AF - 45487/ 1
City of Fridley, Minn.
BUILDING PERMIT'
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Date: ..��.. /� .�� .............
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N° 3 6 4'7
Ovener ....................................... Builder ...�......C/e!C�P� ..�.�
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Address ...................................... Address .............................................
LtaCATI0�1i OF BUILDING
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No. . ��. � � . Str�et . . . . . . . . . . . . . . . . Part o . . . . . . . . . .
Lot . . :� . � . Biack . . o� . . L�, . . . . �Addition or Sub-Dfvision � il.trlolo�. /:`�T. .�. . . . . . . . . . . �
. . . . . ti Ci.amG�
Corner Lot . ..
. . . . . . . . . Inside Lot . . � . . . . . . . Setback ���a�. Q Sideyard . ��.�f � �� � �
.................
DESCRIPTION OF BUILDING
To be Used : � ,, t /
.�% . . . . r�ont �f: �. n� �. ��� ` xeignt . ./.r�.'.' .��. ` sq. Ft. ��. � c�. Ft. !� ���
... . . �....
. . . . . . . . . . . .. . . . . . . . Front . . . . . . . . . ,Depth . .. . . . . . Height . � . . Sq. FC. . .. . . . . . Cta. Ft. . . . . . . . .
Type of Construction . . . . . . . . . . . . . . . . �et. Cost. �4',�. . 4' � % . . . . . . . To be Completed . . . . . . . . . . . . . . . .
In consideration of Yhe iss�uance to me of a permit to construct the building desribed above, I agree to do
tlie proposed work in acc�rdance with the descrlpttan above set fo and in c�npliance with all provlsions of
ordinaaces of the dty of Fridley.
.�.. �.. .�.�..�.�..��""�°.....
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In consideration of the payment of a fee of $��.�..., permft is hereby gran4ed to ...................
. . . . . . . . . . . . . . . . . . . . . . . . . to construct the bufldfng or addition as described above. This permit is gxanted upon
the express condition tha.t the person to wham ft is granted and hfa agents. employec�s and worlmaen, in all work
done in, around and upon said building, or any part there�f, shall conform in all respects to the ordinances of
Fridley, Niinnesota regarding location, constructfon, alteral3on, maintenance, repair and moving of buildings with-
in the dty ]imits and this permit may be revoked at any time upon violation�y of the provisions oP said
ordinances. ..• /
` Building Inspector
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NOTICE:
Thls pe�mit does not cover the conet�uatlon, Installa#ion o� alteration fo� wl�ing, plumbing� gas heating,
eewe� o� water. Be su�e to see the Butlding Inspector fo� separate permits for these itema
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INDUBTRIAL
BU81flfiB8
CITY LOTB
TOPOORAPHIC MAPPINO
B`ootr� 2, pARk ���'�n� ta�=� 6h°�-S A�C� Tso.�
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C. E. CO�JLTER
LAND SURVEYOR
REGISTERED UNDER LAWS OF STATE OF MINNESOTA
LIC6N8ED BYDRDINANCE OF CITY OP MINNBAPOLIB
3300 LYNDAI_E AVE. SO. MINNEAPOLIS S. MINN.
TAYLOR 4-0370
SU/<YE�Y FD R/9� l/i'G � L'�/�'�f`'t E'c"r` �` SC�/V I.�fe:
�urargai a �Qrrtiflrair
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PARM BURVEY6
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JUDICIAL
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I hereby certify that the above is a trtae and correct plat of a survey of:
I�t Thirty-nige (�9�. Block Two (21. PAI3CVI�ir1 HEICHTS ADDITION� .Aaoka County, tdi�Besota�
bs surveyed by me this 16th d8y of 5eptember 1958 A. D. �
Si ng,�d �. � -
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City of Fridley, Minn_
BUILDING PERMIT No 6973
DatB: ._.._��
Oveaer: Builder "
Adar�ss Address
OCATION O BUILDING
No. �.��� st�eet Part c Lot
Lot -�__ Block �� Addition or Sub-Di on � o �
0
corner r.ot _ rne�ae Lot —. � �etback �� sia�a � a
Sewer IIevatlan � _ Foundation IIevation
DESCRIPTION OF BUILDING
T as:
Fiont �` � Depth � Height �� Sq. Fk _�����Cu. F't �e��
Front Depth � FTefght p� Sq. Ft Cu. Fk
Type of Conatruct[on F�� Cost _����.� `�"'� To be Completed
In considerat[on of the issuance to me of a germit to construct the builciing d�cribed above, I agree to do
th� proposed work in acc�rdance with the deacript3on above set forth and fn cbmplianc with all provisiona of
ordinances oY the city of Fridley.
