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AF - 45517Caty of Fridley, Mirm.. BUILDING PERMIT ^ DECEMBER 13, 1966 Date: � �1 ••��- �� /�� N� 911'7 B�� GERALD QENN CORPORATION Addreae Address 1202 HATHAWAY LANE N. E. FRIDLEY, MZNNESOTA 55421 LOCATION OF BUILDING No. 1180_..._ Street � HATHAWAY LANE N. E. .�. Part of Lot Lot — 1 __ Block 5 Addition or Sub-Divisfon .—_ P�E�n1 OAKS, F�? �T ADDITION Corner Lot _ ine�tde Lot ._._ x Setback 35 � �_ sideyard _ 6' Gara�e Side Sewer IIevation 905 .76 _ IIevation 908.76 TOP OF FOOTING To be Used as: DW�LLIIVG �t 54 A�. GARAGE Front 28 Z'ype of Construction �AMF DESCRIPTION OP BUILDING Depth 40 Height ?� Sq. F't. 1��'� C�. F'L 20, 800 Depth 22 ITeight 10 �. � T 602 �� 6, 020 ____ ��, �� 20 000_ _ To be Completed � "Y" ONLY - 178' East of Man.hole WATER 1VEEDS TO BE TAPPED In consideration of the issuance to me of a permit to construct the building d t�d above I agree to do the proposed work in accordance with the description above(� and m ce with a'll proviafons of ordinances of the dty oP Frfdley. � In conafderation of the payment of a fee of � 27 • �� , permiit is hereby granted to—GERALD GLENN CORPORATIOIV to construct the buflding or addition as described above. This�rmi t is granted u�n the exprc�s candition that thepers�n to whom it fs greated and his ageuts, employees anc� workmen, in all work doae in, around and upon satd building, or anypart thereof, sY�all cbnform in all respects to the ordinance� of Fridley, Minnesota reg locat3on, conatructiTTon, alteration, maiatenance, repair and moving of bufldfnga within the dty limfta and� perrmit may be revoked at er{y time upon violation of any of the proviaions oP said ordinances. (:I'.ARFNCE BEI,ISLE B�� �r Nonce: Tbis peeodt d�s nof eovsr ths eeesfweHon, testallaHee tee �rGdne� Plu�abing, ea hsaHeg, awer o� w�fsr. 8� am to as the Bulldie8 lespedor for separais parrutt� Po� �6as tt�na. G c � �� �'' ' � +s � .9. . ��� ' . . . •� • � APP`LIC�!7`a'Ql� FC�R $V.LLDIlIG PERMIT CTTY OF 1�'tt:tD�EY, 1�L*1�TESOTA � ' � . . t�.. .. • ��•� . '�e �� , �d . �% ti ` , AWNffi, S-� NAM�, _ B �.JI�,DER � �ADDRESS � ` ADDItESS ,_� � �-�:_�'` LOCATTON OF BIIILDING rto. / / �s��r� a '7`� � c�.> �,�� Pa� �>�� .LOT � �.o�. � /� oc� � ,j an�Sa+oR � oR sos��vrssot� � .� c� : .� s s�`' � � CORNF� � I,OT �NSIDE LOT�.$THACR � S� �" , SiDT�Y'ARD � f��, S�i �-� i-'" � � �� �-" SEWE'R ELEVATIO$ ��� , . ��� r�-- � . � " A�p�Licant attach� to th;e form Two Cart�ficates _pf Susweq of i�t and �tvpased : �--bu�t,t�,¢ .�.��.tq.:�: �trawn on�..athea� -c�rtificates . . , Tv �be used as ; "``.._ . , ,4 �a .' `�. ', DESCBIPTION`OF"�IJit.D�A�- �� 0 C / /� v,..r ,.�. « `► Sq. Ft. f� x_« �:4 Cu. Ft._ ,� ��; �. , -� � c..s � Front � �,° Deptb��jiei�ht Sq. Ft. �� ;_, �� Cu. Ft._ � �� :�: `�"� Type of Conetruction . Estimated Coa �� ��? °' To be completed / The undersigned �ereby makes application for a permit for the work hereia specified, agreeing to do all work in strict accordance with the City of • Fridley Ordinanc�s and rulinga of the Department of Bui dings, and hereby d�ecT�ares that a1�. the facta and representations steted n thia applic�t3on are true and coxprect. � � � � � �t - � � sz �-_ ��, �(sclzeclule . _„ kr� --�� '�� . � " . � ,. � Fee Costs can be found on the Reverse Side). : -- �- � � Q s..,-°., � !