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AF - 46624City of Fridley, Minm. .�- ._� .... BUILDING PERMIT N� 5 7 i o�'� Date: ....�� - li' � �,� �,� Owner: __� � �.�"'�'�r-,�.� Builder •--- --_�.__..-.---__.______._ Address.._.__.�... __�...____-..�...�� ._._.__._...._._ Address ____ ----��___._._..___...-_.._._........_ OCATIO QF U LDING � Na ..��.(Q-- Street .��/-- #Part of t _. ._....... Lot ._..__�:_..__�.__ Block ___..-....s.-.---- __..._. Addition or Sub-Division . ----------- Corner Lot �.�__._._.._ Inside Lot _�"'".'��.._.--- Setback �� ` SideYard -,��f�..1._ Sewer Elevation ___._��.__•-••---••-• ----•-••-••----- Fovndation Elevation > DESCRIPT60N OF BUIl.Dti�G �m�� vs , . , f o� i,r �rL E; `�f rr.. � � � .�� -"`.... Front _�.�_._ Depth .i.,� �.._. Height � =-`-�''--�-•--- Sq. F�. �.� F:i:_ G�Z. Ft ..r--r � � ., * �,r' f+� •� '`� 1 � j r •° ' ��..' Sq. Ft. .1 � -_--- Cu. Ft. _'.r�� --_`_,_�:� `�"�..� .f f . Fr{�ni�,,.Y �.__.� Depth ...� � --,r Height ��,.� -__ .. . _ 1 w-, Type of �Construction _._��:��:.--- �st. Cost �- - �� --- - - --..... To be Campieted .----- -------- ------ - - ---• - .,.-.. - __._.. ,� Q . , C_ _„/ . � o�" � � /� v� � �- . C� � j �f / ' / ,,� �.�-` - • ��-�. �, ��._--,-L._��.-�-z-c_� �C�rc-�t-=-�..� ` �' � In consideration of the issuance to me of a permit to constxuct the building described above, I agree to do the proposed work in acaordance with the description above set forth and in oompliance with all provisions of ordinances of the city of Fridley. r .Q In consideration of the payment of a fee of $,� I ., Permit is hereby granted to..._. ._ to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in ai1 respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the aity 3imits and this pernut may be revoked at any �,,,� �viol�e� of a�y of the provisions of said ordinances. l ) Building Inspectar NOTICE: This psr�nif doas nof eover tha consln+ction, instaflallon for wirina, plumbing, pn heating, sower or water. B� wre fo sa� N�• Buifding fntpeetor for separab permits for thas� Mems. a�4 � APPLICATIODT Fadt BUILDxNG PSR1r1IT CITY OF FRIDLBY, MiD�B30TA Owaer' d �?ame ---.�:�._..........�...._.Builder ¢a�r.gs Jo�sop ....�..,.._ A�dto$e A�drese LOCATION OF No. V�� street t�� gart of �,ot N.$0 ft..of;Lot 3 and: Lot�,��lock i Addition or Subdivision�h�t . Cor�ner Lot 7[n�ide Lot ,.„_,�„_,Setba�ak____,,,,, Side-Yatd SBfi�R SI�VATI�i FOiIDiDATIODT SLSVATION Applicant �ttach to thie form Certificate of 3urvay of T,ot a�d proposed building location. DESG'RIPTION OF BUILDIBTG TO bB Li88d a�: '' sAi� AS 110 Hartmian Circl� �� _ Front�D�pth J � Height �'� Sq . Ft . ,�% ,. ,._. Ctii . Ft . � O� Gazage P`ront��9 Depth � � Height � � � � SQ. Ft. �! � • Cu. Ft. � � .�.. �..�..��,..�. � � Type of Construction �_ � ;_„__,_�Eati.mated Coat �'`be Completed �.: The.under�igned hereby ma]ces ap$lication fo�r 8 permit for the work herain epecified, agreeinq to do ali work ia atrict accordance witls i:t�e City of Fridley Ordinances an�d ruliag of the Dapartm�ent o� Huild- -,;ings, aud hezeby,deelares that all the facte and re reaenta �� taL�i �,n this appiicat3on are true and correcp� �, �� p��g � 12/4/61 g ��SC1�edule of F�e Co�t� can b� found pn tY�� Rever�se Sida�. � _ � .. :..' .. . � � �� \' _ � ,, ` � � � ;. . �� xw �, � x�� a�� ,�� .� � N�d� V � ��ba l � ca°y� o'�� , � q � �cy � 73°��q 73 z ��a �y�V � � a��:� � ��a � o �aa � o.,� � , � �3°� :� Y n.� � ��; a � �` a� � � ._..�_ - _.. . p �- _ � o.N-m,__�. � '. . �, �� +�-+ � A� �py �o q a� o � �� '� � � �'" � .�. o �� F � ��. � � . 0 E'� «'� F F� CJ C � �a � � ��ov � �� o � �� . � N irt N . �, � o $ o ° .. � � �.. . 07 a W !i ,. _. _ ... _ �.i � " ,:. ..� �, � : : : : 0 . : : : 11% : : : : � V ; : : ; � . . � ; : : g :go � : :a� • . . ,�, 4 � . � � F- ° , � � � � d . a,��r � '�i "a � �i O a` x � a'i � � � � � � 3 � p. ca � � w �a m � � '�i P��, C� PC � V r � � y� � � � � � U o � O � � � � � � � a� � H w Q { • � � �� rr va er� w vr 0 o n o � OC N ttX! u9 N W ' � J o g � �g� ; oo . rs � : � � . .� : .� � � S °' � � ��U�� , � d, a3 �?l �i �'. � � � � � a c° a � �aa� �6 b4 � z II � �I a' , III � �I � II I � I z� y � a � � �f � �i 0 4 Qo o� 0 f� _ � z � � � � O `�'_ W '�,�' O � � E� � a� � 0 A rQ a : Q � �z a� � � �.� � � � °a °a �° �° o°, OD OD N N � : � : : a : : � � : : � o : : aq x : : W p : : �; � : �+ w � �`�'�3 � �� 0 a d ��m�x � � �, W W �a'a"'a"�� `d N � � � d d � b o � � � � �,' � � W W � aa ee eo . � � o� v� � z M N O � � � � z � � � � o�i � � � N � � aa q � 0 4 Eo,'� ... � w "� v� V� vs a � ° $ .� � N � : � k � iC _: z 0 0 if3 : �i : - . . : � : ; : : : � . . : y : . . � : : � : : � � � o � : � �„ .0 O : � o, � o °�,' ° �o �a 0 � ' 'a� i/, iS N °'° ° w � � ° M +s ta . � w W O � � a W x M � � � M a a N�dc� � � w o � � � � s � +y � � � .