�
In camafderation of the �ymeat oP a fee of $� , permit is hereby granted to
to aonatruct the buflding or addition as descrfbed above. Th�ts t is grantsd upon
the express condition that the person to whom it is granted and h3a agents, employees an worl�nen, 3n all work
doae fn, arotmd and upon said building, or any�rt thereof, shall conform fn all respects to the ordinances of
FridleY, Minnesota location, construct�fon, altera.tion, maintenance, repair and moving of buildinga
within the dty l�imfts and pernnit may be revoked at aqy time upon vio�tion of aay of the provisiona of said
ordinaacea � , � � 1
Buildin8 Inspector
NOTIC�
il� psrmh dea not cow� t6s coestroeN�, tnstallallee ise wWeA, pimebtee, ga b�aMeg, ssw�r er watsr. B� wn to ss�
tlu Buildin8 I�eter foe s�parab p�rmhs fo� t6a� N�ms.
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, � . APPLICATION FOR :B�ILDING. PLRD'R� . -
CITY,QF FRIDLEY,. MINNESQTA �
OWNER' S NAME. �0��.�^ . �i �� � �o s � � BTtZLDER' . �S � � r ,
ADDRESS���'E'� ���s/'%�y 1,�J•r.��°- ADD1tE3S � �!3�� c--
. ���f �� , - �
. , . A . : Loca�ox o� Bva,azNC : � .
No. $treet - �art of Lot
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Lot__�� .�Block � � �. Add�.tion or Subdivis.ion_. . .���� � � r�.�� r e �/�,',,�_�
Corner Lot:_Inside Lot Setback � Side-Yard
SETdER ELEVATYON FOUNDATION ELEVATION
Applicant attach �� thia �orm Two Certificates of Survey of.Lot and proposed build-
ing locat3on drawa on these Certificates.. . •.
DESC�IPTIOIJ OF BUILDING
To be used as; . . �
� /¢ f �- - ti� �!�� - - , � .
. ,�.�; �, F�ont . , � - De�th � �,�IIeiaht .
. . �.�q..,FC, • • :� � �� , Cu., Ft.: .
. , .
_ .. , Froat Depth Aeight
, .: • � $q. •Ft�. _ � . ... . � � Cu. �Ft. •
Type of Construct3.on G� �� ��. , 7 �� r a�� �' Eatimated Gost. �/, ��.�
To be Completed �,�z;, L •j S . . ��,1 �� �_ . � . . .
,
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The undersigned hereby makes appllcaC�oti for�.a�p.ermit �or the�work herein specified,
agre�ing to do all work in atrict acccrdaace with the Ciey of Pridley Ordiaances and
rulings of the.Department of Buildir►ge, end,i}erebq declares that all ehe facte and
representatioIIa atated in Ch3s application are ts7ue.and correct. .� � ;
DATE SIGNATURE �'f�,�.-„_ �'�''J' .���
��`
�Schedule of Fee Costs c.aa be found on the Reverae Side).
