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AF - 46494�:.. i � City of Fridley, 1Vlinn. BIJII.DING PERMIT Date: . . . .l�R. . . . . .�. . . . . �'�. . . . .. . . .. . N° 3914 Own�r ....................................... Builder .... .. .� . .... .. �. � 1 r Y A,d�d� ...................................... Addreas ............................................. LOC Tt0(V OF BU[LDING No. . /. .� �O Street . . ��'!�S, ./. :T. . . : L.�Y'�... . . .. .. . . . Part Lot . .. .. . . .. . . . Lot . �.�. . . . . Biock . . . �. . . . . . . . . . . Addition or Sub-Dfvision (/ . . . . . . . . . . . . . . . . . i��r4fJ. . . . ��,/�!.f► Corner Lot . . . . . . . . . . . . L�side Lot � . . . . . . . . . Setback � d. .� .V.~ Sideyard . J Q : : a .~ . . . . . . . . . . . . . . . DESCREPT[ON OF' BUILDING IT T ♦ f �,����. .. . � 5�.�: a. �� 2�!=o Height .l..y 6 �. �./. o�Q. d' �. �. ,l �'/.�".� .................... l�ont ........ Depth ........ Height ........ Sq. Ft. ........ Tj►pe of Construction . . . . . . . . . . . . . . . . . . . Es� Cost. �� �.�'f., Q • ��'To be Completed . . Gtt. Ft. ........ In c�onsideration o! ihe issuance to me o! a permit to oonstruct the ding desribed above, I agree to do the propa�ed work in aocordance with the desr.rigtion abwe set fo in compliance rovisi f alydinances of the dty of F�idley. „� � .iC.. .......... ...�l... .... .. ............ /Q OQ In consideration of the payment of a fee o! $. rl.rl. .�1 permit is hereby granted to ... .. .. ...... .... .. ......................... to constnict the building or additian as described above. This permit is granted upam the express condition that the person to who�n it is gignted and his agent8, employe� and worlunen, in all work done in, around and upon said building, or aqy part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, constructtaa, alteration. maintenance, repafr and moving of buildings with- in the city limfts and this permit may be revoked at ai►y time upon violation of any of the pmvisions of said ordinances. l � ' � Building Inspector J i� � � • NOTICE: Thts pe�mit does not cover the constniatton, installation or atteration fo� wirinp, plumbinp, yas heatin�. ,�j sewer o� water. Be sure to see the Buildinp Inspecto� fo� separata permib for these items. , • • • City of Fridley, Minn. BUILDING PERMIT D$�; _,_ October 7, i968 _ pwner. Lawrence J. Berg B��r � Same Add�s _. 1080, .Hackman Circle Ad� _ Same r�, � �/L1S"/ / N� 9968 LOCATION OF BUILDING No. 1080 ,_, S�t ,_,_�acl�nan Circle � p� of Lot _— 2 Parkview Heights Addn Lot _.. 16 .._....__ Block _.---.___ � Addition or Sub-Division _.._.._�.— ....._..__._- Corner Lot Sewer Elevatiam Inside Lot ___._._..X._.___ Setback ._._—.._ Sideyard �_._.__.__.._.._._...._. ___.�_ Foundatioa IIevation ___—. To be Used as: ,.,_�. A1ter ._ �t _.___.__..:_...____._._._..._._ Front Type of Constrvction DESCRIPTION OF BUILDING Depth � Height ._._ Sq. Fk � Cu. FL Depth _.._ Height ._._.._� Sq. Fk � Cu. Fk _.._ _^ � � �950.00 . To be Completed _�'• In consideration of the issuanoe to me of a permit to caostru``7�uilding described above, I agree W do th� Proposed work in accordance with the description above set f in compliance with provisions of ordinanoes of the city of FridleY• il � In cooafderatfon of the payment of a iee of ��sS2Q .., permit is hereby granted to Lawrenc`e ,�T .