� .�;_ � �� 'a� �;: �, y�y � i� A �P � � ��<a � � P,� � �,�`�' ._ � ' .. �-, � .�= .. -�< ' s,��: ;;�x � , . 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I I�ereb�l c�rtify �k�at the above i� a tru� and cor�ect p1a� of � 5urvey q�ft ' i.ot I, Block 5, PARkVIEVP �I4S FIRST ADD�TIQN, Anoka County, t�linnesota. As suaevey�d by me this T9th daY of April 196� A.D. 1 � � Signed � - ��9� r.�. eso� Reg�istr�tion l��o. C��67 �� .�� : � �� � Z ' / � � . ` . -- _ -- -- --. -�- -� o--- -- —,-- --- — _ � . _ "— � . _" - __ —_.-R� K_�. -�__._ - . . � TaNY C�1��S��� _ ., _ � � � D � � � � 0 ci x � N r��� y x x � � r M o H �' �' � °x x x � w � 4� o RP � � M � �. � � � b � � � �� � � o $ � � m � $f lA � � y � c�vy y y ¢ `�- nyy �" `�� a � � � c�o n: �k,. 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SC► � � `I � ► :!�� �° b � � � Sy p� �• � m �C v3 y � � � � � � yF. a � � � �p � O ~ � �*c�y � � �o � � � � ���� ro y a � : � �,�. �.. ��:: og.. o . . $::: a W cr en Cp � Q O O O � � � 0 � � °�afD � � ���� ° y��� � y w ���� � � o ��,� .. fl, � ty c� �.b � m ��� R '� � p � G� A � ��°� � O =� w � �' � ��5'� ���� a��'� � �a'op .�o �_�� � � �� �� a� �� f'i y � N ���� ��o � � m `D � a � ��� N D � i � � m H 2 m C � � M � Y 0 � b r � 0 � � � � O � � � 0 �w � � � � ' � � • � 3 � � 0.:� A � �. � � � � i� � m D 9 d �� \ .. - , � � ��� �� � . /% �� �'� _� � Gk� /i�• `L°�� - r � - �� l� �1.W'Y'1� DEF'ARTMENT OF I�15PECT[O1V � �`� � � ' m No. larolatimn �ef�ee �t. W�Il Iae. Wall Cs�io� Roof Fl� ICi�d �vo► I�ppli�l . �' 19 �1 // R�om L,e�gth ,�idch Q�ei�ght �1.� Room i.en�ch �lidch Hei� Q%�, -° _ r�--Crackaee aad Are� II BV'm ad Doon�—Gackage a� Area t � Imbler�t�n Glaq _E�. wsq IVd o�. walB taa waU Ce6ling Floor Total �ca�. ieed �. it. E.D.R. or t�. iaa. V�A r mro� Ro� i.,ea�tl► -�6fi'�h /p Haight � a �--Crackste aad Aesa pa �tr� � � � �,�1 , . Nat e�. wall ln�. wad Ceilio� Floor k E.R. or eq. iaa. W.A. Leader area Il,enph W'�eh and Doora--Craskage Arsa � ��q �� Net es�a ws� laa v�il C.eil....� � ►: p•'--°� .. T�,_�l �9tu. � ..�� �laracion � iFap. wall Pi� esp. w Int. wail Ceilitig Floor 'To u. �, f� E.DR or p. ina. WA L.sader aaea Il�ea� edth aod ekaQe ea� Area Li6lcracian C�au Exp. wall // � Nlet ezp. wall lat. wall Ceiliag � :/ .. Flaor T�tal &u. Reyuired ,q. t. E.D. FI. A �'l/ia� sad Da 1 tA RNtI Na ot wea et e�i Glap �ap• wa8 0- N� e�. wail lnt. w+ell Ceiling �.. Flosr Toal &a or �. iei. WA td�er nraa I l..entc6 .��idth �raeluge and Araa � � ■ — a�ea f,:7 ?< - �,:���._ ���� � �k..�<, , � �.��L `���-�AY l� �ATIOALS DEPARTMEI�IT O1F r1�5��TI0Ai 1.15. �►�t�� �ide �msteue�on AI�. Ineeilatio� � n Refeeease Out. Wap tet. dVall Ceiii�g Ro�f Fl�r Kind l�► �a � 19�. Fl R en I.ength .d.�'iidth l�eight Fl.� �� Leaga�► �/�l'a�th � ' t �/is�oan and Dosra—Crackage and Area �limdnwa aad Doon—Craeke�e a�d �rea iWidth HolaAt Pio. ot Llasal E8. Araa �IfltA d8o1�At A1o. o! �eal tt. 9na T1e. et �ane o[ pone Itaht� ot cracBc eQ. tt. No. ot pene et ns IISDts of crael[ q, tL � �- �,o e -�.