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BUILDING PEP.NQT FEE SCHEDULE
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Section 2. The.Inspector o# Bui].di.n�� shall, before isauing any permit for
the erecCion of any building or structure, or for any addition to any �iat-
ing building or etructure, or for any alterations or repaire Co ariy existing
buildiag or structure, upoa application therefor, require the payment bq the
applicant for such permit of fees to the smount hereia below set forth and
in the manner hereia provided to-wit:
2.1. For any such permit for the erection o.f any fire-proof building, other
than a garage� �aarehouse, factory or �rain elevator, or for the erectioa of
any fire-proof addition, for similar occupancy, to any existing building
ahall be at the rate of $1.40:for each one thousand cubic feet, or fractioa
thereof, in such cubical�contents.
2.2. For any such permit #or the erecCion of any fire-proof garage, warelsouse,_
f�ctory or grain elevator, or for the erection of any fire-proof additioa,
for similar occupancy, to any esisting buildiag shall be at the rate of $1.25
for each one thous�nd cubic feet, clasaified as 11fireproof" by SecCion 502 of
the Minneapolis Building Code. °. _
HOUSES
2,3. For a�y such perm�.� for the erection of any non-fireproof build3ag atlte;r
than a garage, warehouse, factory or �rain elevato�c, or any aon-fireproof
additi0n, for similar occupancy, to any existiag bu9.].ding - permit $1.00 for
each one thousand cubic fe�t.
GARAGES
2.4. For any such permit for the erection.of any non-fireproof garage, -
warehouse, factory or grain elevator, or for`the erect3on of aay non-firegroaf�
addition, �'or-similar accupancy, to any existing building or for each auch
_�_. -building or addition - aiaety cents ($0.90) for each oae thou�and cubic feet
or fraetian thereof, in the cubical contents thereof with a miniaaum of $4.00��
For the purpose of computing fees for building permits, the cubical cou�tes�ts
of any buildiag or addition eo a uniform height throughout by muLtiplying the
ground area covered from a point �i� (6) iachea below the floor line of the
bae�ment or cellar to the average height�of the upper aurface or to the
average heighe of the r@of surface of the mai� gable of a pitched roof.
2.5. Fos repairs or alterations to an existing structuxe, the fee shall be
at the rate of $3.00 per each Five flundred Dollars ($500.00) or fractioa
thereof ia the cost of all progoaed work.
2.6. In no case shall the fee__c�arged.for..anp-permi� e� set forth in
Section 2 be less.than $4.00. "
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SUBJECT
City of Fridley 16 4 3 8
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
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� i R NO.
� • COMMUNITY DEVELOPMENT DIV.
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r � � PROTECTIVE INSPECTION SEC. y��3
1 i , ,
, �'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPHOVED BV
!"""'� � ,�� 612-571-3450 910-F15 / /
10 28 81
JOB ADDRESS 1061 I3athaway Ia.ne N.E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 39 2 Parkview Hei.ghts SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Ben Gei.ger 106I. Hathaway Lane N.E. 571-5782
3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO.
Hearth & Ho�ne C�o. 1525 W. River Road N. M ls 554
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP pHONE LICENSENO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WOHK
Install "Class A" Chimne
9 CHANGE QF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REOUIRED POR ELECTHICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THiS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OH WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVEHNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 'JrSO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR OCAL LAW REGULATING CON-
STRUCTION OR THE PE FORMANCE O ONSTRUCTION. y�`1.%. SO
PLAN CHECKFEE TOTALFEE
7.� $18.00
SIGNATUREOFCONTRACTORORAUTMO EDnGEtvr IDnTE� WHEN PROPERLY V LIDATED THIS IS YOUR PERMIT
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SIGNATUREOFOWNER�IFOWNERBUILDERI IDATEI � ` BLDG WSP DATE
CITY �F FRIDLEY Effective Aug, 1, 1981
APPLICIITI�'� FOlt RCSID�iVTII�� QU1LDIf�G PEf��7ITS
(We►�r, Alter�tians, Additions, or Repairs)
011tdER: ��.I F `-Q.,
ADDRESS: % �` �v�,� �
TEL N0: �7 � —� 7 � �
[3UI LDER : `� �
ADDRESS: SC�ti �
TEL td0: �� � ��` / -
Construction Location
STIti�T NO: STItEET: �
.�- �
LOT: �� BLOQC:
Corner Lot: Insicie Lot:
r ��, �%✓� Y
ADDITION : ��.�lC U /
SetbacY.: Sideyards :
Ap�licant attach to this form two Certificates of S�irvey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTI01� OF COF�STRUCTION
� ' Front: Depth: Height:
`��?'�J� �. �� Square.l'eet_ Gl,ibic Feet:
Front: Depth: Height:
Square� Feet: C1�bic I'eet:
/ _
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Estimated Cost: $ S SQ � ��
Alt. A Alt. B
Proposed Drive��ay Width if New Openinq Is Desired: $� $
. SE� R�VERiE SIDE OF SHEET
�ze undexsigned hereby make� application for a perntit for the t:vrk� herein specified,
agreeing to c3o .all work ir� strict accordance ��ith the City of I'ridley Ordinances and
rulings of �tlie Department of Buildings, and her y declares that 11 the facts and
rcprescntations stated ;n this application ar true and corr .
