AF - 46487� Cit of Fridle , Minn�
Y Y
BUILDING PERMIT xo 4121
� Date: r
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Owner: -.--- Builder _...-------.......--.----_._--�.�. �..'` l�"�'�
Address.... --�----- -�--� ....................._...........----...._.....----..._......_..----- --------..._...... Address
L T N OF BUI ING
Na. ...:...>...V__(O._./..... Street ................_.... __ •_.__.. .__..... ._.. .__.....: ..__ . ...J of Lot .___.
. ........... ..... .. ....................---._.... - --- - .... ..--��-------- --
Lot ........j�............ Block .............. �i�......................... . Addition or Sub-Divisio ..--..... ..._....... ....._.......... . ...... .... .....-----...... - ----- .._...
i y � i
Corner Lot . ..............- .._..__........ Inside Lot .......�............... .......... Setback ..-�s�: .�........ Sideyard ...�. Q ' .............. - -_.... -.... ..... - --._-
Sewer Elevation
Foundation Elevation
DESCR1PTlON OF BUILDING
To be Used as:
�% `! .., �} / /� pr
/.V .. - � � ....... Front 7` .�..`..� Depth °1� .!......� Height /�..—. � ~ Sq. Ft. /......D...� Cu. Ft. j..l...(?..�0
.........---.._._._......_ ................... Front ._....--.............. Depth --....-- - Height ._.................... Sq. Ft. ....._......_......_. Cu. Ft. ........_......._.....
Type of Canstruction ....._ ............._..............._.:..........._...... Est. Cost�°iri0_.l.._l...-'""'.-... To be Completed _._............................_...:...............
In consideration of the issuance to me of a permit to construct th uilding described above,�T agree to do
the proposed work in accordance with the description above set fo d in compli �1 p of
ordinances of the city of Fridley.
�
-,i�... - . '... :...._. ..: ... ..__ .---4--- ---- •- -- -
In consideration of the payment of a fee of $..p�� � ............... permit is hereby granted to.._.............__..._........._..._........_......._.
....._ ................_..................._.............................. to construct the building or addition as described above. This permit is granted upon
the e�spress condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall confarm in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buiidings
within the city limits and this pernut may be revoked at any time upan violation of any the provisions of said
ordinances. _ � .,
...... Building Inspector
NOTtCE:
This permit does not eover fhe construc�ion, installation for wiring, plumbing, gas heafing, sewer or wat�r. Ee wn fo se�
fhs Building Inspector for separate permifs for �hese kems.
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City of Fridley, Mi.nn.
BUILDING PERMIT
D$�; __ June 28, 1967
Owaer: __..._.Sg4i�e E. Wo i a�_ B��. Same
Address .___ 1064 Hackman Circle , __ A�� Same�`_
��3 �.o
N� 9340
LOCATION OF BUILDING
No. .._.._..1�4 . Street .�.._._�ackma.n Circle __._ Part of Lot --...--.–
Lot ....._....--18 _....--- Block _�.._.....---.2...._...----..__� Addition or Sub-Divisi� ---_ Parkview Heights
Corner Lot ___.�..__._ Inside Lot ...__....__..... — Setback _._.__._.__.,�_ Sideyard
Sewer Elevatian .—._�.._._.____._._. ._____ Fwmdation IIevati�
DESCRIPTION OF BUILDING
To be Uaed as:
Attached Ga.ragxe �t T20' �p� �_24' g��t 10! ��, �, 480 �, �, 4800
_._.._.__.---__.._..___�� Front _�______ Depth _..._ Height _---.___._. Sq. F't. � G�. Ft
�pe of Construction �_._ Faame ��, �_�2000. 00.._..__.._.___ To be Completed Sept . 1967
In consideration of the issuance to me of a permit to construct the building described above, I agi+ee to do
the propoaed work in accordance with the description abave set forth and in c�umplisnce with all pro�viaions of
ordinances of the city of Frfdley. �, � � -
�. . �
In cansiderati� of the payment of a fee of � �• �� _.., permit is hereby granted to Gerog�e E.
