AF - 46403a
!
City of Fridley, Minn.
BUII.DING PERMIT
��: .-3�.�0...:��........
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N° 3750
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Owner ....................................... Builder �:!!.H!4f1...l.\.. `-�`.?r!�IT �..l..`."'j �"�C,
Addtess...................................... Addre�ss .............................................
LOCATION OF BUILDING
No. .�Q .YQ. Street . .�. f�:t.�V.'S .. .... . .... . .. Part of Lot ... .. .. .. . . .. . . . .. . .
.. .
�c .�/....... s�x ....a..... ... naa�n� � sun-n;�� .P..�. ..�.a..... �
... ...
corner Loc ............ 7naiae Lot . x........ secback 3��. s�aeyara lQ.�." ................
DESCRIPTION OF BUILDING
�To u
.. �c 'S�a.`.�' DePth �.�.`r.. �a HeiBht �.y.� �sq. �./D�,� c�. Fr%9 y%5 ��°�-
. .... .. �t /. 3� .f y nerr� �� ' �/ � x • hac G.,lQ�.''q.a�`' sa. �. .d.l�. y c�. Fr.�.r9.5�4 `/�
� of..l..�.�on ..... .. �.... ........ Fet �/. � �4. ✓...�.�To be ComPleted ...................
Im m�ederation of 1he isaiance to me ad a permit W construct the building de�'bed above, I agee to do
the pmposed work ia accordance with the d�aiptton above set forth and in rnmpllence with all proviaiaos of
m�dinances of the aty of Fridley.
x..................................................
.(/�rJO
Ea cwneideratlon of ffie payment oP a fee of S.. . J.. , Permit is hernbY S�ted to ... .......... .. ....
......................... to construct ihe building or addition as deacribed above. R1us permit is �anted upon
the express condition that the pereon #o wham it 1s �anted and his agents. emPloyeee and woH�en. in all wa�k
done in, around and�tipon said�building, or aqy part theieof. shall conform in all respects to the ordinances of
FYidley, Minnenota regaz•ding locati�, conshvction, alteration, maintenance, repair and moving of build'm� wifh-
in the eky llmits. and this� permit m�v be revoked at eqy time upon violation o���.he pmvisions of said
ordinances. . /
..��.... Bullding� &upecMr
NOTICE:
This pe�mit does not cover tha construation, installatlon o� alteratloe for wirinq, plumbiny, pas heating,
sewer o� water. Be wre to see the Bulidlny Inspeato� for separate permfb fo� the�e itema
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S�a,E�, P.RM12153
City of Fridley
�
AT TME TOP OF TXE 1WINS gU I L.D I N G� ��P E R�M I T
,,
.� .
� , ; ��_�� �_ COMMUNITY DEYELOPMENT, DIV. � . � - � /`_ �
'�. r- � � PfiOTECTIYE INSPECTION SEC. � � 1�3 9�
1 i �
� i"'1 � CITY HALL FHIDLE� � 554$2 NUYBER REV. DnrE vnG[ or �vwrovE� Bv
�•"'� � � � ,•� 8125803050
910-F75 6/1/73 � � �
JOBADDRE55 1040 Hackman Circle N.E.
1 LEGAL LOT N0. . BLOCK 'TRACT OR AODITION SEE ATTACMEO
BESCR. YL Z SMEET
. 2 PROPERTYOWNER _ . MAILADDRESS �� ZIP PHONE
Robert Drowns 1040 Hackman Circle N.E.
3 CONTRACTOR . .MAILAD�RESS Z�P PHONE LICENSENO.
Ri;:e Way Engineering 2654 Lyndale Avenue South
� ARCMRECTOFDESIGNER MAIIADDRESS ZIP PNONE LICENSENO.
5 ENGINEEP MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Reside tial
�7 CLASSOFWORK
p NEW ❑ ADOITION ❑ ALTERATION ❑ REPAIH ❑ MOVE ❑ REMOVE
� -6 DESCPIBEWORK
Inatall dra nage system �n basement
9 CHAN�EOfUSEPROM TO
STIPULATIONS Do not connect drainage system to sani.�ary sever
g�pERATE �UMBING ANDUSiGNS.OR ��fRING,
HEA7IHG, P
- TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE�PERMITSAHE REQUIRED F08 ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITtONING.
�THIS PEflMIT BECAMES NULL AND VOID IF WOFK OR CONSTPUCTION ZONING SO.FT. Cl1.FT.