D.'�R`E: /6 /�. D ( SIGNATUF�: `
Stinulations:
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BdJII,DI•NG PERNlIT F�EE SCHEDU�LE
The Inspector of buildings shall, before issuing permits for the
erection of any building or structure, or for any addition to any
bxisting building or structure, or for any alteration or repairs
to any existing building or structure, upon application therefore,
require the payment by the applicant f or such permit oi fees to the
amount herein below set forth and in the manner herein provided to-wit:
TOTAL VALUATION
$1.00 to $500.00
$501 to $2,000
$2,001 t� $25,000
$25,001 to $50,000
FEES
$10.00 Minuaum Fee $15.00 plus surcharge
$10.00 for the first $500 plus $1.50 for each
additional $100 or fraction thereof, to and
including $2,000
$32.50 for the first $2,000 plus $6.00 for each
additional $�,000 or fraction thereof, to and
including $25,000
$170.50 for the first $25,000 plus $4.50 for
each additional $1,000 or fraction thereof, to
and including $50,000
$50,001 to $100,000 $283.00 for the first $50,000 plus
each additional $1,000 or fraction
and including $100,000
$100,001 and up $443.00 for the first $100,000 plus
each additional $1,000 or fraction
PLAN GHECK: 25 percent of building ,pexmit fee
$3. 00 for
thereof , to
$2.50 for
thereof
DRIVIInTAY DEPRESSION ESCROW: Concrete G1irb S�reets Only
Alternate "A": Removeal and replacement of curb and gutter only
Driveway width plus 6 feet x$13.50
Alternate "B": Ranoval and replacement of curb and gutter and install a 3 foot
wide approach with 6 inch depth
Driveway width plus 6 f eet x$15. 75
VERIFICATION OF F4UNDATI�ON
Permits for construction will be issued a minimiun of 24 hours froan the tivae of
application to allow for proper review of the proposed structure and c�f the
construction site.
A Certificate of Suzvey oi the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with. the framing.
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City of Fridley 2 9 619
` AT THE TOP OF TME TWINS g U I L D I N G P E R M I T R T NO.
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� `L _��__ COMMUNITY DEVELOPMENT OIV. ��� �
r � � PROTECTIVE INSPECTION SEC.
�
1 i �
� �"'1 � CITY NALL FRIDLEr SS132 NUMBER NEV DATE PAGE OF APVROVED B�
�.._.�' `•' 612-57t-3450 910-F15 6/3/99 / /
JOB AODRESS 1061 Hathawa Lane NE
1 LEGAL �OT NO. BLOCK TiiACT OR AODITION SEE ATTACMEO
oescR. 39 2 Parkview Hei hts Addition SMEET
2 PFOPEiiTY OWNER MAIL ADDRES$ 21P PMONE
John Gei er
3 CONTqACTOR MAIL ADORESS ZIP PMONE LICENSE NO
Suburban Exteriors 9701 Penn Ave S Ste 107 Bloomin ton 55431 881-8232 4289
1 ARCHITECT Oii OESIGNER MAIL AODRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAIL ADDRESS 21P PMONE LICENSE NO
8 USE OF BUILOIN(3
Residential
7 ClA3S OF WORK
❑ NEW O ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O f1EMOVE
8 DESCRIBE WOFiK
Reroof house and ara e 31 S Tear-off
9 CHANdE Of USE FiiOM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMI7S AFiE REOUIRED FOR ELECTRICAL, PLUMBING, MEATINa, TYPE Of CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTILATING OR AIF CONDITIONING
TMIS PERMIT BECOMES NUIL AND VOID IF WORK OR CONSTpUCT10N 20NING SO. fT CU FT.