�eY _ to construct the building or addition as described above. This permit is granted upon the express oondition 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 oonform in all respects to the ordinancea of Fridley, blinnesota regarding location, construchon, alterah�, maintenance, repair and maving of buil ��� dty ]imits and this permit may be revoked a t aqy time upon violation of an�of the provisians o! d /'� � NOTICE: iWs pandt doa nof eowr tfM eonstruelioe, ie�iafl�Nen fer rrieisY. Pw�W Y+s h�ipY, �w�r er waMr. !� wn to sw tla duiWieo Iatp�tlor fer s�p�rah p�reiib fo� 16� I1�s. _ . z ,. AP.PiICATION �OR BUIL�INr PEftNlIT �?TY OF FRIDLEYy MINNESOTA � ,/ � � � a� � � . . I_'��. _ ' _:�! � : � a�' �� � / � . �� � ' � �' I . / .�� :',�/l�4%%/I��'� �. ZCCAT�ON OF BJIi;DII�?C�� rao o s��� LO'I' � � BLOCK � A�DITION OR SUBDIViSIQ_�"+ /4 t� � << � I`�'< « �.S ��+�' �' ° ^ COR'!'ER LOT SEtiTII� ELE��ATIOP� II��,I�E LOT �/ SE'I'BAt":i� �I���ARD TOt OF �'OCTI?�G Applicar?t at �ach to this £o�m. 'I'•��c ��rtiii�ate� c�' S� �rey of Lot aru pT'oposed buildiz^_g' locatior �ra��-� o.rs thes� �estificateso �ES �R_T�'I' i OlvT CF BL??I� : NG To Be Used As: � 3 . X �� , ��p�,-d /� 7'`-�-��m^ Frent. Depth Height — – �qua�°e fe�t �� Gubic �'E�t Fz°o:nt �quare ��et Degth Height Cubic Feet Type of Const�°uction Estimated Cost /✓� ! To Be Completed The unde�signed hereby makes application for a pex°mit for +he ;,-ork herein specified, agreeing to do all work in strict accordance with th� rity of Fridley Ordinar�ces and rulings of thc Departtaent o: Buil3ings, and he�eby declares that ali the facts and repre�e.r. �tions statEd in this appli�atiot� a,re true ar,d •orrecto DATE �� SiGIVA'T[TR (Schedule of �ee Costs car� be fou.nd on the Reverse Sideo /_ , � lJ � � .__, , . • �_.,�� �.a ,.,�. • : City of Fridley, Minn. - - 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: October 26, 1971 Owner: _...-----I�x'rv Berg _._._._:._._..._ Builder ..� c^*�^� � ��„�*�.s�$e� Address _---...._10$Q Hackman.�_ _ Address .15Q8 Bernd�le .Avo�ue LOCATION OF BUILDING No. ___--_1080.� Street _._._Hackman Circle � _.� g� � �t Lot .--•-16----�-- Block _---------2_..._...._.._..-------__ Addition or Sub-Division arirv; �,g,; egh ts Coraer Lot __.___._.._...___ Inside Lot ..�.X,__ Setback ...._.... ..�_._._ Sid�eyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING � � ��122 �� To be Used as: Add Fa�i_1.y Room� �nt _ 1$.� _ Depth —. � Height ___._$�__ Sq. F`k _28.8_ Gu. FL ____._._._------------_ Front .._._._.e..� DePth Height . Sq. F'L .� Cu. Fk Type of Construction ___._Erame____......_ Est, Cost ..__$3�54Q..4A-.-____ To be Connpleted �c 1 ST19?t �� Stipulations: Drainage approved by City Engineer 10/26/71. Permit without survey approved by Councilman Kelshaw and by instruction of City Engineer 1OJ26/71. No license approved by City Engineer. In consideration of the issuance to me of a pernut to c the proposed work in accordance with the description above oa�dinanoes of the city of Fridley. 