AUTHOPIZED IS NOT COMMENCED WITHIN 80 DAYS, OR !F CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAVS AT
ANY TIME AfTEA�WORK IS COMMENCED. NO. DWLG. UNITS OPFSTREET PARKING
I HEREBV CERTIiV THAT I HAVE READ AND E%AMINE� THIS APPUCATION STALLS GARAGES
ANDKNOWTHESAMET08ETRUEANDCORfiECT.ALLPROVISIONSOFLAWS yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �
WITN WFIETHER SPECIFIED HEREIN OR NOT. THE CaHANTING Oi A 7ERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pE M TFEE SACCHARGE �
. PROYISIONS OF ANY OTHER STATE OFl LOCAI LAW FEGULATMG WN-
STRUCT40 OR THE PERFORMANCE OF CONSTRUCTION. � 9.00 �
� PLAN CHECKFEE TOTALFEE
9 5
SiGHn p�� icOHTRnCTOROFlAUiHORIZEOnG N� IoaiEi N ROPERLY VALIOA IS IS UR PERMIT ..
n
51GNaTUREOFpWHER�iFOWNERBUILDERI �DnTE� BLDG i�+SP Dn
ApPLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: ��a � e r%� �ir�rwti S BUILDER: r�i �'�L —t.��ci �,
ADDRESS: /O�/O f/ctcJC -< C,'✓� ADDRESS; 2�(4Lc��,d../.. /� S" /)7 l
/� 5-
NO•. /b �(o STREET• J��_ �_ J� w,e �.. Ctr /v
LOT• 2 ( BLOCK• ,? ADDITION•
CORNER LOT; INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this foxm ltao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To Be Ueed As;
llESCRIPTION OF BUILDING
Front• Depth: Height
Square Feet• Cubic Feet:
FYOnt• Depth• Height:
Square Feet; Cubic Feet•
In bus<.r+v�aT
Type of Construction: �a/r.��._.,, SyG,�,,�, Eatimated Cost:_�S /,S Op�
.
To g6 Cotnpleted• �'- (' � 3
Tha underaigned hereby makes applicativn for a pexmit for the work herein
epecified, agreeing to do all work in sttict accordance with the City of
Fridley Ordinances and =ulings of the Department of Buildinge, and hereby
declarea that all the facte and representations stated in this application
are true and correct,
naxE: _S- 3�� 7 3 sicxnzvxE:__ �����. �_
(See Reverae S1de Far Additional Infoxynation.) .
.��� -� `.�S = . 4� � � / .
�_ � �� �� �..��,� �,�� .
� ��� �.� �
.
BUILDING PERMIT 'rEE SCHEDULE
SECTION 2. The Inepector of Buildings shall, before issuing permits for the
erection of any building or structure, or for any addition to any exiating
huilding or atructure, or for any alteration or repairs to any exiating
building or etx'ucture, 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:
UbTIFORM BUILDING CoDE: Type 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents, Type 3& 5-$1.85 for
each one thousand cubic feet. .
ADDITIONAL INFORMATION
�'or the purpoae of computing fees for building permita, the cubical contents
of any building or addition, ia determined by multiplying the ground area
covered from a point six (6) inches below the floor line of the basement
or the cellar to the everage heights of the upper surface or to the average
heigl�t of the roof surface of the main gabie of a pitched roof,
For repaira or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
In no caee ahall the fee charged for any pexmit as set forth in Section 2 be
lese than $5.00.
VERIFICATION OF FOUNDATION
NOTE; Permlta for eonatruction will be isaued a minimum of 24 houra from the
time of agplication, to allaw for proper revfew of the proposed structure and
oi tl�e conatruction site.
A Certifiad Survey of the lot� ahowing the location of the foundation, onee it
has heen constnicted� will be required before proceedin� with the f7raming.
CERTIFICATE OF OCCUPANCX
Applieation for a Ceztificate ot Occupancy shall be made ten (10) days prior
to the uae or occupancy of any atructure for which a building permit has been
iasued; and said etxvcture shall not be used or occupied until a Certificate
of Occupancy hae been iaeued.
�
LAW OFFICES
WEAVER, TALLE &. HERRICK
GNARLES R.WEAVER
HEPMAN L,TALLE
VIRGIL C.MERRICH
ROBERT MUNNS
,JqmES D. GIBBS
WILLIAM H,GOOORICH
THOMAS A.GEDOE
JEFFREY P, HICMEN
To: Darrell Clark i I�:
� �!
F4�om: Virgil C. Herrick
�2oww�5
��vu �cJr y�}c,�.