�. :u . ,. ,. - , ,., _ � �,, 9�t. eveli Ceilieg F7aor Toaai �ce. � .. .�� = �iL.�,�s'�!7 ,, .,,{, �\�� Ia6ltrati�m � � t� esp. �rall I�t. �a�l iee6ea� Flaor • f � T�tatl �tu. 0 � oa �. ams. �.A. l.�ader erea � Le� W;dch —Crae�a�s a� Arga A/o. Llm !� Area �1rba or er�oia �e. Rt � � : -- .__�� � f ' . , . <.: , /` / r' ' _ �1�� ����/1(,/.�/ �r�� 1, tit._ `: � Y'�: �' C . � A�1:Pl�D a1�1� �. v.an � � �t �. wali i�aa. �q �� ��� ; � T���,� s�. ����� 0 �,������ �laea � F.�p. wall . ,m► I�dxt ezp. wall Imc. wall Ceilin� �loor � Total Beu. Required aq. E.D.It. oe aq. ins. W.A. L.ea�er ares FI. � I Len�th �i� @Vin�a nnd �re-�ruka�e � Area wraee 8e1�6L Na ot Lloaa tt. 6rea P1q. � IDses o(gan� Itfhb ot eeeci se. tL Ias6ltration �laa �• � _ �let �. v�all �t. wa11 Ceilie�g Flaor � !'otal Bt�e. Requiaed f�! E.D.R. or tq. i�. W,A. Leadee ares FI � � I.en�th i� ��ndaan nnd rs—�ncice� aael Area IQtA I�bt Na �t nesl p Aep N0. O! D6ae Ot n6B� Iltbt. ef eraek m_ f� ,: _ �:7�t �. > / � ��� � ��I _ _ ��i� = ��� . _ ri����� :� , e ''�`'�° e // �_ . � T � ��7� DEPAItTMEN"P e0� iNSPECTION �� e�eratr� ,: G� Gmoer�ctfion Ido. lns�elation , QE/ind0w� D�e� Refxrence Out. �Va1D Int. Wall Ceiling IZ�� F1oaa Kiad �� ��� 0 19 • oom Lee�gth Wi�th d�igbt fil.� lio�en IJength V�lidt6 �t _ Wendowe nd D�ors—.Caackage and /�rea Wia:�ws and Dooes—Crael�age and Area tv�d xe►fne No. ot L�aoa� re. wrca waaee Hslght rto. ot Lee �h. ar�a Pto. ed ot ga e Iisht� ot crack p. tt. No. ol pane et nan� ut�es er �.�..e .1. �. i9 _ ._.. . . . . I�a6ltra�eon G4a� Exp. evsll l�let e=p, w i�:. �►su c���o� Floor � 1l'otal �tu. Recsuirtd aq. k. ��.�r ^iq.�i. ���ader area Fl. �ooa� Ls��th Vi�idth l��ight th \ilindew� aad Q�a�rat�a� ead �ea i9td¢Po 01e t No. �t L1nu1 tl. Aren Ida ot paoa ot aee� u�be■ ..� ..e...s .. � In6ltration Glaas �. wall Net eap. wa11 i��. wau Ceiling �t,,... Z'ocal �tu. lZequi�edl aq. ft. E.D.�i. or aq. ine. W.A. Leader aa�m _ a Fl.l Room I i�engch �Videh Ha i Windows and �or�-�raelcage and Area :dldth $el�6t No. o! Llneal ft. Aras No. o! g�n• ot uana llehe. se e....r �. Gef. �Qu � �$lteatim� �8� In6dvatioe s°.S 9'�' Cl�a, �''r�di �� � �sp. wall Tlet ssp. wall — IVe2 e�. waDl Int. v��ll Imt. w�ll Ceiling Floor Ceiling Floor T�1 �tn. Toca! �te. Required sq. k E.D.R. or p. i��. �/.A. Leader area Required sq. k. E.D.R. or u�. i�. R/A. Leader uea FI. �m � Lengt� �f/i�tb Hsi�ght �, �e�e I I.,e �/iadowa and Doors--Cracka� amd Area � Widt6 ee�b H.�Bne N�. oc s,ee..i tc. ��, �i/mdaw: a� �ra--Craek��e amd Ar+�a Ida ot ol pae� II 6¢a ot crack �..d2. WIdtR llelss� Na ot Llnas! ft aArao � i�10• Oi 068e e[ etnw I/sA�. e� ����. Ia6lSrati�a� GI� Fa�. wall Alet ea�. w�U Iat. arall CeiGng �1� - 7`�tal �Ru. ��1�.��• �. �■ � Q � �L ' InGlteataoa Clae, F�. .aa1D Net e�p. wall • Imc. a��ll Ceiling Floor Taal Bau. �� ' eq. �t. E.D.I�. oa ip. i�. Q/A t�: at+� ,�� .� i �S � . City of Friciley AT THE TOP OF TNE YWIN9 • j �u.