1.75 Sta ttxe building h and in co I agree to do pro�iedons o! In consideration of the payment of a fee of � 21. 00 , permi�t is hereby granted to T•arrv RP� _____.. .�____._._........_:..:__ to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and worl�en, in ali work done in, around and upon said building, or any part thereof, shall conform in all respects •to the ordiaances oi` Fridley, Minnesota regarding location, construction, alteration, maintenattce, regair and moving of buildiIIgst yyithin the city limits and this permit may be revoked at any time upon violation of any of the provisiaa�s o! said ordinances. �� ,�.� Bt�ilding Inspector — NANK MfTNT('.N NOTICE: This p�cmit do�s not cove� the consfruetion, instaUation for wiring, plum6eng, gas hsating, sewar or w�fer. B� wn to sM 1h� Building Inspeeto� for separate psrmits for fhass Aams. ._ ,� � APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA � . . �� Q ER S NAME BUILDER. � WN . ADDRE$S � � �" ADDRESS ,�S� 0 � r^'—" r NO•. � D 0 STREET• IAT; � � BLOCK: � ADDITION: * CORNER LOT: INSIDE LOT: � SETBACR: SIDEYARD; Applicant attach to thie form �o Certificatea of Survey of Lot and proposed building location drawn an these Certificates. HESCRIPTION OF BUILDING To Be Used As: � c / � �cn-� Front : � O Depth • � b Height • � Square Feet: d- 0� Cubic Feet: Fxont; Depth: Height• Squaxe Feet; Cubic Feet: 1�►pe of Conatruction: Estimated Cost: $�j � Q � L .�. • To Bs Completed: � � — �5 ' �%% _ _ The uadezsigaed hereby makes applicatian for a�enui� for the work herein apec�fied, agreei�ng ta do all Moxk in sttict accordance �ith ttle City of $�cidley Oxdiasnces aAd suli.ngs of the Department of Buildings, aud heraby d�cl�tree that all the facta aad representationa stated ia tlxis appiication are true aad corzect. DATS : � � � — � � �� SIGNA1Z1x8: (Sea Reverse Side For Additioaal Info�ation.j � o� f� / l�ff ��r ,� � /�/�/ � � V L' d l� % � / r �/ F /�. : � -- ,� ,�,` �. � / _ .,' � �'��"'�+►� �- r,��r�-� r� v r s� �py ,� -�s �,.�'o �s� E� Y � ' � !1' Y C-' c� ��=IV C r�. �j �sJ1r' /d� � � h��4w -.� .�Y ?/1/ s T/?LC r�o�/ e�- � if � Y _ " �� � �. / C /� Ai S_r' � �i'aP f�' v �` v �* ii � / T �/ �, � F .1Jl; �- / ��2 G ' � / , '' /V C l��'�/y � T � � � -..r. � / r�.� �T� r,= S v/�i / �—'- �" �7'/'fL /�6� �~!� 2 .99' � SUBJECT � � City of Fridley � AT THE TOP OF THE TWINS g � I L D 1 N G P E R M I T � � � � COMMUIJITY DEVEIOPMENT DIV. L PROTECTIVE INSPECTION SEC. � _ , 1 �__'-� r , ; � , � � �'�'1 � CITY HAIL FRIOLEV SS432 NUMBER �""� � �', 612-571--3450 9t0-Ft5 108 ADDRESS 1080 Hackmann Circle N 1 LEGAI �OT NO. BLOCK TRACT OR ADDITION DESCR. 