�� 4t t,l:
316 E45T MhIN STREET
ANONA�MINNESOTA 55303
921-5913
8219 VNIVEP51TV PVENUE N.E.
FFI�LEY,MINNESOTA 55932
Sfi0-3B50
FIRST STRTE BANR BUILDING
GOON RAPIDS,MINN.55433
955-1330
Re: Zoning ordinance violation by a fsmi.ly in an i�l District
Date: June 21, 197y
ISSUE Whether Fridley's Zoning Ordinsnce is
aone (R-1 District) adde an addition
to permit a father and mother-in-law
violated if a family living in a one-family
to their home including a second kitchen
to live with the�
CONCLUSION In the technical sense the ordinance probably would be violated. A one
family dwelling can only contain one house keeping uni.t, and, as a practical
matter,the proposed additions xould result in another houaekeeping unit
since there probably would be seperate lodging, eating and cooking facilities
for the mother and father-in-law. However, zoning restrictions are ta be
strictly conatrued and not extended to cases not clearly xithin its provisions
and purposes.
�w The definitions and descriptiona cantained in the applicable zoning ordinances
of a single Family residence are generally determinative of the uses allowed o£
auch structures within the appropriate zone. 8 MeQuillin, Municipal Corporation,
(25.128 (a)) (3rd /Fd. 1965)
Under the provisions of the FYidley Code, a one-family dwelling is allowed
as a prineipal uae within an R-1 District. (205.051 (1)), F�idley Code (Z973)
A One-Family Dwelling ia de£ined as ^A detached building designed exclusively
for.occupancy by one Pamily.�� (205.02 subd. 19, F4�idley Code (1973) Whereas
(205.02 aubd. 23 ) defines family as ��An individual, or two or more persona
related by blood or marriage, or a group of not more than £ive persons (excluding
servants) who need not be related by blood or marriage, living together sa a
single housekeeping unit in a duelling unit." Since the mother and father-in-law
are related to the £amily by blood or marriage, the determinative isaue on the
inatant case is whether the family and th@ mother and father-in-lax will b�,
after the addition of the additional living aree and kitchen facilities, living
to�s't'k��'�+� .Ri�; :hou�eP,' -�i �l?�ft :
Although not defined in the Fridley Code or under the caselaw, a housekeeping
unit appeara to be characteriaed by common lodging, cooking and eating facilities.
For example in NA� tvna Park As��n v. Steinher� 138 Conn. 357, 84A. 2d 687 (1951)
it was held that use of a 1.1,-room house by four families t+ho lined and cooked
together ae a aingle houaekeeping unit, the lodging, cooking and eating £acilities
being common to all, conatituted use as a single family drtelling xithin the re-
quirement of a zoning ordinance adopting the houaekeeping unit teat for determination
thereof.
Similarly, a maraes home housing about 20 marsea having their orm rooma,
either aingly or in paira, joint use of the parlor, and limited kitchen
facilitiea for light lunches or anacka for thoae flu�niahing their own food,
and having a matron in charge of houaekeeping, usa held to be a family duelling
within an ordinanee defining a family as a aingle houaekeeping unit. Rohertson
V_ Wnatern Rr+� ti st Hnn}y tal_ 267 S.W. 2d ,395 �g9 • 1954)
In the present case it vould appear that if the additions to the house
resulted in aeperate lodging, cooking and eating facilities for the mother and
father-in-lax, vhich facilities arere more than merely incidental to the con-
venience of the family, the family rrould cease to be a aingle housekeeping unit
and conaequently, the house would not be a one family dtrelling. However, it
ahould be noted that restrictiona in zoning ordinances, being in derogation of
the common law,,should not be extended bq implication to cases not clearly
within the scope of the purpoae and intent maaifest in language of such ordinance.
Robertson V. Western Baptist Hoapital, 267 S Wad 395 ��Y• 1954)
As such, I don�t think it could be contended that the exchusion o£ this
type of arrangemexit falls within the acope of the atated purpoaes and intent of
the F'ridley Zoning Ordinance; which are set out in (205•O1 of the Fridley Code
(1973))
410 W. LAKE ST.
MINNEAPOLIS, MN 55408-2998
612/824-2656
Ser�iy 77e 71n�Cirin Sis�e /970'
ORSAT TEST RECORD
1072 PAYNE AVE.
ST. PAUL, MN 551013892
612/772-2449
AODRESS �(�[.�� {{�lC..�-y� GVl'�t CITY ��(� �,��j
OCCUPANT OWNER Lpv'U � � �� D (���5
DATE HTG. INST. �-y� grf INSTALLED BY ST����(Q ��(1/�
GAS LINE BY--- {tW1
TYPE OF HEAT: GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONUERSION
MAKE (}V CA- iitl/� �,�.f! t,� b-CF MAKE OF BURNER
MODEL �(,�,� (')(pQ �aL�' I�( MODEL
SERIAL Q(9Q� ay(�3��- N�1�- �lqg MAX.