----�_� INTER-DEPARfMENT REOUEST � � j PUBLIC :lORK3 DIVIStON , j � l �--�� � CITY HALL FRIDLEY 60432 l�w� � �J 612-660-3450 0 ' SE�IER STOPPAGE SEWER STOPPAGE AUDRESS 1180 Hathaway Lane DATE 12-26-89 CALL RECEIVED BY Jim Brindle AT 1:40 pm (AM)(pM CR�W LOCATION WHEN NOTIFIED City Garage EQUIPMEWT TAKEN TO SITE Pickup truck and jetter. CAUSE OF STOPPAGE Unknown. The blockage was about 155 feet east of the manhole located west of the home. The blockage was close to being in front of the home at 1180 Hathaway Lane. � TIh1E STOPPAGE RELIEVED 2:05 pm DESCRIBE DAMAGE (IF �INY) _Basement was completely finished with carpeted bath and bed- rooms and family room. The carpet in the bathroom was totally wet, because most of the water came up th �h the shower drain, which did not have a ball check. A �ortion of the carpet in the hallway to the bedrooms and to the family room was wet. ANY STATEMEPJTS MADE BY CREW OR HOMEOWNER REGARDING DAMAGE OR POSSIBLE CLAIM The homeowner explained that he had been bailing (mopping) water from the floor for ' uite some time before he decided to call the City. Servicemaster was contacted, and Dester Ki12 was going to call homeowner. REW AP�D HOURS 2 men, 2 hours ! _-1 sue�ecr PER . c�ty of Fridley 2 0�� s AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � ` RECEIPT . � ` _�__��_ COMMUNITY DEVELOPMENT DIV. r � � � PROTECTIVE INSPECTION SEC. ���� 1 = i � /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY �""'� � ,�� 612-571-3450 910-F15 6/18/�.l � � J08 ADDRESS 1180 Hathaway La.ne NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oesca. 1 5 ParkView Oa.ks First Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Earl Niewald 1180 Hathaway Lane NE 571-0245 3 CONTRACTOR MAIL AODRESS Z�P PHONE LICENSE NO. American RemodeTing Inc. 370.0 Anna olis LN Pl u - 4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PMONE LICENSE NO. 5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION ❑ ALTERATION �O REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Res ide �velling 9 CHANCiE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIHED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. 7HIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. • NO. DWLG. UNITS OFFSTREET PAHKING 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 yp�UATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPUED $7pOO,O y�3,'rJO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR IOCAL LAW REGUTATING CON- �`9O e OO k'i.re SC yS`% e OQ STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECKFEE TOTAIFEE . �ZQ�a�JQ� SIGNATURE Oi CONTRACTOR OR AUTHORIZED AGENT IOATE� yy N PROPE LY A THIS �S VOUFi PERMIT SiGNATURE OF OWNER iiF OWNER BUILDERI IDATEI D �NSP �A � �`�2 0 �Co� �ALD2° `� �'�' �lc� ��� Effective 1/1/91 � [l � � � I�1 AND R-2 �� � � Huilding P�ezmit Applicatian Oonstniction Addres.s: ���Ga ���a�GZ ' ��'� �" � I,eqal Desc�iption: owr�er rrame & . �� l �. � . �sactor• L�"� �� � . ... - � ;� LI�T� A�: C�,R� i�: .,�.. ,�.