� H 0 � w °o � � � .Ww� E+ E, m m z � � � o c� � w � F O � � � � o a V F W a w > � L x � a � x a O�! a � �a h � n a � z w > 0 N Y t f ' � � � � � � di�'� *� � ; � �� O O � • L �. �j! ,p ;0 r...� � � � � � c � � � } � � y" :C � o w *a � {�,1 O ,v.�a N a w � . � O O V � � �� a •� a o0 � •F• i c a a+ ° � •- L d � � � H 0 C � L � � o ° ._ y.. � � %� � � .� W � O � C V . � 3 0 O O~. a � 4 0 � �. I d � N � N � ,� � v., v � � � � Q � � Ki o � � z � � � s � ,g C � � � �' � ' � � � � d� � ° U •^ � � � 0 ► �� d � U � �o � � � � � � ' �O � � � U U� � C A � C� w � o� � � � .s � � .� � � o � � � a � w � � a � � � d � 0 0 � � � .� � � � � oti� � � :t� � � � o � .� � u. .,- � d �� „o .� o �� '° o �� .� 'N C� •� ° ti � � � �. �, .��"� � a� o^� °'o�,°' � � � ° �� o� � '� ^o � � � W � •N �°'�°� �� o� � � � lyv d I� � y � •� � .o �� w Y��N� �� ,o c� .��o� w �.�� .� .� w �� oo�. � � � � � � w^ � � � �, � ,.� .� � „ a .� .� � � � �, � �� 0 ��o o�� ° ° �� fi' � O � �� .� � *� .,� � '� � AQ � � � "' 0 �� s d��°' � �s��a �. �� w�ow s ,� •N �i �� Qi � � N .� � � '� ° �H � �� a 'a� � •c�i � � w�. .��„� � �� _ ��3� � 0 a°'��N < .°oo'�d �s�°'a � C�ty ��Q�r�� . s� + ` --- . r ; ,,-- --, GOMMVNITY O£V�LO��AEMT DIV. � � i rfOOTECT�vt �M��crro�+ ��r. F �` t r_�_y � C+TY MALL fR�Oy(Y �8r32 i�.....1�.� �.1 ��2-68a-3t80 • Job Address , 1 � . trac,.tlor Ki te $lA�[CT Permit No . ,'jr� .. HEATIidG PEP,��IT APPLICATIO''� � hMJwd�+c7! A�V. pATE PA6E OF APARGyED BY 910-FZ7A 0 2/15/73 1 �l 80d i /. /L[�� ^ .� . /. .// ��//.i �- -. �. e / _ ane ��, _ __ --1 �l' � 3 � - G��v�r�r e�,�a� tst Rta: �� T��' Heatin�;/Po„er P1ar.ts ;= ilirnace Shetl & Duct �ork . . . . . . . . . . . . . . . . 520.00 i S te2�t Hot Wa r . Re�ptacement oi F�rnace 6.pp a ..... . .. Repair� & Alt�rations--np to S50J.Q0 6� E^_ _ Trade Name Re airs & Alterations each add. �506.04 Size No. p . 3«, s-- ---- � t I Q 3— t � 841ECH. WA.�i AiR Capacity .��..� , f� U S4. l t� �rnace Sheil & Duct Wark to 120,000 B1V ...... ..310_00 S— EriR BTtJ Ton. each add. 6a,GOa BTU . . . _ . . . . . . . . . . . . . . . . 3.W ; Total Connected Load �_"T�� Replsce�ment of F�rna�e .. . . .. 6_00 i��-1.52_�2— Kind of I`uel Repain �r A}teraLiens—L� ±e a500.00 6.00 � Repaizs & Alterations each add. S500.00 3.00 s i3ulrier 3TEAi�i or HOT V4�p.'r��t �Y�'s'�2:t Trade bTame Ftirnace She2l 3c Lines—to 400 sq. !:. F.DR Stenm ?�O.�JQ $__.__—_ i Flunace She{l & Line---to 640 sq. ft. EDR Fiot Water 2Q.pp �_ Siz2 I�a. ti i Each add. 2Q0 sq. it. Ei�R Steam 3•rX3 �..__ __ —__ Capacity Sq.Ff � Each add. 320 sq. ft. EDR Hot Water 3.00 j EDR 5Tli Ton. OIL BIIR1�i�R—to 3 g2I. per houc 6.Q0 a—_!._ f over 3 gal. per haur—�ee Fee Srhedule GAS BLIR23ER t�ip to 1�3,C3C? BTU) 6.00 ;_ �, �� f wer 1??9,0(;Q Fi'I"LI 5ee Fsa Sth+cdula I GAS FITTiP�G F�,'.i:,: 2d0 R1lT`E TOTAL � ist s flXcuT� . Xs �co s 2�_ U v Additionat Fiatures x .7b S- � Gas Range to 1S3,��€? z� b.C�O =� .50 State Surcharge � �:lgi CO��ITIO:fI:�a �; � FAN H£AiIi�G $Y::T�"Z� Sm� Fa St2ur.�r.lr � V'Egd'YIL.'lit?3G $YBT�`.�i r ALTERAYIO:bB ts FEPAIRfS 'rOT3aL F� 9-l�w.� 5L i 1 FQJ�F'� t I2�lFiL �" 02 ' � . � � � ignatuYe ; _ ��—�^7� , � , a tIi— c� � � , � � s� � ' � � s r .a.. � � �; . . � a � � � � 0 � � � � � O Q W J � 13i v t/f W � �.1 1-r �C a r � �V� �r �� a�b �� $ U ,�°r�+ M � �+ F+ • M �t � ..•''. .f� .°�i �3�a �� vd M�i S�+ � O u� °i r�`°"�a �� ..' M CD �p Q y � V a ,� � . �a�.�� -�� t°OOs ��c �� s 'O �c ro �{ « � �v` ap ta0 �A � C C+ 7 �h' � � �+.� r' Q 'OJ: ��°a W � C i: 4 p ry�� E,y►.� � u U �� a �o � �, o G G � t d o � � F g � N N N M � 8 8 8� 8� 8 8 8 �o � � � o � � m M N . W : 8 g o 0 i� 'fl 3 y � �� n � � � o 0 � � �� :: V � Q Q � � � � � v. � y. � W. Aa � a a` a tl � � 8 � � � N R M � 3 � � � � s�v�� u �$�� y � 4 L. ey '� a o � � �� "' '� � � � � a � � a : �� a� � � if U � E w .� - � a' �_ � �� M 0 � 0 z � tL OC � ti� � Vi N K N � 8 � 8 0 0 � � � « � a � �_ � � a a 9 W .' � .� w S � E g � � � � � �p„ S o oc a � °�' �, W W �� a a � ': � � .�-t a° y �y d N � M N � v�i v; �� M � � a w � ��G ��w� � a � V x � M $ � � � ia � � � � �, o a �o �. '' �� „� a � M x o W � a � 00 a o� a ► z � � V � � � o � a 1�� ` � I � � N � � . � � a � m a � � t� E°- M � z � !'+ � � m � � f� �1 i � ' M N p � � O l� � � � N �c � 0 k lt M � � � � � � oh ! V �+ -1 1 � - - � __ L� - _ _— _— � � a � va ..�-..... i; H � � �� n�'� � � � X ia ..�i� ~ � �' C iC�.'" � �� M .