INPUT (pQ, (�(� MAKE
—�-
CONTROLS
MODEL
BTU RATING
OF FURNACE
THERMOSTAT}j�I�V��� HEAT PLUG • q UENT SIZE 3"
—�---.
VALVE _ AUCCJ KING OF LINER a$`� JCt.� i SIZE S�� NONE
LIMIT ,�MCO DRAFT HOOD �Jt'> REGULATOR �.�-p
LIMIT SETTING ���� �' CHIMNEY CONSTRUCTION ";Q" ��p-��
FAN SETTING q�-1'a{'jc � DRAFT S��E�t TEST TAG _� Cg'p� (��
PILOT TYPE C�Ii�u.� �lLL,� LIGHTING 1NST.�J t�(d.VUtc�C�
PILOT MAKE AV C(7
PILOT MODEL —
PILOT TIMING tln,s�3(,Lj"
PRESSURE 3.5" PERCENT CO2 R So DATE TESTED �J' `�'I` g%
INPUT CFH�_PERCENT 02 y 70
STACK TEMP. 3�O`F PERCENT CO p NAME Of TESTER '� ��
soe�ec. PE __._ .
City of Fridley ,� � � � 4
ATTHETOPOFTHETWINS BUILDING PERMIT�
' � a�c�rvr� �
� .
� .____ COMMUNITV DEVELOPMENT DIV. �^� �^
r � � PR07ECTIVE INSPECTION SEC. Qe. 7
� �
� � ����\ � C1TY MAII ifi�O�EY i�JQ2 NUMBEP NFV D�TE V�Gf UF �ppRO`/fO BY
�---'� � �'' 612-571-3450 si0-Fi5 11/6/95 / /
JOB AODRESS 1040 Hacicmann Circle NE
1 LEGAI L07 NO. BLOCN TRACi OR ADDITION SEE ATTACHED
oesca. 21 2 Parkview Heights Addition sNeer
2 PROPERTVOWNER MAIIADDRE55 21P PHONE
Scott Eytcheson 1040 Hacl�ann Circle NE 574-0755
3 CONTRACTOR MAIIADDRESS Z�P PHONE LICENSENO
Same
a ARCHITECTOROESIGNER MAILADDRESS 21P PHONE UCENSENO.
5 ENGINEER MAILADDRE55 ZIV PHONE �ICENSENO
fi USEOFBUILDING
Residential
7 CLASSOFWORK � NEW ❑ ADDITiON � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Installing windows, door, sheathing/siding to existicg 3 season porch
9 CHANGE OF USE:ROM TO
STIPULATIONS
TYPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAD
SEPqRATE PEPMITS ARE REOl11RED FOR ELECTRILAL, PLUMBING. NEATING.
VENTILATING OR AIR CON�ITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO.FT. CU.FT.
AUTMORIZEO IS NOT COMMENGED WITHIN 60 OAVS, OR IF CONS7RUCTION
OR WORK IS SUSPENOEO Ofi ABANDONED FOR /. FERIOD OF 120 OAVS AT
ANY TIME AFTER WORN IS COMMENCED. NO. DWLG. UNIT$ OFFSTREET PARKING
I HEREBY CEflTIFY THAT I MAVE READ AND EXAMINED THIS APGLICATION 1 STALLS GARAGES
ANDKNOWTHESAMETOBE�RUEANDCORREC�.ALLVROVISIONSOFLAWS ypLUAT�ON $URTAX
AND OROINANCES GOVEHNING TMIS TVPE OF WORK WILL BE COMPLIED @ @
WITH WHETHER SPECIf1ED MEREIN OR NOT. THE GRANTING OF A FERMIT w�LOO .p.SO
DOES NOT PFlESUME TO GIVE AUTMORITY TO VIOLATE OF CANCEL THE pERMITFEE SAC CHARGE@
PROVISIONS OF ANY OTHEfi STATE OR LOCAL LAW REGULATING CON- @'L1.00 Fire SC p.SO
STRUCTION OR THE PEFFORMANCE OF WNSTFUCTION. w
PLAN CHECNFEE TOT@ALFEE
.y22.��
sio *uaeorcor�:aac*oAOAA�Twoaaeoac6H* ion*E� WHEN PFOVEALY IDATED TN�S IS YOUR PEFMIT
i/-6 -�s` � /�-G—�ii
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C1TY OF fRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
co►�sr,u�tio�A�s: 10 Yo flRGk �/Arv.�/ c 1L .