Wojack to construct the building or addition as descrlbed above. This permit is granted upoa
the express condition that the person to whom it is granted and his agents, employees and workmen, in all wark
done in, around and upon said building, or any part thereof, shall oonform in all respects to the ordinances o�
Fridley, Minnesota regarding location, constructiai, alteration, maintenaace, repair and mavin8 of buil
within the dty ]imits and this peraut may be revoiced at ar�v time upon violation of aqy o! the P�visioas of
ordinances.
CLARENCE BELISLE B�� ��
NOTICE:
Tfiis p�emit doa nof wwr tlw �onsfeueNoa, MahllaHon for �rirLY. P�W Yas M�Nsa, sw�r er wNw. b swr to �
th� Bu(Wino la�qor for a�paraN p�rsih for fh�a itNm.
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A??�'�ZC A=1.G: ;�� ��i 3?]�i.D �iIG °�' :�� iT
Ci.'LY 0: iw:�:���� ri�iyLi�S'�,'TA
OWNER' S NAME ��D �,,�� �- .�l d J���K R`:;,�� ��ER
ADDRESS I b� `l �4e .vv�an•� C'' �%�' ��� A??�P.ESS
L�JCA�ZON QF BUILDI;�G
NO.�`-�► STREET ���l�l',-iQ h h L°1 �r � Ie PAIiT 0� LOT
�
LOT �� BLOCK a AD�ITTON OR 5Ut3�s.VISION ����� �(,v �fS .
CORNER LOT INSIDE LOT a/ SETBACK SIDE-YARD
SEWER ELEVATION FOUNDATIOPJ ELEVATION
Applicant attach to this form Tcao Certific�tes of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTIO.I OF BUILD�N� _
To Be Used Aa : . . _
��� Front � D Degth o� Height /�`�
Sq. Ft. �-{$D Cu. Ft. �/ � �' C�
Fror.t � Depth Height
Sq. Ft. Cu. Ft.
oy
Type of Constructioz� ,�,�t_��... Estimated Cost �6iQp
T.o Be Completed T� le D a�� ...
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Frid?ey Ordinances
and rulings of the Degartment of Bui�dir_gs, and hereby declares that all the facts
and representations st�ted in this app:icatf.on are true and correct.
DATE dd�� / -�j G % SIGNATURE ,Ci�2i�. ) _.�i�-r-.�� �. �L�a7��______
(Schedu e of FQe Casts can be found on t_he Reverse Side}.
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ihC)USTflIAL
HUSINES>
CiTY LOlS
iOPGGRA�'NIC MAPa;NG
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i �. E. GOULTE�?
LAND SURVEYOR
REuI51EREU UIJC.��R LAVJS OF STA7E: OF MINiIESOT�?
L�CEf�SED °1' O�i`!Y4•.rr5 OF C�!•! C'•'� N:ti'vEl�F'Ol_t5�
33UU IYNDAi E AVE SO MINN�Ar ULIS 8. MINN.
?AY'LOR 4-0370
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I h�r�z;y certify t.na� th: "above is �� true �:nd correc� plut o� a su.rvey o�;
Lot 18, Block 2, PAP.KVI��l :Zr,IG=I`�:'� ADDI`=IOiv, Anok�_ F.ountl ,:iirinesota.
As surveye� �y r�.e t:zis 3rd dG�,� o� Auyu�� 1�5�? A.�.
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City of Fridiey 2 9244
.
AT TNE TOP Of TME TWINS g � f L D I N G P E R M I T
� � COMMUNITY DEVELOPM�N7 OIV. FiECE1PT NO.
� ; � --.-- , a�� 9
r � � PROTECTIVE INSPECTION SEC.