�. G� ��<� 10 tr v V . � o � � � t� pC � a � i� � � � �� i < � O � � � � .. SUBJECT � PE ��¢� City of Fridley 2 2 3 5 3 AT THE TOP OF THE TWfNS 6 U( L D I N G P E R M I T _ ; � RECEIPT NO. � � � • COMMUNITY DEVELOPMENT DIV. /j r� � �' � PFOTECTIVE INSPECTION SEC. 7 �/ , , � 1 �'�'� � CITY HAIL FRIOIEV 55432 NUMBER REV DATE PAGE OF 4PPROVED B� �'-"'� � '' b12--571-3450 910-F15 3/23J94 � � 10B ADDRESS 106 H r 1 LEGAL �OT NO. BIOCK TRACT OR ADDITION SEE ATTACHED oescA. Pt 2,3 1 Sandhurst SHEET 2 PROPERTY OWNER MAIL ADORESS ZIP PHONE Clayton Hicks 106 Hartman Circle NE 571-6354 3 CONTRACTOR MAIL ADORESS Z�P PHONE IICENSE NO. American Remodeling 3700 Anna olis Lane P1 -002 d AHCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LtCENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OP BUIlO1NG Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION C� REPAIR O MOYE O REMOVE X 8 DESCRIBE WORK Reside, install gutters, wraps, soffit � fascia 9 CHANGE OF USEFROM TO STIPULATIONS TYPE OFCONST. OCCUPANCYGROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIREO FOR EIECTRICAL. PIUMBING, HEATING, VENTILATING OR AIR CONDITIONING. TMIS PERMIT BECOMES NUIL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. fT. CU. FT. AUTHORi2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONS7RUCTION OR WOfiK IS SUSPENDEO OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPIICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. �IiE GRANTING Of A PERMIT � 13 � 29O 6. 64 DOES NOT PRESUME 70 GIVE AUTHORiTY 70 VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �L.rJ3.0� Fire SC 13.29 PLAN CHECK FEE TOTAL FEE License SC .00 177.93 . SIGNATUREOFCONTRACTORORAUTMORIZEDAGENT I�ATEI WNEN PROP L VALIDATED TMIS IS YOUR PERM17 - � 3-2 �� SiGNATUREOFOWNERiiFOWNERBUILOER� �DATEi pG � 5 Ot�TE N� � � CITY OF FRIDLEY_ ADDN [ j � ALTER [] SINGLE FAMILY AND DUPL.EXES R-1 AND R-2 Boilding Permit Applicxtion Effective 1/1/93 -�71-3Y,�0 _� • . Constivction Aadress: 1 d 6 �ff,�"�'i � �v �� ;e�' / P � � - - � . . Lega1 Descnphon: i T 1 �S�l- 6.3sy Owner Name & Addc�ess: � e . � Contractor: l�/'j'1 fi�� .•�t� ev� o�r/ � MN LICENSE #�Gt� ��0 d � Tel. # 3�S3-C�oaO Address:��'7o G l�rv w a- �oi � S I. /U Atfach t,o this application, a Ce�tific� of Survey of the lot, with the proposed construction drawa oa it to scale. LIVING AREA: GARAGE AREA: DECK AREA. pTHER: DESCRIPTIEiN 4F iMPR4VEMENT' �� {(i� Heigttt �� Width Height �� y�� . Hgt/Ground — Sq. Ft Sq. F� Sq. Ft. _�_ Comer I,,,ot j] Iaside Lot [ j Ft Yd Setback _ Side Yard Setbacks Type of Constcuction: Fs6mat,ed Cost: $ � � a�� Approx. Complexion Daie: �/- t �-y 5� .. (Cost on BackJ Driveway Curb t�t �dth Ne�ded: Ft + 6 Ft = Ft ac $ _$ DATE: � =1? - `'7 �/ APPLICANT: �� %�c� %i%�a.1/�o Tet. #,�'S3- ooaa -�- � '-= Permit Fes S/S3 ° G Fe� Scheduie on Reverse Side Fire Surcharge 9i I 3•� y .001 of Pernait Valuation (1/lt�h96) State Surcharge $ L. G`-/ $.50/51,000 Valuation SAC Charge $ �: °�' $750 per SAC Unit License Surcharge $ �, b� $5.00 (S�ate Licensed Residential Contractors) Driveway Escrow $ A1� 'A' or Al� "B" Above . Park Fee $ Fee Determined by Eugineering Sewu Main Charge S Agreeme�►� Nec�Y [ l Not Na�essazy [ l TOTAL $� . 3 STIPUI.ATIONS: � Cy�r� ' . 3-a3-�3 � sus�ecT NO. City of Fridley 25 3$1 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T � � � � � ' COMMUNITY DEVELOPMENT DIV. / / � � � r � ti' �� PROTEC7IVE iN$PECTION SEC. �'j� � � ��'1 � CITV HAL� FRIDLE� 55,32 NUMBER REV DATE PAGE Of ADPROVEO B� " �""�"� �'' 612-571-3450 9t0-Ft5 8/18%97 / / J08 AO�RESS 106 Hartman Circle NE � LEGAI �OT NO. BLOCK TRACT OR ADDlTION SEE ATTACHED DESCR. Pt 2& 3 1 Sanhurst SHEET 2 PROPERTY OWNER MAtL ADORESS ZIP PMONE Cla ton E Hicks 106 Aartman Circle NE 571-6354 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNE1i MAII AODRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZiP PHONE UCENSE,NO 6 USE OF BUILOINCa Residential 7 CLASS OF WORK O NEW O ADDITiON � ALTERATION O REPAIR ❑ MOVE O REMOVE X 8 DESCRIBE WORK Construct a 12' x 10' Shed in Rear Yard 9 CHANGE Of USE FROM TO STIPULATfONS See notations on plan. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAO SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING. HEATING, VENTILATING OR AIR CONDITIONING. THIS PERM�T BECOMES NUIL AND VOID IF WOPK OR CONSTItUCTIQN ZpNING SQ. FT. CU. FT. ' AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR If CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY TMAT I HAVE READ AND EXAMINEO 7HIS APPLICATION 1 STALLS GARAGES AND KNOW TME SAME TO BE TRUE ANO CQRRECT. ALL PROVISIONS OF LAWS YALUATION SURTAX ANO ORDfNANCES GOYERNING THIS TYPE OF WOfiK WILI BE COMPLIED $2 OOO �I.00 WITH WHETHER SPECIFIEO MEREIN OR NOT. THE GRANTING OF A PERMIT � DOES NOT PRESUME TO GIVE AUTMORI7Y TO YIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULA7�NG CON- $62.25 Fire SC �Z.00 STRUCTION OR THE PERFOfiMANCE OF CONSTRUCTION PLAN CMECK FEE TOTAL fEE $65.25 SIGNATUHE OF CON7RACTOA OR UTHOR 0 AGENT IDATEI �� —� ; }� HEN PROPERIY LIDATEO 7HIS IS YO f PERMIT �� . . SiGNATUAE FOWNEA�ifOWNERBUI�pEp� IDATEI j Bl� �NSP �1hiE NEW ADDN ALTER [a �l [� ConstructionAddress: Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDII�IG PERMIT APPLICATION Owner Name & Address: ��'YL.