L.egal Description:
Cffeclive 8/1/95
�4�Z�1�
Owner Name & Address: ,�o,7r� >ch rS�� �y � L� r���N Tel. # 5���-o�ss
Contractor. SCCF MN LICENSE #
Address: ��`>O 11AG.�m.oay✓ G�C �.zocy./,��✓. 5S5-�z Te1.1/
LIVING AREA:
GARAGE AREA:
DEC% AREA:
OTHER:
Attach to this appliption, a Ce�tificate of Survey of the
lot, with tl�e proposed conshn�ction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Leagth Width Heig6t Sq. F�t.
I.ength Width Hgt/Cttvund _ Sq. Ft.
2 ,V�w UJirv�/or�J o� �10orL �- /���GT/Lifs -- _—
Corner Lot [] Iaside Lot [] Ft. Yd Setback Side Yard Selbacks
Type of Conshuction: Z�/�r �a co�c: s� a�• �o
wpprox. coroplcaon nate:
(Cost on Back)
Driveway Curb Clrt WidUi Needed: Ft/. �+ �6 Ft = Ft x$ _$
DATE: ��_ APPLICANT: �/� Tel. � .�79troJSs
�CI'ml[ FCC
Fire Surcharge
State Surcharge
SAC Charge
$�-
$ �U
$�
CITY USE ONLY
ti
1
;
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f"
Fee Schedule on Reverse Side
.QOl of Permit Valuation (1/lOth96) �-����i'� �i�sr�wi
5.50/S1,000 Valuation l,,�,i'� �/t�-cl Sl�1�1a�/� ��
$850 per SAC Unit S�pir'c�t %/t�P�Jn�
L.icense Surcharge $ 55.00 (Smte Lio� Residential Contradors) , j���"� �G�i�i,
Driveway Escrow $ Alt "A" or Alt. 'B' Above
&osion Control $ a450.0(} Consavation Plan Review
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$
$
$ 22 ��U
Fee Deteamined by Enginaering
Agcement Necessary [ ] Not Necessary [ )
INDUSTNIAI ��
lUSINE54 ��t��
CITY LOT$
TOPOGR4pNIC MAPPING
, C. E. G O U LT �:R
. LAND SURVEYOR
� REGISTEREO �NDER LAWS OF STATE OF MINNESOT�1
LICENSEO !Y OPpINANCES OF CITY Oi MINNEAPOLIS
3300 LYNDALE AVE. 50. MINNEAPOLIS 8. MINN
� TAYLOR 4-0370
�+urbepor'g (Eertiticate
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I hereuy certify tha:: �rie ai�ove is a true an3 �irect plat oi a survey of;
-��.
Lot R`�ier.ty One (21) , Block �._ ;o (2) , Parkview Heights A3dition, Anoka
County, Mivnesota.
As surveyed by me this.30th. day of Mrxch 1�59 A. D.
, _ . _ � .? r.�. i .
• /'
� '
Signed . �p�C� • v z.0 ; i .° ..
rainnesota REgistration No. 2584
: .. ' .- , :i��� .
. . ..', . � � .:� . . , . . , ' : .�:. .�._'
... � ..�y __ l. . � _. . . . . _...:___
SVBJECT
City of Fridley
ATTHETOPOFiHETWINS BUILDING PERMIT
r
� .
� ' COMMUNITY DEVELOPMENi DIV.
� �
� ; V��.����'
r � PROTECTIVEINSPECTION SEC.
1
� � /'�'1 � CITY NALL FRIDLE'/ SSC32 NW/BEP REV D�*E
i'"'"� � �'� 612-571-3450 9t0-F�5 8/19/96
JOB ADDRESS 1040 Hacl�ann Circle NE
1 LEGAL �OTNO. BLOCK TPACTORADDITION
oESCa. 21 2 Paxkview Heights Addition
2 PROPERTY OWNER MAIL ADORES$ Z�
Lisa/Scott Eytcheson 1040 Hacl�ann Circle NE
3 CONTRALTOR MAILA�DRESS Z�
Steven R Lee Contractor 9465 Irving Ave, Brooklyn Park MN
a ARCNI7ECTOR�ESIGNER MAILADDRESS Z�
6 USE OF BUILDING
Residential
7 CLASSOF WORK -
❑ NEW
8 DESCRIBE WORK
Reroof House S
9 CMANGEOFUSEFPOM
MA1l
v�GE O�
� /
��
7�F=��E
PEGE PT NQ.