� . �•��• i�Gv� �a� � �� ��_ 7�1. � ��/ ����� Z�el. � °J6°�G��-�p �� i�� �"��"�� Attach to thi.s applicatia�, a Certificate of Sluvey of the lot, with the propased ooa�stnicti� drawn an it to scale. D�IPTIC�I 0�' I,e.ngt21 Width Heic�t Sq. Ft. Tr�r7 h Width Heic�t Sq. F't. Ieix�th - wiath x9t/c�au�d sq. r't. �brner Iat [] Inside�Lo,�c [], Ft. Setba Side Yani Setbacks Z�pe of �tsuctioaZ: � ^ �G, / Fstimated (7ost: $ a ��� Approx. Ocs�pletia� Date: Pronosed Driveway Width If New Openiryg Is Desired: Ft. $ $ Width + 6' See Back e n�: �-/���/ � , �. # ����=�Q�� Permit Fee $ � ° � Fire �arqe $ :�" State Stiu�r2�at�e $ � > SAC Q�ge $ Driveway ��ow $ Fark Fee $ sewer r�ain �axge S � ��� ���: CITY UbE C�Y F�ee S�edule aai Rever-.�e Sicie .001 x Piermit Valuatian (1/lOth $) $.50/$1,000 Valuatioa� $650 per SAC Unit Alt. "A" or Alt. "B" AUove Fee Det.�,�,,,; *+� by II�9�r�4 � N�xY L l � N�rY [ ] � , �'�� � ��--- �J , o� -- �6 ��� � ��. O � r 'n m m . �� � O � O Z � m z � Z � O O Z � n � � v m � d w � c � s N � m � 0 D � �r m r � �O � o = � N � � C � -n O Z N �v � x' O � c � o � � o o rn ? �D D_ v � �°—, tn n� y �v D � m � O ' � 0 � � '� � f�A N ��� C d 01 W� O fD ��c n� ni o� 3 5 S� °' � m m m -o � � p ,Ti `D _—"`� °1 ==-���ao�v-� � � � � � � c�i m N, ao �° �. c � � � N N •�-,�, � � � N � �p N � '� � -� � <, r � N y N � m D� Q ' N ('"'p N ' �, '�O N � � , ��.-� „ � � � � � � m � c � m Q. � m y � Z 0 I I I I I I I I I I( I I � ��+ � Es � c� �r+ ts� En � c� rfl C71 O O O y O v V�I �I C1� A�I 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 O . � D � fn 'o � � � r < � rn � a � W �oo � � n O � � Z _� z 0 c � S v � � -n m � � a? Z v ° � �m � � � � � v, 1+ � °: a ci y .�► � 4 � � v m � � � � W O c g a � � � C N a N � n i : �J N I � 01 N U� a a � co c '�,�' m �' cc .�.► ,O� (�p � .d-►, � N � � � y W O � c. a o; � o , � � d � � i � N � 01 � � � v � � � �j Q' •�-► = c'�D � � rn � � m n o�i � n A � m a� �D 7 �/1 �+ a s o �' � � � � ' � � � � � o ; n, .�n. vi ' � , � r C � Z 'n � C � m � m � z O � m -� O D r L O W � � � THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNiNG APPLIAIVCES OR THE APPLJCATION WILL BE RETURNED • ii ii • ► I ► I ► • ► ► • : � ► � !• �� : • ► _ ' / : ! � �� When �nlacina an„r existinp furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes ('► No () The venting system is plastic/PVC and meets ail current codes and manufacturer specifications including s'izing, length, number of elbows and termination. Yes (► No () The undersigned also verifles that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does indude AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () No () The QYi�fiina cemhu�en air is sized and installed to meet the current codes and manufacturers specifications. Wh@n �2qUlred t0 ����� a new cemh�e_±ien_air� it will be si�ed and installed to meet the current codes and manufacturers speciflcations. �en jp�� �p�•� �pr�tinAiy pm, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers speafications. This does include AGA-GAMA Category I Central Fumac� Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes ( ) No ( ) Yes( ) No( ) Yes( ) No( ) Yes( )No( ) ... .�«- �..- - ..,.,,_.._�-. .�. -. .��-«. � ..��.�.