� � Contractor: �� ---�� Effective U1197 �� k '� ' • �, �� » �� 7 , �� ; ,� Tel. # MN LICENSE �t Address: �D� ,�,�..-�.,,,�,, ��,� �%� Tel. # �7�^ 63.�'� Attach to this application, a Certificate of Survey of the lat, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Length 1 a� Width i o' Height � i� Sq. Ft. / 2D Length Width Height Sq. Ft. �n� �id� Hgt/Ground Sq. Ft. ��.--� �!��. Construction Type: ��. Estimated Cost: $ ,Zc� c, e, � (Fee Schedule on Back) Driveway C`urb C�t Width Needed: Ft. + 6 Ft = Ft �x $ —$ DATE: �/' APPLICANT: C� �. ��c�.�, Tel. #�7%G3� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL s�rr��l�n�r�ro��s: � 2.Z� $ �. $ �- $ $ $ $ $ $ � : Z� CTI'Y USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1J10th%) $.SO/$1,000 Valuation $950 per SAC Unit $5.00 (5tate Licensed Residential Contractors) Alt. "A" of Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ) .. . August 12, 1997 CITY OF FRIDLEY TO WHOM IT MAY CONCERN: I, Helen Sampson, agree to have Clayton and Jean Hicks Extend their new asphalt driveway to the lot line of our property adjacent to our common stone wa11. ��P��-- -- �c*�,�e.�� / . ^, � i , �ii • � �/ ! % Helen Samps � Date: /6 � r�'z��,�,� �'�� ._-�p %7F' //O ii �i �� -��.x�` � ��` .r'�'�� ^'��,'4�z�'� ' � � , �' -�"� ' "� � � � � � , '"�� r �y .�s �.a .,� ,.� .�' � �: �' �`�� -� � ,�''�� _�' �� `�5�� _"� la �„�� r '-��' ,� � `y �,� � � � -� '"' � �'..�-- � --�- • ,,,,t .�,� „,6 x , r f �. `'�- � ,�;p, �� ,� -._� �. r ,� _- Y �sa��- , , � �-7 _ . . (�,„.. .�� `� �_ . J� l�..'�'� ;.• � I- z -�r .1� . . . . _ . . . . . . �. :. . . . .- . . ' '�. _. .. . � �. . . . �'. � „ � � ��; -� � _� � .. � _ � �- _ � �_ , y �; �: � , - - � fi. . „ 7 ,� ,� ti � �^ -� � - � � r i'�''�� ` �,�� '` �'�; � � s: - . �:; ', `�,� 3�'L3��6�,,.�. � .,,� e - . # .:= , a- _ , : �� . ` � �, S- - �, . . p § y �.t27{ , 4 . 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''a o y � 3 � ~ x �,�� U � �� ..0 aj O o ai 'c a� ^ v •3 c� .a '3 � � � -• U � O O O O O O O O O O O O �^�r st et et et x X X X a00NC0 T T T O � O O 0000 �� C/NNNN = X X X X MOOON�U •• T T T � � O J O � N EA m > � t � N � : t� 3 � h 3 c � .C. v o y � 'Q C�.1 � N F„ . � � � � � 0 �D � f`� .C3. � t!') � � � �i a c�a � r m � d U m a N � N � 'o Y � � X � W i X W c`d T U � 0 O. � � 3 0 � � � �v �a oD � � Z T�^ Na � 0 m os 3 � m` Q d 0 CC 'd � v � � m C � O O LL m � O m .Q � O 0 �� . Ry a � � �y L _ � 3 n v� a m m Y � o. N c -v -e o � y � � C (p m U o � m n O �+ Q b y a N Q � o � �� r� � � � n i 7 C '- °o�`p�Q � g o O � � � m O -�p d��,= a. m _ � F- F- Q m C � � ob.a C � � o •� ?+ � o � � . a, � � - � °�. O �- G � `� 'v � `� O 'y � � E ° 'o C.i � T r= � �� a V C � � 'l7 3 � e� n, �` �. V � �a � m � > c� � � � Q � � � OO � W � �. � � Q � � O v '� W � � 0 . �Q� n' � �C � " d aa �� W �o er v� 3�� N x�� z � �e, � o '�e�' ° ,� �- r� � � 0 � 0 . o > � y,�„+ !t � �� w �O � >, � et �'+ N z � �°�'o p 3 op o� � M � N � � �✓ �� O O O O O O O O O O O O O O � � O O O O O O O O O O O O O O O tn O tn I!') CG O�A � O O O O O � O� M��~�� r N N N N M �Z � L .O w � a0 �p0000000000000 C �pO0000000000d0 °o,�cDCOOVC�io,-�.riaoocovo _ .�tpCp�COr�OM(040�Nf� � � T T�t� T T N T N N Q N T N N � C m �� r� N r� N N� N N x X X X X X X X X X X X X X �oDa0a0000CV NNCV cOtDtD T t T� T T T T T r P" �.. �':� SUBJECT • City of Fridley 2 7 3 0 3 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T � REC � . � � � ; y ��_ COMMUNITY OEVELOPMENT OIV. r � � PROTECTIYE INSPECTION SEC. S� � . � � � � �"'1 � CITY HALL FRIDLE� S5132 NUMBER pEV o�TE v�GE oc �vvnOVEO er �""� � ,�� 612-571-3450 910-F15 8/19/98 � � JOB ADDRESS 106 Hartman Circle NE � IEGAL LOT N0. BLOCK TRACT Op ADDITION SEE ATTACHED DESCR. gt of 2,3 1 Sandhurst sHeEr 2 PROPERTY OWNEFi MAII AODRESS ZIP PHONE Cla HIcks - 3 CONTRACTOH MAfL ADDRESS ZIP PHONE LICENSE NO Allstar Construction 331 N - A ARCHITECT Oli DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO. 5 ENGINEEii MAIL ADDRESS 21P PHONE LICENSE NO 6 USE OF BUIIDING Residential 7 ClASS OF WORK � NEW ❑ ADDITION ❑ ALTERATiON � REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and ara e(28 S Tear-off 9 CHANGE Of USE FROM TO STIPULATIONS Underlayment must coa�ply with the State Building Code. TYPE OfCONST. OCCUPANCY GROUP OCCUPANCYIOAD SEPARATE PERMITS AqE REOUTAEO fOR ELEC7RICA�, P��1M81NG. HEATING, VENTI�ATlNG Ofi AIR CONDITiONiNG. THIS PERMIT BECOMES NULL AND VOIp IF WOpK OR CONSTRUCTION 20NING SO. fT. CU. fT. AUTHOAI2ED IS NOT COMMENCED WITHIN 60 DAVS, OR Ii CONSTRUCTION OR WORK IS SUSPENDE� OR ABANDONED FOR A PERi00 OF 120 DAYS AT ANY 71ME AFTEH WORK IS COMMENCEO. NO- DWLG. UNITS OfFSTREET PARKiN6 I HEREBY CERTIfY T►IAT 1 HAVE fiEAD AND EXAMINED THIS APPLICATION STALLS GARAGES ANO KNOW THE SAME TO 8E TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAk AND ORDINANCES GOVERNING 7HIS TVPE OF WOqK WILI BE COMPl1E0 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2335 I.. 16 DOES NOT PHESUME TO GIVE AUTHORITY TO YIOIATE OR CANCEL THE pERMl7 FEE SAC CHARGE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION pR THE PERfpRMANCE OF CONSTRUC'f10N. �]1}. 