AUTMOR12ED IS NOT COMMENCED WITMIN fi0 DAYS, OR IF CONSTRUCTION
OH WORK IS SUSPENOED OR ABANDONEO fOR A PER100 OF 120 OAYS AT
ANV TIME AFTER WORK IS COMMENCED NO. DWIG. UNITS OFFSTREET PARKING
1 HEREBY CERTIfV THAT I MAVE fiEAD AND EXAMINEO TNIS APP�ICA710N STAlLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of �AWS yq�UATION SUR7AX
AND ORDINANCES GOVERNING TMIS TYPE Of WORK WI�L BE COMP�IED
WITM WMETMER SPECIFIED HEREIN OR NOT. TME GRANTING OF A PERMIT $Z7O9 1.35
DOES NOT PRESUME TO GIVE AUTHOFITY TO VIOlA7E OR CANCEL 7HE pEqMIT fEE SAC CHARGE
PROVISIONS Of ANY OTHER STATE OR LOCAL LAW REGULATING CON•
STRUCTION OR TME PERfORMlrNCE Of CONSTRUCTION $83. 2'rj Fi re C 2. %1
���� PLAN CHECK FEE TOTA EE
�'v"" �3 �� Li ce S 5.00 .31
- SIGNATUAE OF CON'FACTOA OA 4UTMOAIjEO AGENT 1DATE� N ROP ALIDA TMIS I�UA P
�I /
S�GNOTUAEO�OWNEA���OWNENBU�LDERi iDAfEi B G�N$� q6tE
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ADDN
AL1'ER
Effective 5/10/99
I l CI't'Y OF FRIDLEY
[�,]� SINGLE FAN�.Y AND DUPLEXES R-1 AND R-2
BUII.,DING PERMIT APPLICATION
Construction Address:
Legal Description:
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Owner Name & Address: B-�n� � ` . #_ S' `� 1 - � � �a
Contractor: MN LICENSE # � 02 � �'
Address: � i O ( f� �1 ��_ � �SL.�( 4 �_Tel. # $�'S% ' �fo2 3 �
Attach to this application, a Certificate of Survey of the
�.,_ lot, with the proposed construction drawn on it to scale.
DESCRII'TION OF IlVIPROVEMENT
LIVING AREA: Length � Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECB AREA: Length Width Hgt/Ground Sq. Ft.
OTI�R:
Construction Type: _ Estimated Cost: $ � •�6 .9.�Y ` �'Q� �
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ .
DATE: � � ' � 9 APPLICANT: `�' � Tel. # �� / - � a 3 �
Permit Fee
Fire Surcharge
Sta.te Siircharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
�ewer Main Charge
e
TOTAL
�TIPULATIONS:
� 3, Z�
$
$ , .�
$
$ ��
$
$
$
$
$ �- ��
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,0� Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residential Cont�ctors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Nec�sary [ ]
�
BUII.,DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addition to any existing building or structure, or for any alteration or repair to any existing building or structure,
upon application therefore, require the payment by the applicant for such permit of fees to the �oiant herein
below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,0(}0
$2,001 to-$25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $5�,000
$500,001 to $1,000,(�0
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $1(� or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,0�
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,0�,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 f�et times $15.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to �o�r �or ��oper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has be�n ��a����� �1
be required before proceeding with the framing. .