i.--.�'��"'�'� CITY MALI fRIDIE� SS��2 NYMBER pEV O�TE ►�GE Of �►vnOVEO Sr
L 61Z-571-3a50 s�aF�s 4l19l99 / /
JOB AOORESS 1064 Hackmann Circle NE
t LEGA� LOT N0. 6LOCK TRACT OR AODITION SEE ATTAGHED
DESCR. 18 2 Parkview Heights Addition SMEET
2 PfiOPERTY OWNER MAfL A,O�p�S$ LV PMONE
Geor e Wojack 1064 Hackmann Circle NE 571-6264
3 CONTqACTOR MAIL AODRESS ZIP PMONE LICENSE NO
Z Roofin 1814 uarr Rd, St Cloud, MN 56301 320-654-1115 20040160
1 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE UCENSE NO
S ENGINEER MAI4 ADORESS ZIP PHONE UCENSE NO
6 USE OF BUIIDING
Residential
7 CIASS OF WORK
O NEW O A�DITION O ALTERATION fx7 REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (28 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMITS ARE REOUIRED fOq ELECTR{CAL, PLUMBING. MEATING, TVPE OF CONST OCCUPANCY GROUP OCCUPANGY LOAD
VENTI�A7ING OR AIR CONOITIONiNG
THIS PERMIT BECOMES NULL ANO VOID If WORK OR CANSTRUCTION ZpNING SQ. FT CU FT
AUTHORIZEO IS NOT COMMENCED VyITNIN 80 DAYS, Op IF CONSTRUCTION
OR WORK IS SUSPENOEO OR ABANOONED FOR A PERIQO OF 120 OAYS A7
ANY TIME AF7Ei; WORK IS COMMENCED. NO DWIG. UNITS OFFSTREET PARKING
I NEREBY CERTIFY TMAT 1 HAYE READ ANO EXAMINEO THIS ACPLICA710N 1 STAlLS GARAGES
AND KNOW TME SAME TO BE TAUE ANO CORRECT. ALl PROVISIONS OF �AWS VALUATION SUR?AX
ANO ORDINANCES GOVEfiNING TMIS TVPE OF WORK WI�� BE COMP�IEO A 2� 399 $1 . ZO
E ER SPECIFIEO MEREIN OR NOT. TME GRANTING OF A PERMIT .p
ES N P UME TO GIVE AUTHORITV TO VIOIATE OR CANCE� TME pEpMIT FEE SAC CNARG
P OVISI F NY OTHEfi S�{ TE OR LOCA� LAW REGULATING CON-
ST U � 1 E PEF1fOfiM�NCE OF CONSTRUCTION �7�F.75 Fire �2.40
PLAN CMECK fEE TOTA� E
Licen S $5.00 .35
N UpEOFCON•AAGiQROp�UrMOA�ZEO�GENT iO�fE� EN OPE All ATE IS IS P i
� i r
S�GNaTUAE OF OWNEQ��� OWNEABWIDER� �OATE� � g� �NS� � � O�iF
�' �i Si
NEW ( ]
ADDN [ ]
ALTER I l
, � : .
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COI1Strl1Ct10IlAdtiiBSS: _
Legal Descripdon: �
Owner Name & Addres;
Contractor � '
Address:,�„�.` � �
, ,�, .
. '::r �
CITY OF FRIDI.EY
SINGLE FAMILY AND DUPLEXES R 1 AND R-2
BUILDING PERMIT APPLICATION
(�1��7r'��
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Effective 1/1/99
��
�� ��
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' Tel. # l '
d� �L
MN LICENSE # l �
Tel. # �- �-8 ��
/ /!S�
Attach to this� applicadon, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF �MPROVEMEN'r
LIVING AREAs . �nS� _____-- Width Height
,' "; „ - Width Height
GARAGE AREA: � �ng�
DECK AREA: Length Width Hgt/Ground __
01'HER• , � `�2 - .
Sq. Ft.
Sq. Ft.
Sq. Ft:
. �
Construction Type:
Estimated Cost: $ �
�-}�i � (Fee Schedule on Back)
Driveway Curb Cut Width Needed: �6� Ft x$ _$
�
DATE: � APPLICANT:
t�.�-�-�� ;�,
Permit Fee
Fire Surcharge
State Surcharge
SAC � Charge' '
License Surcharge
Driveway Escrow
Erosion Control
Park. Fee._ ,
Sewer Main Charge
$ � .�
$� , b
$ ,�%
i $ �� a
$ D
$
$
$ _
$ _
' "TOTAL �.. � . . $ �. �S�
STIPULATIONS:
Tel. #
Fee Schedule on Reverse Side
.001 of Permit Valuation (1110th%)
$.50/$1,000 Valuation
$1050 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 [ ]
�.���
A
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