3%5 %
�PPROVEO BY
SEEATiACNED
SMEET
PMpNE
574-0755
GHONE LICENSE NO
424-1198 5758
PHONE LIGENSE NO
NO
❑ ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE ❑ REMOVE
(24 Sq) Tear-off
ro
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS APE PEOUIHED FOR ELECTRICAL. PLUMBING, NEATING.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSiRUCTION ZONING
AUTHORIZED �5 NOT COMMENCED WITHIN 60 �AYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR aBANDONED fOR A PE(iIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. OWLG
I HEHEBV CEATIFY TNAT I HAVE REA� AND EXAMINED THI$ APPLICATION 1
AND KNOW TNE SAME TO BE TRUE ANO CORPECT. ALL PROVISIONS OF LAW$ VALUATIO�
AN� ORDINANCES GOVERNING THIS TYVE OF WORK WILI BE COMGLIED $� 9HO
WITH WNETHER SPECIFIED HEREIN OR NOT. THE 6RANTING OF A PERMIT �
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pERMITFEI
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION O THE PERFORMANCE Of CONSTRUCTION. �6z.ZS
PUN CHE(
k ��� Licens
� SIGN<iUAEOFCON'RPQORORAUiHOAIZED<GENT IOA�Ei
OCCUPANCVGROUP OCCUPANGVLOAD
$O.FT. CU.FT
OFFSTREET PAFN�NG
STALLS GARAGES
$URTA%
$.99
$ACCHARGE
Fire SC $1.98
TALFEE
s%o ��o.zz
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CI1'I' OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effecrive 3/1/96
�3�s1
ConstructionAddress: � 0 ya �<u. �C wc v-H � C� y�
Legal Description:
Owner Name & Address: �,� s c� <i fc e�/' Tel. # S 7 1- � 7-s s
Contractor: ,� T-c-.�.�„ � �� � y�"� � e.r � �, MN LICENSE # .S`� 7-��
Address: � Y � s � � s- �. . �--� �'� /�w.,/�/cr �e�cTel. # y�,Y- / ( i %%
LIVING AREA:
GARAGE AREA:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
L.ength
Length
DFSCRIPTION OF Il14PROVEMENT
Width Height Sq. Ft.
Width Height Sq. Ft.
DECK AREA: I.ength Width HgtJGround _ Sq. Ft.
OTHER: �%`-r w o�" � L� ��v �- `2 0.xJ C. �4- � c-.� a- te� �-y f a-
' ' a �
Corner Lot [ ] Inside Lot [ ]
Tyge of Construction:
Appmx. Compledon Date:
Ft. Yd Setback Side Yard Setbacks
• Fstimated Cost: $ o , — � C
(Cost on Back)
Driveway Curb C�t Width Nceded: Ft. + = Ft x$ _$
6 Ft i
DATE: � l��p bAPPLICANT:�./P� �� Tel. fi y�,`/� / 1`�v'
Permit Fee
Fire S�rcharge
s�c� s,�,��ge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
�� �� Fee Schedule on Reverse Side
$ /-9�4
$ • �q
$
$ �S C�Ci
$
$
$
$
� O�a�-
.001 of Permit Valuadon (i/i0th%)
$.soi$i,000 v��►on
$900 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ J Not Necessary []
♦ sue�ecr ERMIT NO.
C�ly of Fridley �� n. � 3
ATTMETOPOFTHETWIN$ BUILDING PERMIT
f
� l ii � Q.
` __ _ COMMUNITY DEVELOPMENT DIV. ( //
� � �' PROTECTIVE INSPECTION SEC. 7gg�
i �
' � ����� , CITY MALL FRIDLE� SSA�P NUMBEN REV DATE V�GE Of .�OPROVE� Bv
i.--'� � �'' 612-571-3450 9i0-P�5 1 /9/96 � /
J08 ADDRESS 1040 Hacl�ann Circle
1 LEGAI LOTNO. BLOCK TRACTORADDITION SEEATTqCHED
oescn. 21 2 Parkview Heights Addition sNeer
2 PROPERTVOWNER MAILADOflES$ ZIP 7MONE
Scott Eytcheson, 1040 Hacicmann Circle, Fridley, MN 55432 574-0755
7 CONTRACTOH MAIL ADDRESS ZIP PHONE LICENSE NO
Scott Eytcheson, (same as above)
a ARCNITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO.
5 ENGWEER MAILADDRE55 Z�P PMONE UCENSENO
6 USE Of BUILD�NG
Residence
7 CLASSOFWORK � NEW � ADDITION ❑ ALTERATION pG HEPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WONK Residing
9 CHANGEOFUSEFROM TO
STIPULATIONS
SEPARATE PERMITSARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING, TVPEOF CONST. OCCUPANCY GNOUP OLCUPANCV LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BEGOMES NULL AND VO10 IF WORN OR CONSTRUCTION ZONING SO.FT. GU.FT.