16 2 Parkvie 2 PROPERTY OWNER MAIL ADDRESS Lawrence J Berg 1080 Hackmann Circl� 3 CONTRACTOR MAII ADDRESS Same 4 ARCHITECT OR DESIGNER MAII AOORESS 5 ENGINEER MAIL ADDRESS 8 USE OF BUIIDING Residential REV. OATE 7/22194 ZIP PAGE OF � % 571-82 PHONE PHONE PHONE PERMIT NO. 22748 RECEIP . ag a APPROVED BY SEE ATTACHEO SHEET LICENSE NO. LICENSE N0. LICENSE NO. 7 CLASS OF WORK O NEW � AODITION ❑ ALTERATION � REPAIR � MOVE � REMOVE 8 DESCRIBE WORK Construct a 5' x 15' Deck in Eront Yard 9 CHANGE Of USE FROM STIPULATIONS See notations on plan. TO TYPE OF CO� SEPARATE PERMITS ARE REQUIHED FOR ELECTRICAL, PLUMBING, HEAT�NG. VENTILATWG OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID tF WORK OR CONSTRUCTION ZONING AUTHORI2ED IS NOT COMMENCED W�THIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPfNOED OA ABANDONED FOR A PERIOD OP 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. N0. DWIG. I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF IAWS ypLUATION ANO ORDINANCES GOVERNING THIS TYPE Of WORK WI�L BE COMPLIED WITH WHETHER SPECIFIED HEREItJ OR NOT. TME GRANTINCi OF A PERMIT ��11 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEL THE pERMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- � 19. OO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. OF CONTRACT R AUTHO ED AGENT IOATEI � � fFOWNER�lGO ERBUILOERi IDATE� 1�VA�HfHG Before digging call for all utitity locations 454-0002 REQUIRED BY LAW UPANCVGROUP FT. CU. FT. OFFSTREET PARKING �GAHAGES SUiiTAX $.50 SACCHARGE Fire SC $.61 TOTALFEE $20.11 �D THIS IS YOUR PERM�T �� natE� STALIS G Y LOAD NEW ADDN ALTER 11 {I ri Cons�truction Address: Legal Description: C1TY OF � FR[DLEY S[NGLE FAMiLY AND DUPLEXES R-1 AND R-2 Buiiding Permit Application �� �� �i�'.YY1 �—�—sa.../ -C-' 1 � _ Effec;tive 1 / i /94 � �� i A / -a•- w r.e n '� r✓+�- v Owner Name c4i Address: f 0� Ir� �-n,��v e% /Z- TeL # �°�� �7� �Z�� Contractor: � � �� t=�7� � � � MN LICENSE # � ��� Address: :s?�'"�1 E' _ Tel. # ` . LIVING AREA: GARAGE AREA: DECK AREA: OTI�iER: Attach to this appIication, a Certificate of Survey of the lot, with the proposed constructian drawn on it to scale. DESCitIPTION OF IMPROVEMENT � Length � �Vidth Length Width Length � / °� Width � Height Sq. Ft. Height Sq. Ft. Hgt/Ground � Sq. Ft. =#-� ' S� Corner Lot (] Inside Lot [] Ft. Yd Setback Side Yard Sdbacks Type of Construction: Estimat�ed Cost: $ � Approx. Completion Date: (Cost on Back) Drivewa urb ut Width Needed: �I' t= Ft x =$ DATE: `� Z �� APPLICAN • Tel. #S ��— ��` G � Permit Fee Fire Surcharge State Surch�trrge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: , �;�- �� $ % �, C��� Fee Schedule on Reverse Side $ � (r / .001 of Permit Valuation (1llOth`J�) � � ,S C:�' $.50/$1,000 Valuation $ $800 per SAC Unit $ $5.00 (State Licensed Residential Cantractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Pian Review $ Fee Determined by Engineering $ Agreement Necessary [ j Not Necessary [ J $ -��' � 1 I � TT;',�� i !HOUSTR1Al . � . � , � � � � T � � . ?� . �. � F1�RM SURV£YS BUSlNE9S . � � LAND SUFIVEYOR uKesHOae Glrv LaTS ! TQWORAPMICMAPFIN4 RE^viSi`ER�D L':�:��R LRNJS �� srnr� c� ?utyra�sor,a �. � �UD�C4tL��� � - LiCSNS€D GY ORDINANGE �F CITY OF Itt:iNEAPOL75 � i 3300 IYNDALE AVE. SO. PdtNtVEAPOLiS 8. MtNN: �� T.'-�.Yi OR 4-0370 I� / �� � � i r � � ,..�C�'f� l� � Y' fo.- .l�r-' !��_i� � ��A � 1.� !�/'� .