � Estimated Cost: $ � ��
Zb Be Cbmpleted: �- I l' 7% � �
' Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $� $
� � . . SEE REVERSE SIDE OF SHEET ,
.The undersign�d hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE: �"� l Q'� I SIGNATURE : -�
Stipulations: '
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S�CTION 2. The znz;pector ot 13ui2cling� st�al.l, be�ore i.ssuing pc�nits for the erec�ion
oL• any uuiJ.ding or :�L•rucLure, or fax any addi.tion to any existing buildi�ny or siructure,
. or ior any ZltcraL-ion or ret�aizs to •any er.i ,ting buS.ldS.ng or �stzucturc, . upan agplication
'L-hereforc, require the payment by the applicani: for. suci� pexmiL- of fee� to the amount
herein bel.ow set forth and in �tie manner hercin �rovidcd to-wiL-: .
NJs4J CONSTRUCTION: Single ramily IIomey and Garages: $�L.00/1,000 cubic ieet. -
kLAN CIiECY.: 25 percent of bui.l.ding pexmit fee.
DRIV�tdAY DEPItESS20I1: (Concrete, Curb Streets Only) � �'
' Al.ternate A: Removal and rep7,acGment of concrete c�xrb and
gutter only; Driveway width plus 6£eet x Y,�5�y5
. -� Alternate 8: Removal and replacement of concrete curb and
• gutter and install a 3 foot wide approach with "
.- : 6 inch depth; Driver�ay width �plus 6 feet x$17.85 '
•' �. • ADDI TIOI�AL I�FORMAT I ON
For the purpose of computing iees for building permits, the cubical contents ot any �
' buil.dinq or addition, is determi.ned by multiplying the ground area covered from a
, point six (6) inches below the floor line of the basement dr th�•cellar to the
averag� heights of the upper surface or to the average height of the roof suriace
of the r�ain gable of a pitched roof. '
For repairs or alterations to an existing structure, the fee shall be at the rate
o£ $3.00 ,per. each five hundred do].lars -($500.00) or fraction thereof i.n the aost
af all pxoposed work. _
_�n •no r.ase shall the fee charged for any pexmit as set forth a.n Sectaon 2 iae less -
�han $7.50 plus $.50 state surcharge. � . -
� ' - - .. .._.. _ ,_ VERIFICATIO�! OF FOU1�(DATIOtd �
NO�TE: Permits for construction will be issued a minimtun of 24 hours from the tame
o� application to a].l.ow for proper xeview of the proposed structure and of the
constrexction site. -
A Certificat� of Survey of the lot, shoeaing the loca�ion of the foundation once it .
has been constructed will be required before proceeding with the framing.
� . � CERTIFiCAT OF O�rilp�nrrv _ � . -� �
Application for a Certificate oi Oceupancy shall be �nade ten (lp) days prior to the
use ar occupancy of any structure for wiiich a building permit has been issued; and
sa�id structure shall no� be used or occupied until a Certii'icate of Occupancy has
been issued.�
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GHI�Y l�iD BTlICR VBRIFIClITION
The undersiqned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes () No ()
2. Is free from rust or deterioration Yes () No ( j
3. Has no foreiqn objects lodqed within Yes () No ()
4. Is securely supported Yes () No ()
5. Meets all current Code requirements for
size and total BTU's connected
€ . -�ia� -���1 h�a�; aas,T �'�'rJ � � s�
All other BTU's
TOTAL BTU's
Remarks
List Alterations seinc Done:
Yes ( ) PTo ( )
HEATING COMPANY
Signed By
Date
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sue�ee� MIT NO. '�.
City of Frid�ey 2 8 68 3
,` 5����6�� TNE TWINS g � I I� D I N G P E R M I T CEIPT NO.
� `v _ COMMUNI7Y DEVELOPMENT DIV. ����
r � � PROTECTIVE INSPECTION SEC.
� . �
`_---� ��"' �'� CITY NALL FRIOLE� SSIJ2 NuMBEA pEV O�TE v�GE OF APVrtOVED er
i 612-571-3450 910-F15 11 30 98 � �
JOB ADORESS
5889 Hacl�ann Avenue
t LEGAL �OT NO. BLOCK TRACT OR ADOITION SEE ATTACHED
DESCF. � 2 Parkvi SNEET
2 PROPERTY OWNEFi MAIL AODFES$ ZIP PMONE
Jan Ro enbuck -
3 CONTRACTOR MAIL ADORESS ZIP PMONE LICENSE NO
Vikin Hm. Im rov. Co -
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PMONE LICENSE NO.
5 ENGINEER MAII ADDRESS . ZIP PNONE IICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADOITION O ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage (21 S) Tear-off
9 CHANdEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYpE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PEiiMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING
THIS PEFiMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING SC. FT CU FT.
AUTMORIZED IS NOT COMMENCED W.ITHIN BO OAYS, OR If CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 DAYS AT
ANY TIME AF7ER WOqK IS COMMENCED NO OWLG. UNITS OFfSTpEET PARKING
1 HEREBY CERTIFY TNAT I HAVE REAO AND EXAMINEO THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORiiEC7. ALL PROVISIONS OF LAWS yALUATION SU1iTAX
AND ORDINANCES GOVERNING TMIS TYPE Of WOiiK WI�L BE COMP�IEO
WITM WMETMER SPECIFIEO HEREIN Ofl NOT. TME GRANTING OF A PERMIT 1799 . O
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEL TNE pEqMIT FEE SAC CMAFGE
PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGUTATING CON-
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION 56. 5 Fire SC 1. SO
PLAN CNECK FEE TOiAL EE
At ���� � �� ✓� � / �
S�GNATUp OF CON'AACTOp OA AUTMOp�2ED AGENT iDAiEi HEN RO V L AT IS IS V� PERM=T�
J
s
S�GNn1UpE O� OWNEA��i OWNEA BU4DH:1� �DATE� iNS� � �i�TL
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�EW ^ [ � Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 q
BUILDING PERMIT APPLICATION � A� ��
. ��' ��
ConstructionAddress: .� c�S� % /��e le ��� fn�,� � � _
Legal Description:
Owner Name & Address: , 2e�� s � d�r �� .�,�. � Tel. # � 7� - �� �+ �
. ,
Contractor: ���' /�c�� ��/� .f.�F �,�� P ` �, ( o� � MN LICENSE # y� 7 L
Address: �J�.�� �% s�, ti-�'� �� c.�s _ ��- �s�� � Tel. # 5 7 Z'��> v
L
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 `JVidth Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Construction Type: ,�� � c�c c�= �/� Estimated Cost: $ �%��7'
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �� � -� o �' 8 APPLICANT• ����� Tel. # s � Z o � � �'
CITY USE ONLY
Permit Fee $ �� ,�S Fee Schedule on Reverse Side
Fire Surcharge $ l� c°� o.001 of Permit Valuation (1/lOth%)
State Surcharge $ � $.50/$1,000 Valuation
SAC Charge $ $10(}0 per SAC Unit
License Surcharge $ S- d d $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
�
$
$450.00 Conservation Plan Review
Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ � �/ S
_,, - , �
BUII,DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $SO,OQO
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the �rst $SQ0,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.