75 Fire S�,' 2.33 PLAN CNECK FEE TOT L FEE �--� �� Licens 5.00 3.24 ��IGNOTUAEOFCON'RACTOpOpAUTNO ZEOAGENr iO�TEi N OPE ALID T THIS IS YOUR PERMIT ! s � S�GNATUHEOFOWNEAi�fOWNEABUILDEA� �OAfE� g� �NSp q�TE N� ""�'-' L l Effective 1/1/98 ADDN ( ] � CITY OF FRID.I,EY ` ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION � ConstructionAddress: Legal Description: � Owner Name & Address: 1� n ' Tel. # S7/- (p3� �( Contractor: �QQ MN LICENSE #'��7 Address: LIVING AREA: GARAGE AREA: DECK AREA: � OTHER: Construction Type: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlVIPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. �'rn�- r,�� /�nwn-..tp _ � 8 � � - Driveway Curb Cut Width Needed: �'j DATE:�-�g�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ � �/ ?�.� $ o � J.3 $ ,/ $ $ S - UC� $ $ $ $ $ g�'°� Estimated Cost: $ �� Sf (Fee Schedule on Back) Ft. + 6 Ft = Ft x$ _$ �� _ Tel. � CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50!$1,000 Valuation $1000 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 [] ,�, .��,;�. suuatT City of Fridley AT TNE TOP OF TME 11NINS B U I L D I N G P E R I. 1 I T i � � � ; `L _��_ COMMUNITY OEVELOPMENT OIV. f � � PROTECTIVE INSPECTION SEC. � , � . , `.'-_� ��"'�.1 CITY MALI FRiOLE� SSIJ2 wuysEn t 612-571-3450 9t0-Ft5 �oe AooRess � 106 Hartman Cir 1 LEGAt, �OT NO. 9LOCK Ti1ACT ON ADDITiON oesca. t. 2� 3 1 Sandhurst ___ 1 ARCHIT�C 5 ENGINEER 6 USE Oi Bl Reside 7 CLASS OF e �ESCRIBE )WNER MA�L AOOR�SS � � Jean Hicks )p MAIL ADORESS I.ite Home IIDD�'OV. R400 OR DESIGNER MAII ADORESS WORK 9 CHANGE Of USE FROM STIPULATIONS MAt� D�TE 81; P�GE OF / / BC'FiMIT NO. 30116 RECEI . _� �bnaOVEO B� SEE ATTACMEO SMEET Z�P PNONE 571-h354 ZIP PHONE LICENSE NO d�S_��7 �nn�4�S� ZIP PMONE UCENSE NO ZIP PHONE IICENSE NO ❑ NEW O ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE TO Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of the house. Permlt lnspectian Cards Will Be Mailed 3n �dameowner To i'ost TYPE OP CONST. OCCUPI SEPARATE PERM{TS AqE RfOUIREO FOR ELECTRICAL, PLUMBING. HEATING. YENTIIATING Op AIR CONOITIONiNG THIS PERMIT BECOMES NULL AND VO�D IF WORK OR CONSTRUCTION ZpNING SO. FT AUTMpRIZEO IS NOT COMMENCEO V{IITMIN 60 DAYS. OR IF CONSTRUCTION OR WpRK IS SUSPfNOED OR ABANDONED FOFi A PERIOD OF 1T0 pAYS AT ANY TIME AFTER WORK IS COMMENCED. NO OWIG. UNITS I HEREBV CERTIfY 1MAT 1 MAVE READ AN� ExAMINEO TNIS APPLICA710N S7A��S ANO KNOW THE SAME TO BE TFiUE AND COqRECT. ALl PpOVIS�ONS OF LAWS VAI,UATION ANO ORDINANCES GOVERNING TMIS TYPE OF WORK WII,L 8E COMP�IED WITH WHETHER SPECIFIEO MEREIN Ofi N07. 7HE GRAN7ING OF A PERMIT Q�G21 �OES NOT PRESUME TO GIVE AUTHORI7Y TO VIOLATE OR CANCEI 7ME pEqM1T FEE PROVISIONS O: ANY OTHER S7ATE OA LOCAL LAW f1EGUlA71NG CON- STRUCTION OR THE PERFOpMANCE OF CONSTRUC710N $111.ZS S�GNATUAEO�CON'A1C70pOp�U�HOAiZEOAGENT IOATi� ROUP pCCUPANC�lOAO CU FT OFfSTqEET PAAKING IGARAGES SUpTAX $2.31 SAC CMARGE Fire SC $4.62 TOTA�FEE 1 .18 IS I$ R�G � �is1E � , � NEw - [ ] ADDN [ l ALTER [ � CITY OF FRIDLEY SINGLE FAMILY A1vD DIJpLEXES R 1 AND R-2 BUILDING PERMIT APPLICATION Effective 111t99 ��pf�� ConstructionAddress: 106 Hartman Cirele NE Legal Description: OwnerName&Address: Ciavton & Jean Hicks 106 HartmAN Cir. NEI'el. # 571-6354 Contractor: Window-Lite Home Improvements MN LICENSE# 20039258 Address: 8400 89th Avenue n. Suite # 460 Tel. # 425'2227 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: - DESCRIPTION QF IIVIPROVEMENT , Length Length Length Width Height Width Height Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Sl Construction Type: Fstunated Cost: $ 4, 6 21. o 0 tFee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: 8-16-99 APPLICANT: K.Pegg- WindowLite CSR �'� Tel. # 391-8315 crrY usE oivt.Y Permit Fee $ �� l��S~ Fee Schedule on Reverse Side — F�-��e�rge-- _ __.,.� _ _ :�vf-Permit Valuatia�Jlf�%� _ State Surcharge $ ,�..� / $.501$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ S. O d $5.00 (State Licensed Residential Coatractors) Driveway Fscrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservadon Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary [] TOTAL STIPULATIONS: $ /�3, i� N O O N ri i C IV m � � c 0 a� > a�i �� W � L v Z � � y � J ;Hw Z � >C �Z Z4 O �* W C�.