- _ , n,�� � � ,� LL �.,: q,, , ; s " �urnpgur'� 4ertifirxip � 0 \ \ ` �� � � � � V l� � \ � O � �� ' � .;i ^ /l�'—� �- I hereby certify that the above is a true and correct plat of a survey of: Lot Sixteen (16), B1ock Two (2), Parkview Heights Addition, Anoka County, Minnesota. As surveyed by me this lst, day of June 1959 A. D. Signed ��o,:�/!��_�r`.�'..-rc..:� Mi.nnesota Registration No. 2584 �a � � , _ ,: � �� � . �+�; � ,:.. �; ,��. :°. . .. — .�.. � ' . . . , Y , rt• �. .. , ;'., . . �, • , � . ' , :. �' �, :z� ;� x a i ..- _ . F , . 2 ', { . . � . . . . . a�:, � � . s #�.� *, a, .:r � . . . ._. . . , . � s,w � "°r"'z` "ae' �R `r3 �`$ . r�iu,�r �, n,.. ha�,b a > �v a .c""� ''�i � :.. < � t . f.' ' " � �� ��i� �y�y .'N' Y ? , � ,,,�'� ZM ' N$T.� y l `w _vY�.�y, - y' . . . y � x 2 ; _, � /' . . . . . f`� . �'�' w-�"'� �� ' ; � :., � - �� . . � . z� .' � " �'': �" M �J . . . • • �. # �ro� - . . .. . . a: . . ' � . . . , . . � 0 'i � � �o � O � � w Q 0 � Q m O � � t-- O � w �- Q � O z � w F- Q � w � � F- X LL � Z m � � J � c .� ar ai ' L 'p � Y � 3 �' ' � U , Y Q' ' � L � � y � N U � Ll C � � N 1 � • O O � '� U � C U j 0 � J � � � U � � Q �„ � Q � i � Y � Y O i �a 3 [ E � � � o -' � -o , � o : m�.o L � � C � m m : � N . rn .. � rn � � i m � � v c . 3 V : m m � f- Ol < 1�: rn _� � � 1 V � W � � J i � 1 3 m � 3 0 N Q � a� � � rn c U � m � z H � � LL1 a �1 O � � N 0 U � m � � N ll� � � Z Q d � � U � Z m � � J a � � n 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 � v�ri r� r; r� � o � o ci o ,ri �» �» u9 � � � v� E» � is » » � � � I � I 1 I y I I I � Z � N N i U N a� � a� � � U � X Y � V � LL � �a � � � � °' v rn Q W � � Z� � m c� 1 I � � - m� C � C-J '� �-,C,, N d d C 7 C a m t6 � N m N N � N 3 X n v_, � ap as � F- = 2 c � o � O � Q �� c6 � N � U C � C) N y� 0 y fl 3� �- O ' � ltt `�N �N y v� v 1- zommva��'n�33c�C�m � � �� n � � � � � 0 c0 O C Z tL � w � N � � c I L � 7 0 � m � p m w > Z: O i3 °' m ¢ .� Z O � ¢ � w F- J Q � � Z U a � � � Q � Q � a Q w o 0 o � � � � Q X a� Z u- � Q O � 7 O � � U = � � O O C � o N J Ii Q � � � o �� 1 � w w � " � � l0 F- L � U �, 7 � m m � R.;,�., .,:., _.�.�-�„�,. sue�ec* .- c�ty of Fridley 3 2 9 7 7 AT TME TOP Of THE TWINS g U i L D I N G P E R M i T r � ` RECEIPT NO. • COMMUNITV OEVELOPMENT OIV. � � � ; V �"�� , r � � PROTECTIVE INSPECTION SEC. 1 . � `---• A �/"','� CI7Y MALI FRIOIE� SS�32 NUMBEN pEV OATE pAGE Of A►PROVEO 6� L �� 763-571-3450 910-F 15 8/ 12 / 0 2 / / �oe nooRess 1080 Hackmann Circle NE t IEGAL �OT NO. BIOCK TRACT OR AOOITION SEE ATTACHED oesca. 16 2 Parkview Heights Addition SMEET 2 PROPER7Y OWNER MAIL AODRESS Z�P PHONE Lawrence/Geraldine Berg 1080 Hackmann Circle NE J CONTRACTOR MAII AOORESS ZIP PHONE IICENSE NO Same � ARCHITECT OR DESIGNER MAIL ADOF1E55 ZIP PNONE LICENSE NO. 5 ENGtNEER MAIL AOORESS ZIG PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CIASS OF WORK O NEW ❑ ADOITION � ALTERAiION O REPAiR O MOVE O REMOVE 8 DESCRIBE WORK Install new window in basement wail 9 CHANGE OF USE fROM TO STIPULATIONS See notations on plan. TYPE Of CONST. OCCUPANCV GROUP OCCUPANCV LOAp SEPARATE PERMITS ARE RE�UIFEO FOF