AUTHORIZED IS NOT COMMENCE� WITHIN 60 DAVS. OR IF CONSTRUCTION
OR WOf±K IS SUSPENDED OR ABANDONED FOR A PEfiIOD OF 12p DAYS AT
ANV TIME AFTEF WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET GFHKING
I HEREBY CERTIFV THAT I HAVE READ AND E%AMINED THIS APPLICATION SiA�LS GARAGES
ANDKNOWTHESAMETOBETRUEANDCORFELT.ALLPROVISIONSOFLAWS yq�UATION SURTA%
AND ORDINANCES GOVERNING THIS TVPE OF WORN WIIL BE COMPLIED �1fOOO.00 tate SC .SO
WITM WHETHER SCECIFIED HEREIN ON NOT. THE GNANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEL THE pERMITFEE SACCHnRGEp
PROVISIONS OF ANV OTHER STATE OR LOCAL LAW FEGUTATING coN- $37.50 lt8 SC .p1.00
STAUCTION OR THE FERfORMANCE OF CONSTRUCTION
VLAN CHECKFEE TOTALFEE
$39.00
5i rUPEO��ON'AaCTOaoRnuTNOA�ZEOaGEm1 ioaiE� WHEN Pi70PE ALI TEp THIS IS vOUR PERMIT
o y� ar, uu� /D��
SiGNnivaEO� A���OwvEPOWLOERi iD Ei g� p O<tk
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ConstructionAddress:
CITY OF FRIDLEY
SINGLE FAMII.,Y AND DUPLEXFS R-1 AND R-2
Building Permit Apptication
� /%? � tvl✓ G/Z r
Effective 3/1/96
I
• i :
Legal Description: ,� / L7/%(/��
Owner Name & Address: SLo�f"�t�y 7`G ii � Sp hi TeL # S7y' ��'�
Conuactor: SC L F MN IICENSE #
Address: S.v�+-� .t3'
Attach to this application, a Certificate of Survey of the
lot, with the proQosad construction drawn on it to scale.
DFSCRIPI'ION OF Il14PROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Pt.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length _� Width HgUGround _ Sq. Ft.
OTHER: _��' S 1 a I rJ�}
Comer Lot [] Inside Lot (] Fe. Yd Setback Side Yazd Setbacks
Tyge of Const�ucdon: Estimatecl Cost: $ J /1CA• d�
Approx. Complerion Date:
(Cost on Back)
Driveway Curb Cut Width I3eeded: Ft. + 6 Ft = Ft x$ _$
DATE: APPL.ICANT: Tel_ #
Permit Fee
Fire Surcharge
State Su�harge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Conirol
Park Fee
Sewer Main Charge
TOTAL
SITPULATIONS:
CITY USE ONLY
$,3 7, SU Fee Schedule on Reverse Side
$ �. b6 -001 of Permit Valuation (1/lOth%)
$ . 5d $.50/51,000 Valuation "
$ $900 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 [ ]
$ 3 . �
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� ad�t ui �a;awei _ _
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ad�(1 u�-�a�aweip }y ya6ua-7 � ;ySraH �o�auuo� }uan � a�ueitddy
satpui �a�aweid ;y6�ay;uan
adl13uan uowwe�
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uopeuLO;u���aauuo�;uan pue;uan uowwo��aziS pue a 1 aauei� y
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�a}}s l,�aLOO pa��e}sui pue paz�s sio�auuo� }uan pue =uan uoww� ay� s�
-saouepdde �pap �em�eu pue pa;sisse ue3 �o} sa)qe1 Sunuan
a�ewn� �e,qua� �/�oba3e� yy�y�-y�b apn�w saop s�y,l •suo�e�uc�ads
s�aan�e�nuew pue sapa�;ua�n� a� sya2w pue �(�qwasse pa;si� e si;i
leyl sayuan Rqa�ay pau6is�apun at� wa3s s u�3uan mau e u�p�sui uay/�
__ __-_ ___ 'srror�eay!sads s�adr�e3nnem pvesa�i o�7ua� a�{i laatu v; _—
pa��e=sur pue pars aq pu�n �� ne uousnqwo� Mau e ��e�sui o; pa.tmbal uat{M
�suope�ynads s�am�e�nuew pue
sapo�;ua.un� at{3 aaaui o3 pa��sw pue pans si �ie uopsnqwoa uRstxa at{,L
sa�uei�dde }�e�p �ean1eu pue pa;rsse
ue� �o} sa�qe16uUuan a�ewn� �et�ua� ��U�6ale� yw�-y�y apn��ui
saop s�y� •suoqe�yc�ads saamy�e�nuew pue sapo� �uaLn� ay3 s�aaw pue
�(�qwasse pa}si� e si;iun �uausaae�da� ay3ley� sayuan os�e pau6is�apun ayl
O oN {�O sa�, •uopeuiuuai pue smoq�a Jo �aqwnu 'yafiva� 'Surns 6wpn�aw suone�yr�ads
�� �a�n��e�nuew pue sapo� �uaym ��e saaaw pue �nd/��=se�d si wa�s�Ss 6uquan a�
() oN �sa� •pannba� a�aym paddo�sa.ig pue payoddns /�am�as si pue
'suo�ru�sqo 'uoRe�ouaiap ';sru wo� aa�} si pue pauiwexa uaaq sey bunuan
acp �e� saycran ,Sqa�ay pau6rs�apun ac� 'aaueln} ups�xa ue ur�r� a� uay/�
NOLLtl�Idl�i3A aIV hiOLLSf18W0� ON�d Zl01�9NN0� 1N3A 1N3A N�WWO�
. i
-���.�IN�
HEATING
AIR CONDITIONING
ANQ ELECTRIC, INC.