� N Z � C3 _ � G �"' QZ HV Z � a `� �° �Z �a oz ao aa O� W O� Q W t� � J a z a o a � � 0 z 0 H U W w n" Z � Z j N q M L►! A � d' � i � � �, m > ��c�� = a� � � � F}-M�Q� Ul�Oli v ,1 �x � \ � '4 � � � � _ 1� � � � ¢ m O � W J � � W V N W Q � � \ W U7 � C7 Z w o Z O m � ¢ � 0 �- Y � O Z � � W � � � �- N O U a w H Q � � W � � � :: o 0 0 � o 0 0 � o co 0 M '-+ � � � � � � 7 i � m � .� C 3 °' � � � � � � m � � � � � � R � i' 0 ?� N DIi=� ` 'O '�' LL" � O C � ' � C � N �-+ N � y U � Z � � � cv N � h�Q fl, � . C U � �.fl' R a1 ca � LL. � ,0 i � In Vl � Li Q U' C`3 a�.. Q >� v L a> m 3 0 v � �Z� � � N J d � � v� � V G Y C ? O � U U �p L y V o d � I = I � 00 C � a�i � = Z o � � � � o � H- � Z �-- 00 tL � � � °o o° O N � � '�'� V � l� N � � ` ¢ � � ��' C � O �� >, � ` C � O U C7f\ ( �Q V � 0 W 0 Z N N N � _ a� Rf Z N a � F� a� i � m m � Y U Q m Z 0 � v i N � C � 0 i +-� O � � � U c Q � � Q i Q '� µ- Q O � � � a� � � O O gr — � Q � C � N C � � R � O vf L U V O A R 3 � '~ � U � t a> � v "''�— a� ��L o � = 3 s � � � � V N � Q��, tC � � � U i � U 'CS � O R � � � U � O U ,� � � .Qv'-� v Q ,c � � Y � Q N L f4 C Y � Q N � 3��nL �`°'-c �oo- a�i � � � � o c ,�; a� � L �� N � •� � v, � � m c pp L, � O 00 .� �. �� O C � � N N a � c�i • � � � a � � F- v� i i o � �� Y O O � V C lC Q .y- Q n 4- 3 O C � \ > tv �i O � o � lt") � N V � 0�0 � � W � w � � N J .a+ � �' o � H � 4 � ► � W 1--� ` Q � `� lv � � V 1 h � � W F- h � .� � � `l� `� a� � � � � ►� � � � C L 00 � 0 � � T � � � Z � > �_- � � ° W � � 2 cn tai Q Z � O O n '�Y 64 w w � Z 0 F- v W � � Z W � � 0 r 3 i � � � 3 � O � � � � � n. � o � � � � U C tQ . Q C � � � � C O C � c� U � N O � N C •N O � a �' C Q' O C U � 4 � l'�.J � � � �U�-21,��' (, �,,� •�S f' KUI�I l. I 2 f iJ�� f R 1 LLL. t O O M ° i � It�.,+ . ; , , � ; i t ry t � � � � � Q f y � i , � � f ( � � ' � ` I � :, � , i r-� ( � _ � ��; o � � , I � <<� � � � � O � � 7 � ! � � � �' Uo�� ! ;w � � °C r, z C' Zy o i �'"� S f� � � N �. � z � � R C�i t!y �-� N i Q "" � � j � ` 4! `�-' ' � V � f V i d J j , i � 'a4 c i ( � � � 0� � ' l�a.' O ' j� ; � � Q. � �� ` V7S?a Q ��', , .� � Q � � � ---#.� ; � i ; � c� - � 1 n. � , r c�y. G � i y � � � { z `�' � �' � � � , � z � � � � � � a + � � 0►- w � �, —` � , i a � C: t!f � I r� l�: N� j � , m Z � d � " a � � � l � � '��' � -s O � ` ' G i d— Q '� � � o �� F- �o -, � m w zt-mu_ mm �q dz � Z� � � j 1 � 1 aa � j } � ' � �Z � ; � �� 00 � Q � o � °c�- 4 0 � G,.+ � O G :.� C 47 �,J Rl r-+ �� -� C�! Z t'i a9� � c� t� �� N "'\ � v C � � UN � � � � i \ �U m � �� r � � L � � O Y � Q � ,� •_ �5 V , � � � ;�yc� y ci c ti. Qy � � R y O p � +- :t .--. U � � La: til � A � � � � � � V ti.�. O t: vN�� i2 'C5 �? C1. � C Q t'3 � tC d R Y � o;n � � N � �= ��o.� ao 'U � � � �- � °° •- �y G � H G � � � pp � Ci O .�' � � m � � � o c N _3 = OO � � d � � � a� � t-v�� ! t i � � i ,� � � � � � � , }.�- w U V � p ..1 z t�i . 0 G � `' �' vs x � � � i ca , � �" � � � 3 � � y p ? , � � � r.�. G C � a. � 41 .�e c> � ar p i O� O •i C R d� +' O U Q1 Q] r C) � i d � , ti '� c�6 � � lQ �f � � �C "'� teJ v aG. O': tL � � R n, � Z � � - � � — � Q � � Z � N �/: _� ,�, ii � +-�`., `x vy � � � Q C/) C G , Z7 r . � D ' � �'a' � f" � N � Qr C� � O 'C PJ �. � H � � a �i °j .-�"�' U � o OC � � � �' NZm R� � 6> � � i +' y R �� i�. ? N � � - � � .. �- .« �.-. � '+'�m n c �. � � �� p � � � ,y �c�5' a `�-'(�._ � ..^~.. ,� � o � �bi �- M ►._ y M N N L b: N i � ,ct'� �.' � a; � ¢ c7 c� c7 �c a `�' o ., � � � � v W N � �; a � �' N O om � :3 ctS Q C��O 0 � m 'c3 > 0 a a .g 3 i '�J � � o d viVN � O c ,., 'Dy Q' G7 � Q � �O O � � � C � C � W � G u- w O Z � ,",� � O U �' m � � a. z � �' L � W a �� Z0 ' d "ki101 CUMMON YENT NCNT C4NNECTOR AND COMBL�STtON AIR VERiFiCA770N When replacing an ezist;te� tu��nce, the undersigned hereby vecifes t�`�at t#ee ven�ng has been examined and is free fro++, rvst, deterioration, obslnrdions. and is secureiy supported and frestopAed where requirec�. Yes (v�No (? The venting system is ptasticlPVC antf rr�eets at1 current codos �nd manufacturer specifiCativns including sizing, iength, number of elbows and temtination. Yes (y�No () `fhe undersigned a(so verifies t'r►at tlle teplacement unit is a{isted assembty and meets the current codes a�d manu�acfurers spectiticatior�s, This does include AGA-CAMA Category � Central Fumace Venting Tables for far� assisted and naturat draft appliances. The existitM combt�stio air is sized and instaited to meet the cusrent Cod6s and manufacturer's specifications. Whe� requ9red to instati a new combustion air it wiil be sized and instaped To meet the current codes and rnanufacture�s speafications. Yes (� o ( ) Yes ( � o ( � Yes (�No ( ) When instatiing a he ventina�,s,�tem, ttte undersigned hereby vertfies that it is a listed assembty and meets the wrre�t