� AppGance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliar�ces __ Total Btu Input ,� _ - Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type M � r r • ► .,- . .;- HEATING CO: Signed By: Date : � _ CIIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UIVIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 Apri120, 2004 Mr. Earl Niewald 1180 Hathaway Lane NE Fridley, MN 55432 Re: Fina1 Inspection at 1180 Hathaway Lane NE Contractor: Lindman Plumbing Dear Mr. Niewald: A plumbing permit was issued on March 6, 2003 to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this pemut. As of this da.te the inspecrion has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your pemut open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh Buildi�� ._ Inspections 763-572=3604 DATE �� ' � 7 SITE ADDRESS � THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE VdITH APPLICATION PROPERTY TYPE PERMIT TYPE BUILDING RESIDENTIAL AP'PLICATION CITY OF FRIDLEY �jOUR E-MAIL ADDRESS _ ��/U /C�/.D�� OCONTRACTOR / 9 �rJ � /� /vi l�t� frT A�.cJA �/ �i i 3 �s �/ -�"� � NAME: STATE LICENSE # ?►.� � � : M €'t� A L � �',2��/e Permit No.: Received By: na� �` ADDRESS: C1TY STATE ZIP PHONE FAX I� SINGLE FAMILY/M ❑ TWO FAIVID.Y/NEW O BASEIVIENT FINISH 1� ROOF ❑ DRAIN TILE O DECK ❑ SIDWG O OTl�R ❑ SWD�MQWG POOL TYPE OF WORK: I � ��' DESCRIBE VdORK BEING SIZE OF ROOFIIVG NUMBER OF SQUARES _r� � GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Alnminwn ' ❑ Other . ❑ HOUSE & GARAGE ❑ ATfACi�D GARAGE ❑ DEtACHED GARAGE OSoffit ❑ Trim ❑ Fascia WII�iDOWS IN E)QSTIldG OPENWGS OYes ONo IACATION OF WINDOWS OR FOR NEW OPENIl�l(iS-DESCRIBE SIZE OF OPENING CHANGES & HEIGHT �ASENII-�iT REMODELING SUBMIT: 1. Existmg Floor Plan 2. Proposed floor pl� 3. List of structural memhers to be used Ft FOR NEW CONSTRUCCION INCLUDING DECKS, ADDiTIONS. & PORCIi�S SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (LJSING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $�G%� OCCUPANCY TYPE Permit Fee Plan Review F�e Swcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due � $3 a� $ $ � S� $. / � `� 7 $ $ $ $ $ $ $ d7, (�� See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review F� Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks aavable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMTf-NOT VALID UNTIL PROCESSED 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 wor will be in accordance with the approved plan in the case of all work which requires revie and approval of plans. SIGNATURE OF APPLICANT � � Q.2� � PRINT NAME ��1_ �A��E L�/I Id'DATE �� '� Page 2- Building Residential Applica.tion `F �, .z _� � , BUII.DING PERNIIT FEE SCHEDULE ;� . �., The Cbief Buildi.ng Official shall, before issui.ng permits for the erection of any building or slructure, or for any addition to any exisling buildin.g or structure, or for any alteration or repair to any existi.ng building or struciure, upon applica.tion therefore, require the payment by the applicant for such permit of fees to the amoun.t herein below set forth and in the manner herein provided tawit: ' VERITICATION OF FOUNDATION Permits for constru.ction will be issued a min;mum of 24 