ELECTfiICAL, PLUMBING, HEATING. VENTI�ATING OR AIR CONOITIONING THIS PERMIT BECOMES NUIL ANO VOID IF WORK Oii CONSTRUCTION 20NING S4. FT CU FT AUTHOR12E0 IS NOT COMMENCEO WITHIN 60 DAYS. Op IF CONSTRUCTION OR WOFlK IS SUSPENOED OR ABANOONED FOR A PERIOD OF 120 DAYS AT ANY 71ME AfTEii WORK IS COMMENCED NO DWLG. UN17S OFFSTREET PARKING I MEREBY CERTIfY ?HA7 I HAVE REAO ANO EXAMINED THIS APPLICATION 1 STA�LS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECi AlL PROVISIONS Of LAWS VA�UATION SURTA% ANO OROINANCES GOVEFNING THIS TYPE OF WOpK WI�L 8E COMPllEO �SOO �. SO WITH WHETHEfi SPECIFIEO HEREIN OR NOT 7HE GRANTING OF A PERMIT DOES NOT PRESUME TO GIYE AUTMORITY TO VIpLATE Op CANCEL THE pERMtT FEE SAC CNARGE �ROVISIONS OF ANY OTHEFi STATE OF LOCAL LAW REGULATING CON- STqUCT10N OR TNE PERFORMANCE OF CONSTRUCTION �Z3.SO Fire SC �.SO PIAN CNECK fEE T L iEE $24.50 � 5 N�TU�7E O� CONCFA(;TOpOQ oUTMOQ� D�GENr �O�iE� WH N PR .�V VALI Ai D� THIS IS YOUp PERMIT • S�GN�TUQE O� OWNEp��� OWNEpBW�DEA� iO�TE� pG �p5o ����k NEW ( j CITY OF FRIDLEY Effective 1/1/2002 ADDN ( J 6431 University Ave NE. Fridiey. MN 55432 (763) 572�604 Bidg Insp ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUIIDING PERMIT APPLICATION Cohstruction Address: f G 1�o HQ'/�l �� Legai Description: Owner Name & Address: .�.c���� �/�f.e.-.�o1�'n� �2r� Tel. # S71 f�a?� _/�, � , Contractor. '.�Zar� - �o� u�,�if ��Sd�c/1 MN LfCENSE # Address: Tel. # LNiNG 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 Width Height Sq. Fk Length V�dth Height Sq. Ft Length Width HgUGround� Sq. Ft r�n l ��n �ase� �i� -�t/o�// " � � Construction Type: Estimated Cost $ �� �- O � Driveway Curb Cut Wdth Needed: Ft + 6 Ft = Ft x$ _$ DATE: �/ ��D �i APPUCANT: Tel. # �7� f�0�,��� Cali (763) 572-3604 for Pertnit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ f•�" •�• � $ f $ $ $ $ $ $ $ $ .�� � Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Att. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ) STIPUTATIONS: � � � � � , . � N 00 � � � � � � � � � O � � � � � Q -� � � ` \ \ \ \ ` � � � � � � i � i i i � � i I � � � � � � � �' � � � ' (� . .� I � J � h � � � � � n ,�-.z w Q a � 4 � � � � � °� /�� � � � �; � w r. �; �` 2 �' J ''1� `o� l� > � _� \ ` ` \ ` \ \ \ � \ � ` \ � � � � � �� � � , , � , , � � � � M �� � � Z,� =�'c � �� ' 0. � , d ' a� ' b � i W � i � � i i � Q , � , , � � Q � , , , � � � � � , , . , � � , � � , , � � � � � u � � � , � � � � , , , , - , , � � � � � , , , � � � � ; ; � ; � � � � � 4 , � , � ----------- , �-------------------------------------------------------- -----� � � � �---------------------------------------------------------------------------------------� T 0 0 f�j '9,i.}I� 'd?I0� NO,LV� 4ZOZ 66Z 5ZB Yd3 85 � SO ZOOZ/ZT/80 , �E1N �DDN aLTER t� [J �� Construction Address: CITY OF FRIDLEY 6431 Universiry Ave NE, Fridley, MN 55432 SINGLE FAMfIY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION i f�r � �° 5 Jb �°�� (763) 572,3604 Bidg Insp (763) 571-1287 Fax Legai Description: �' � Owner Name & Address: � Tel. # rlin � .s 7 � �cZ �Q'j �,�� � � -.