oodes and manufacturers specficatiorts. This does indude AGA-GAMA Category t Central Fumace Venting Tables for fan ass�sted and natural draR apptiar�oes. Yes No () Is ihs common vent and ver�t connedors sized and instaqed correctly after an appliance has been removed from the ��mmon vent and vented separatefy as per currerrt codes. Yes No (} liance Ty�se�nd SizelCommon Vent and Yent Con»ecbdr InfortnaRion Appliance #1 Type 8TU Input -��}��an Assisted or Nat _,______ Appliance #2 Type ��[�� TU lnput Fan Assisted or Nat � Appiiance #3 Type �. BTU [nput Fan Assistad or Nat Totat Appliances ?atat Btu �nput ___Y______ Cammon VeM Type Vent Height Diameter inches Appliance #'1 Vent Connector H�igh! i� Length �i piameter in Type App}iance �!2 Vent Connector Heighi N Length �i Diameter in Type Appliance #3 Vent C4nnector Height ft LertgtF+ f# Diameter in Type - •� ._ Y.: i ' ��c°� ��t� �., .. _ , � � • ! - � �l f. i ., . � _.�.�u[ � u. � . - . : i ! I V�► .�;�..�� . . - � +r x Z0�Z0'd S09$6£iL Ol ��QIZl� �fl 1.Li3 iJ0?!� 8S=2I 000�-IZ-f10N CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 57Z-36U4 1+'AX: (763) 571-127i7 �-- -� PERMIT v0.: 200400274- �a�� ` "/ DATE ISSUED: 02/2512004 ADDRE5S : 106 HARTMAN CIR NE PIN : 153024120029 LEGAL DESC : SANDHURST ADD : LOT 2 BLOCK 1 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOW/DOOR REPL VALUATION : $ 9,899.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER SECTION 310.9.1.2 OF THE 1997 tJNIFORM BUII..DING CODE WHEN ADDTIONS, ALTERATIONS OR REPAIRS IN EXCESS OF $1,000 ARE IvIADE�fib RE LLINGS. CAULK AND FLASH ALL EXTERIOR OPENINGS. REPLACE 11 WINDOWS WITHIN EXISTING OPETIINGS IS APPLICANT A CONTRACTOR? 1 APPLICANT SEAL GUARD SYSTEMS INC (20093688) 3770 DUNLAP AVE N ARDEN HII,LS, MN 55112- (651) 481-7888 OWNER HICKS CLAYTON E & JEAN 106 HARTMAN CIR NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this applicarion and lmow the same to be true and correct. All provisions of laws and ordinances goveming this type of wor� will be complied with whether specified herein or not. The ganting of a permit does not presume to give authority to vialate or cancel the provisions of any other state or local law regula�construction or the performance of construction. B1dg BUII..DING PERMIT FEE FIRE SURCHARGE STATE SURCHARGE, VALUE LICENSE SURCHARGE TOTAL PAID WITH CHECK # 20424 Permit fnspecfion C Wiii Be Ma ard� �o Ho,neo ��ed wner To Pos# 181.25 9.90 4.95 5.00 201.10 NEW j] CITY OF FRiDLEY Effe�tive 1h/2003 �/ ADON [ J 6431 University Ave NE, Fridley, MN 55�432 (763) 572-3604 Bidg Insp --:, ALTER [ j SINGLE FAMlI.Y AND DUPL�XES R-1 AND R-2 (763) 571-1287 Fax J, `' r" BUlLD4NG PERMIT APPLICATION . ; �;; .�l%�� i Construction Address: l �h.1/ �/��'1Y1Q1� t .!�%lf ��P Legal Description: Owner N Contract+ Address: LluING AREA: GARAGE AREA: DECK AREA: OTHER: � t?��',�I_'��S' . _�% �a. � �� • .. . • , � � II/ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCR1�Ti:?�. ^� tMPROV�111El�T Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width HgUGround Sq. Ft. Construction Type: �- 1QC0 Estimated Cost: $`7 O 7�� 1�i S Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: ��D7 APPL{CANT: TeL #��c�/�`Z��0� Call (763) 572-3604 far Permit Fees if mailing in appli ion. Fax to 763-571-1287 if using credit card and we wi11 call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Controi Park Fee Sewer Main Charge CITY USE ONLY - $ �S Fee Schedule on Reverse Side � $ � �%. � � . .001 of Permit Valuatian (1/10th%) $ y 9.$ �.50J$'!,�� 1�2�U8ilO^ $ $1275 per SAC Unit $ c5 °— $5.00 (State Licensed Residential Contractors) $ Alt. "A" o� Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [] Not Necessary [ J T07AL _ $ �/. � ST1PU ATION • .. . ADDRESS PIN LEGAL DESC PERMTT TYPE CITY OF FRIDLEY b431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 1�'AX: : 106 HARTMAN CIR NE : 153024120029 : SANDHURST ADD : LOT 2 BLOCK 1 : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWIDOOR REPL 571-1`lii7 PERMIT O.: 2004-00805 DATE ISSUED: 06J02/2004 VALUATION : $ 5,950.