hours from the iune of application to allow for proper review of proposed structure and of the construction site. A Certifica.te of Survey of t�ie lot, showing the location of the existin.g foundation will be required before proceedi.ng with the framing. New Houses Onlv City of Fridley Buildi.ng Inspe�tions Department 6431 University Avenue NE Fridley, MN 55432 � 763-572-3604 Fax: 763-502-4977 �.1s . _ CI'IYOF FR[DLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 BUILDING PERMIT APPLICANT: PROPERTY OWNER � � I, . �, understand that the State of Minnesota requires that all resi ential building contractors, remodelers and roofers obtain a state license unless they qualify for a specifc ex mption from, he licensing requirements. As the owner of the property at / CJ r , Fridley, I am exempt from the state licensing requirement I i I am not building or improving this property for purposes of resale. By signing this document, I attest to the fact that I am improving this house for my own use and do not intend to sell it. I hereby claim to be exempt from the state licensing requirements because I am not in the business of building or remodeling on speculation or for resale and that the house for which I am applying for this permit, isl the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license, I forFeit any mechanic's lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. Furthermore, I acknowledge that I may be hiring independent contractors to perForm certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minnesota law, and that I would forFeit my rights to reimbursement from the Contractor's Recovery Fund in the event that any contractors I hire are unlicensed. I have also been informed and acknowledge that by listing myself as the contractor for this project, I alone will be responsible to the City of Fridley for compliance with all applicable building codes and city ordinances in connection with the work being pecformed on this property. � n Name r�- ' � �: "�, . Date � r �- l� � Building Inspections 763-572-3604 DATE • I � • � ST1B ADDRESS � THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATTON PROPERTY TYPE PERMIT TYPE �rYrE oF wo�: BUILDING RESIDENTIAL t�PPL�CATION CITY OF FRIDLEY YOUR E-MAII. ADDRESS ❑ OWNER � STATE LICINSE n ❑ ADDTIION ❑ GARAGE/SF�D ❑ BASEMEI�T FINISH ❑ ROOF ❑ DECK O SIDING ❑ SWINIlVIING POOL ❑ NEW ❑ ADDTI'ION �iv1AINTINANCFJREPAIIt ❑ REMODELING DATE / d 't 7�3— 4D�c SIZE STORIES �VIN�WS � DRAIN TILE ❑ OTHER , � /o � �a Permit No.: Received By: Date Rec'd: ���463� ����� DESCRIBE WORK BEING DONE• 1n�,� ���� � SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sa. Ft. ROOFTNG NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: ❑ HOUSE ONLY ❑ HOUSE 8c GARAGE ❑ ATTACHID GARAGE O DETACI�D GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used � FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl OSoffit ADDTiTONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures Q Other ❑ Fascia -— - and proposed-projeck 2. Two sets of construction plans W��WS �t� 3. Energy Calculations IN EXIS7'ING OPENINGS.qIAres ONo L�,� O,N OF WINB WS 1�'��' � OR FOR NEW OPENINGS-DESCRIBE SIZE OF VTC,I a OPENING CHANGES & .