— MN LICENSE # Address: Tel. # Attach to this application, a Ce�tficate of Survey of the bt, with the proposed construction drawn on it to'scale. DESCRIPTION OF IMPROVEMENT LMNG AREA: Length � W�d� Height Sq. Ft GARAGE AREA: Length Width Height Sq. Ft __ "�l ��� DECK AREA: Length Width Hgt/Ground Sq. Ft �oo r' OTHER: �� �o Constru�tion Type: Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x� _� DATE: �� /— O � APPLICANT: � � Tel. ��-� �S 7� � 1UJ Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we wil{ call you for carcl number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ - J�S $ $ � �o� $ • S� $ $ $ $ $ � Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 per SAC Unit $5.00 (State Licensed Residential Contractors) Att. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAL $ � �� � STlPULATIONS: c r ---------` __ .--� - � � � ��� \V1. �� �S �� 1� 1 JI � � -�-� `� ��`=���� (bS = c� � �f�� �5 �� ��S � � ��� i�s Ro � � � � � � i�-i � ( � � o� �_��� � � ,� _, ��,, �N � � 5� I ( ��- ����, j ,' C �� �� y��. � s � -F-�- � � n�� � ANc�- Q_. _�__ __ �' i—�( p I�J � � - � � �-�-I� G , �U �. S �S , �� - _....._-____ " \ i :+ �\ I T_T) l._—. � � (o� . ��� �:s �. I ' � S �?� �-� � �; � e���� _ ____ _ __ _____ ________ __ _ ��� ��-s� �� �d� r �U � (Yl. l��:J :�t�-�'1� ���.��� �� � � ��� ___. � � -�.S ( - G� � � �� � ���t � �- i ��� ��� ` ` y�SS � 11 -e- i� ' r,t�, �v �r� � � c7 �-G� ����� ♦ � / �� � � � � � ��� ���� � 3�NY/Il��'. ,.. �3M3: Building Inspections 763-572=36U4 DATE �'� ti V O 7 SIT'E ADDRESS �� THIS APPLICANT IS: PROPERTY OWNERI TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE ` c PERMIT TYPE TYPE OF WORK: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS �C0T3TRACTOR � � • • � :t��.r:+� �, - . . � � • . ��1!?l��� STATE LICENSE ADDRESS: B.�fIIGLE FAMILY/NEW O TWO FAMII,Y/NEW C( O BASEA�NT FINISH ❑ DECK ❑ MAW7'ENANCEJREPAIR DESCRIBE WORK BEING SIZE OF IMPROVEMENT OF SQUARES GARACFS PROPOSED SIZE: PROPOSED HEIGHT: SIDIIVG ❑ Vinyl ❑ Aiuminwn ' 0 Othcr . EXP DATE FAX �vcnox s�z [JCIlON S71 ❑ GARAGFJSI�D O ROOF � SIDING ❑ SWA�IIv�JG POOL ❑ ADDITION O REMODELING LENGTH W ❑ HOUSE dr. GARAGE ❑ ATTACi�D GARAGE ❑ DETACIiED GARAGE OSoff t ❑ Trim ❑ Fascia WINDOWS 1N EXLSTING OPENINGS �Yes �IJo IACATION OF WIIdDO S OR FOR NEW OP�iINGS- ESCRIBE SIZE OF ,/!� � n G, S; !1 OPENING CHANGES � . OF ❑ wulnows ❑ DRAW 7TLE ❑ OTHER PermitNo.• T �l�y Received By: Date Rec'd: 7 �7 HEIGHT A��-�� v STATE ZIP, �ASEMIIQT REMODELING SUBA�IIT: I . Existing Fioor Plan 2. P'roposed 800r ptan 3. List of struchiral manbus to be used Ft FOR NEW CONSTRUCl70N INCLUDING DECKS, ADDITIONS_ & PORC}�S SUBtvQT: l. Site P1arJSurvey showing tl►e qcis[ing swcWres a� proposed project. 