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF TI-IE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPEI�iINGS. REPLACE ONE WINDOW WITHIN EXISTING OPENII�iG. STATE LICENSED CONTRACTOR 1 APPLICANT SELA ROOFING & REMODELING INC (1050 4100 EXCELSIOR BLVD ST LOUIS PARK, MN 55416-4727 (612)823-8046 � �� /� ' HICKS CLAYTON E & JEAN 106 HARTMAN CIR NE FRIDLEY, NIN 55432 AGREEMENT AND SWORN 5TATEMENT This permit becomes null and void if work or construcrion authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Ins � Dat�D_�y BUILDING PERMIT FEE FIRE SURCHARGE STATE SURCHARGE, VALUE LICENSE SURCHARGE TOTAL PAID WITH CHECK # 20970 �rmit �s�;o�, ;;a WIII Be �81l�d rt�$ f� �Q��R@fi TQ P �� 125.25 5.95 2.97 5.00 139.17 NEW ADON ALTER ��; a-�-R � [ ] CITY OF FRID.LEY [ J 6431 University Ave NE, Fridley, MN 55432 { j SINGLE FAMILY AND DtJPLEXES R-1 AND R-2 BUILDING PERMIT APPLlCATION Constnactian Addr Legai Description: Owner Name 8� c Contractor: Address:,_ � LfVfNG AREA: GARAGE AREA: DECK AREA: �� . ��11 � ��d �- Effective 1 /1 J2003 (T63) 572-3604 Bldg Insp (763) 571-1287 Fax � Tef. # MN LICENSE # �� Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCkilPTlJI`! ^F lMPRF3V�ME;�T Length Width Height Sq. Ft. Lengih Width Height Sq. Ft. Length Width HgUGround Sq. Ft. OTHER: Construction Type: �� / � t ated Cost: $_,.;��!J�/• �� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ � �� DATE: APPLICANT. ; Tel. # � Call (763) 572-3604 for Permit Fees if mailing in application. Fax to T63-571-1287 if using credit card and we will calt you for card number. Permit Fee Fir� Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge 70TAL CITY USE ONLY - $ �• Fee Schedule on Reverse Side $�� ..001 of Pe�-��t L'aivai€�► � � �i i G�i�%} $ � $.50/$1,000 Valuation $ $1275 per SAC Unit $ ,� • OD $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 [ j $ � � / / STIPULATIONS� c�� Buildzrt Enspections 7b3-572=3604 BUILDING RESIDENTIA.L APPLICATION CITY OF FRIDLEY' �ATE /' I 3� O 7 YOUR E-MAII. ADDRESS 3ITE ADDRESS �Op f/f1 R 7- M R N Cr �R C le �i� �� L£�/ ,/�7 h/ . S'3�".3�- I'HIS APPLICANT IS: � OWNER ❑CONTRACTOR PROPERTY OWNER/ TENANT CONTRACTOR SUBNIIT A COPY OF YOUR STATE LICENSE VJITH APPLICATION PROPERTY TYPE PERNIIT TYPE TYPE OF WORK: o�C��-i�/�io Permit No.. Received By: Date Rec' d: ; ��`1 �wDxESS: /oG f�,r artz1 fr�✓ �;c c!� � c�� lC,c r'a� ��c/ STATEMi✓LIP_ 5�3 a- PHONE: z6 3 �S" �:— � � (R 1 NAME: STATE LlCENSE # i��3i7:�lil ADDRESS: CITY STATE ZIP PHONE FAX ❑'f'WO FAIvID.Y/NEW ■ � y DESCRTBE WORK BEING DONE: SIZE OF IIvIPROVEMENT NUMBER OF SQUARF•S _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SmING ❑ Vinyl ❑ Afwninwn ' ❑ Otl�a . wnvnows IN EX7STII�iG OPbTTAIGS DYes ONo OR FOR NEW OPENINGS-DESCRIBE STZE OF OPENDIG CHANGES 8c TYPE OF WIIdDOW 7'O BE IIdSTALLED FINISH ❑ ROOF ❑ SIDING ❑ DRAIN 7'ILE ❑ O'THER � ADDITION O REMODELIIJG n/�w� oh F �/I�L'Oii C�d�C}� T f.' ❑ HOUSE dc GARACsE ❑ ATTACE�D GARAGE ❑ DETACHED GARAGE OSoffit ❑ 'Trim ❑ Fascia LACATION OF WINDOWS NUMBER OF WIM WIDTH /p HEIGHT BASEMEtdT REMODELING SUBMIT: 1. Existing Fioo� Plan 2. Proposed 800r plan 3. List of strucwral membas to be used Ft FOR NEW CONSTRUCI'ION lNCLUDDJG DECKS, ADDTI70NS. & PORCI�S SUBMIT: 1. Sitc PIarJSurvey showing fhe acisting strucmres � P*oP� Pro1� 2. Two sers of com�tructian plans 3. F.nagy Calculatia�s ALL FEES ARE BASED ON VALUATIOIV, INCLUDING Tf� COST OF LABOR AND MATERIALS: (LTSING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ -7 000 . oo OCCUPANCY TYPE Permit Fee Plan Review Fire Sw�charge Sfucharge License Surcharge SAC Gharge Curb Cut Esctow Erosion Control Pazk Fee Sewer Main Charge Total Due � ��, a� See Back Page for Fee Schednle $ � 65% of Building Permit Fee $ .001 times the total job valuation $ � , .0005 x Permit Valuarion Minimum $.50 $ 55.00 (State Licensed Residential Contractors) $ $1675 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=5 $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $_ __�v,� �_ _ _ Make checks payable to: Cety of Fridley Attac 'fHIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSBD I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of a!1 work whic requ'ues revi d appr val of plans. SIGNATURE OF APPLICANT � PRINT NAME �i'Ia/� / 1�Z QdQ / DATE � f��O � � �i�� ..• � � , �� .� � � � �� i � � � �� (� w M � ___-. � � l � � � --� Q �, � � � � � �� ,.� � _ � - _ %��%'` �� _ ( �' �..�"4W ` _ � I � a y � �� '� � " � C�'� � � A [ b F� W �Q � ��+— N � � � 1 ` ._ _ _ __y..� �_� � � c�.:' _: : ~ � � 4:�� ' ' � , • � ~ . � � t% ' `1} � �� 1 ��f-��"_� � I�� V .�� r,_ - � � W �:, �. � `� � _... i f ..- # � . � �� . , -_.: ,: � � � � � ..._ �� r U� � A ? -- � / � - - � -�, :l C a$ cl .r 2 � �� z � �� w�� 0 � � � ` 2 1 - o �� 0 0 � J 4 ep 4 3 � �z �. e �� .�'°� ,.;` � =" �,`"-�—. _ ,�; ,� � � �� t , i� �i � t1� �c 4r t.+�_� C� � � v; � —� � � t� .� � � `�- � . � � °�� r `' � � V, ,_.,�-.,�-� � � . � �� ,� w � � tY .._-- � � � , w "' � � � � — � ` c W � � �= � � �� --� � j %1-- � 3 �., f � � _ ,� _ � - � —v�._._ a . ? (� �' -� �,�, �t � � � �� v � � � � N � x a � � � �3-�� . ��✓j� � � 1 �-u A v �+ 1 � % � � • - —� _ � � �� .? . ? ;� � �3 � � _� _ �'0 3�1 � z � �� _ �� s � � �� ws�- �� ? _ ? ,� u� �' � � � �� 7 � � � �� . y_ � � � � � � � Q ♦ ��, �`� �� .. �-� .- , � �' � v� . �- �- a► � � � � Z � � � Z . 1 � Z _ � � ' � .� � � --,� � � �n � � � � � Q � V/ � � � � � � � -� � �� .? �w � � � � � � � �" � � � C�- w � � � � � � e ' �