aooaess�—��yl1{ ltiK.CMIi1� � 1/'[ 1e �/.�C�
OCCUPANT FL��Q
HEAT LOSS DATE HTG. INST. ��— Q I
sao ev Q n
Elecirical Work Bv _ . A� % �
TYPE OF HEAT G/L_ FA� HW, STEAM_ SPACE HfR._
GAS DESIGN
MAKE �(tiHD
r.wasi — d. F_
s��i o FJJ�ya
INPUT _ � • S�
CONTNOLS
LimitSeni � 0 �
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Building PLUIVIBING PermitNo.: (��
Inspections RESIDENTIAL APPLICATION Received By:
763-572-36Q4 CITY OF FRIDLEY D�r�aJAN 4 20
DATE YOUR E-MAIL ADDRFSS �
SITE ADDRESS SnwtL a� �usr�ar - �
rxts n�muc.v�rr �s: ❑ owrieR �orirxP.croe grian Halgrimson
PROPERI'Y N�: 1040 Hackmann Circle Northeast
OwNERI ^DDa�ss: Fridle MN 55432 ,TE—�
TENANT Y�
PHOx�: 7635749179
CONTRACfOR N,�
SUBMIT A COPY OF STATE LICFNSE H C% EXP DATE
YOUR STATE �DRESS• i CITY ' �J STATE�S{�I1P SrS�'f�09
LiCbT1SEWITH . PHONE f�y 827-�/033 - Fnx �j�. B1_7-g12 ..
APPLICATION -
PERMTT TYPE �CSMGLE FnMILY O TWO FAMII.Y � �� �❑ TOWNHOUSE
�rYrs og woiuc: ❑ �w �j�,.nc�r
DETAILED DESCRIPTION OF WORK
PER MS 16B.665 ihe peimit fa is a minimum of $15.00 or 5°/. of the tothl cost up to $500.00, whichever is greater, for the
improvement, instellation or reptacement of a residential fixture, exclud'mg the fiztures. (Tl�iss6ovldaeflect only.the cost of labor )
Labor cost under $300 = S 15.00. Labor cos[ between S30(i to 5500 = cost of labor x.OS =
.: --FOR:EROIECTS WHERB L.4BOR EXCEE9&SSOO;FEFS ARE BASED ON f 10.00 P£R FIXT[JRE; IXCfP't;�fiERETW:I£9,..i�77C'�IRfS'-- (WD1GA'IE TQTA� .
NUMBER OF EACH BELOII� - � .
BATHSWK/lAV FLAORDRAINS SHOWER WATERPIPQJG
BATHTUB GA3 P�ING Me�cm'ucavsE) SWQ.9ofPlG POOL WAT'ER SOFINER (535)
CLOTf�S WASHER K1TCf�'N SINK WATER CIASEf BACKFLOW PREV. (SIS)
DISHWASHER _ LAUNDRY 1RAY �WATER i�AIER (S3S� FOR IRR1GATfON
WA; ER MEI£R OTHER
Permit Fee S Number of fixtures (a� S I0.00 x S 10.00 = S
Surcher e .50 Number of fixpues � 515.00 x 515:00 = S
TOTA.I. DLJE S Number of 6xhues � 535.00 _� x 535.00 =� 3S po
Stste Surchazge = $ .50
Tota1= $
'II-IIS IS AN APPLICATION FOR A PERMIT-NOT VAL(D UNTIL PROCESSID
I hereby apply for a building permit and [ acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an applicati for a gemiit an work is not to start without a permit; that the work will be in acc dance with the
approved pian in the case of r,�uhic i view and approval of plans.
SIGNATUREOFAPPLICANT I PRINTNAME �G NO✓�IOYYI. DATE �� P
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
F'AX: 763-502-49?7