2. Two sds of construction plans 3. Enugy Calcula2ia�c ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF L�OR AND MATERIALS: TOTAL JOB VALUAT� N$G�D� 97 U.B.0 FEE OCCUPANCY TYPE Permit Fee Plan Review Fire S�ucharge Surcharge License Surcharge SAC Charge Gtirb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ $ � $ � . �-1 ti $ $ $ $ $ See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum 5.50 55.00 (State Licensed Residential Contractors) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftxS21=S $450 Conservation Plan Review ! Fee Determined hy Engineering Agreement necessary ( ) Non Necessary ( Make checks payable to: C� of Fridley THIS GS AN APPLICATION FOR A PERMTT-NOT VALID UNTIL PROCESSED Attach I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Friclley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a pernnit 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 wh' requires review d approval of plans, i SIGNATURE OF APPL[CANT �����I96�riy�'L1s�,4�—PRINT NAME��� DATE /���% ��/ . ,� � " `��� �� � ,. . . . .�. . From: unknown Page: 2!2 Date: 11 /20/2009 2:29:53 PM ��` , � , , , . 4 Building MECHANICAL Pe��t Na.� Inspections RESIDENTIAL A.PPLICATIUN Received By: 7b3-s�2-3604 CITY UF FRIDLEY D��' 9 7b3-S02-4977 FAX ���x-,g.a,, DA'I'� 11/1812009 YOUR I'rtitAll. ADDRESS ��aveaheedrgsndelr.cam S1TE ADDRE3S �� �CKMP`NN CIRCLE FRIDLE�1, MN 56432 THIS APPI.lCANT IS: O OWNER C1CON'TRACTOR PROPERTY NA�: GERALOINE RER(3 OWNER/ ADDRESS: 1080 HACKMANN GRCLE GTY ��Y SI'ATB MN �p 55432 TENANT 763.y��,8285 PHONE: CQNTRACTOR COMPANY TSAME: DAVES FIEATlNCi. AIR d� ELECTRIC SUBMl7' A COPY OF �NTACf PERSON. A� ��' _. YOUR STATE STATE UCENS6 # IXP DA7E LICBidSE WITH ppp�:1G0137TH AVE NE ��y COU11�U► Fi�IGHT3 STATE MN �p 55421 APPLiCATION ��E 763-781-8801 Fpg 763-789�8808 P��T .�,p� �NCL6 FAMILY O 7'WO FAMiLY O TOWNHOUSE TYPE OF WORK: a xew (��r�csn�rrr O ALTCRATION/REMODEL 1_LI DETAiLED DLSCRIP'l10N OF WORK �EPl.ACE EXISTINC3 FURNACE WlTH NEW LENNOX FuI�IACE I�q1O50UH-3BA-0TO FE�S ARE HAS�D ON S1�:A0 PER FIX7'URf, EXCEi�T WHERE NOTE0. FIX7IJRFS: (INQICATE TO'1'AL NIJMBER OF EACH BELOW) Equipmcnt ItWtelled MFa: � MODEL: � SIZF/BTU �"m° MT(i: MODEL: SIZFJBTU MPG: MOD6L: SIZAIB'N ___�____,. t23.00 PIREPLACL' (GAS)SIS.00 CiAS RANGFJ�OVHN SI0.00 TO AIR BXCHAN4EER S15 REPI.ACE (WOOD) 535.00 PfEW OAS GR1LL Si0.00 ,_BOIL6R 535.00 IiNACE 533.00 GAS lJNlT HCR S! 0.00 C}IIMNEY LtNER 510.00 �AS DIiYER f f 0.00 _POOL FIEATER 535.00 DUCT WORK 510.00 GAS PIPING f I0.00 VEI�FII.ATOR S I 5.00 Numbcr of fi�ctures Q S 1 fl.00 �„ x$ i 0,80 =$ Number of fixtures � SIS.OU x Sl S.QO =$. Number of fiyxtures (c� 525.40 � x 525.00 =.S_,______ Numb� of fixti�res � S�S.00 � x�5.00 > S�•� � St�fe Surcharge = $��_____,�Q INIMZJM FEE 535.$0 Tota! _ � THIS 1S AN APPLICATlON FOR A PERMIT NOT VALfD UPTI7L PROCESSED 1 hercby apply for a buitding permit and I acknowledge tl►at d+e info�on above is complde and accurate; that tMe work will be in confoanance with the ' ances and codes of the City of Fridley and with the Minnesota Construcxion Codes; that 1 undorstand this is not a permit but onry ap lication for s pe�mit and work is not co start without a permit; that the work will bo in accordance with the approved plan in the e o t r whi i w an¢ a proval of plen . , � SICiNATUItE OF APPLIC INT NAME L`���`"n •6 � PLEASE NUTE: SBPARATE PER S ARE RE UIRED UR.BUiLDING E4ECTR.tGAI.. ANp MECHAN[CAL WQR�C �.�. _a�r+_..s��--- a.ia, va i�a �viuJ Building Inspectioas Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977