� 2 TYPE OF WINDOW TO BE INSTALLED Cl�'YltJ1M NUMBER OF WINDOWS .7 ALL FEES ARE BASED ON VALUATION, INCLUDING THE COS'I' OF LABOR AND MATERIALS: TOTAL JOB VALUATION $I 3. �Q9 ooU.B.0 FEE SCHEDULE) OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcfiarge SAC Chazge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ q%. a� See Back Page for Fee Schedule $ � 65% of Building Permit Fee �'� p .001 times the total job valuation $ �., .0005 x Permit Valuation Minimum $.50 $ -�j • O� $5.00 (State Licensed Residential Contractors) $ $1550 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Detem�ir►ed by Engineering $ ��_ Agreement necessary ( ) Non Necessary ( ) THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSffi I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a pernut and work i not to stazt without a pertnit; th�t the work will be in accordance with the approved plan in the case of a11 work hi requires r view p roval of plans. SIGNATURE OF APPLICANT � PRINT NAME ✓/�.� �T1J f I yI DATE �Y ���/ '� n t � Building Inspectians ��3-s�z-��o4 7�i�-502-4977 FA� srt� npn�ss r � ` TTrrs nrrucnt�rrr es: OWIITER/ TENANT SUBMIT A COPY nP YavR sra�r� LICENSE, DOND AND CERT�iCnr� OF INSURANCE PERMIT 'iYI'F TYPE OF WORI�: f ':� ``�1 f F� 1 `� i O UWNER �� ��xJ'�B�N� ��. �a^ Pennit No..?A�1"�l�G �►�J�EN�Y1�Y. AP��.,�����Q� Yteceived $y: e �ITY OF` FRIDLE� n� 4 d� �� 2 0� EFNI�:CTIVE 1-1-05 Yau� c•MnII, nrin�ccss b�` fl(�.�, �; ��-� a���: I. 4�.► „. - - � - nanRCSS: tf9'O (.-{q�hq.9,,� L. r..rrY PIIONE: �! �0 5'' .+��! - O�_� ti'fATF. I.IC'F.NSF e TF�yi,rr � S K �xY ua•rL 1 � ' � / - a iTATF RO1M N� CJ O�f �,� P'� L}CY UA'fIs ��-- 3 �• c`3' ADDRF.SS: � tl 3�/ �.- .1_� f �✓ cr�Y ./L�I�n�_ ___�5TA1'E; /r/,_LIP,��I% �r�tvF _7( f ° �S� , �1� S i=ax `�''S.7 - 9 31- `�'�' .�" �' �!N(iL� FAiV1iI.Y Q NEW J��'�ATT,Fn DESCRIPTIUN OF WORK ❑ TWQ FNyj[,Y G TOWATIIOUS� �EPLACEMENT /' �.���_ S�f;��.� � �-- P�lt MS 16B.665 the permit fee is a minimam o� $I5�00 oe 5% ot Ufe Eotel eost up to SSOO.QO, whichovcr is gre�tcr. for ihC improvemen�. installation ar rcpiacement of a residentlaI fixntrz, exeluding lhe fixl��s. {This shouId rGIIr.�t only the east of lebur ) Labor cosl undcr $3U0 =$15.00. Lahor cc�.;t Fyetw,�n $300 to �500 = cc7st uf l�bor x.US = plus .50 surch�e FQR PR()IF.GTS WfIEItE LNiUR GXCGL'll5 $SUU, H�SS ARE BASF.D f,1N $1 �� FR FIXTLIRE. exc�rr vv��� NcrrEn. FIXTIIRF,$; (INf7fCATF TOTAL N[1MRFR pF F,ACf� $ELOV1�. MWIMUM I'�� $155D. _ BATH SIIVi(/LAV FLUOR DRAfN$ SIiOWER WA'IER PIPING —�AT�� �(iAS P1PIhJ(i (NF.FA rfTY I.rr,} —g��p rppL � W/�'j°EA SOFfIVER ($3S) _CT.OTNE$ WASlIER k:IT'('FlEN SINK Wn'('ER�'I,pgET' HAGKFL�W PRF.V. ($15) _ UI3kTWASIIER ._ LAi1NC1RY TRAY WATEit I�nTGR (S35} �pR iRItI(7nTI0N WATCR NIGT�R OTl1CR T9�IE�IT71lIIARIIIAAI�114 � � ` '°•`" • ""' � � Number of fixtures (a� $10.00 Q x �10.00 = � Surchar e .50 Number of fixtures (a; $1 S.Od �( x g15.Q0 =$ TOTAL D[TF $ ,�Q OR Number of fixture.s �$35.00 � x$35.00 =$ � D d .TM $1 S.$0 State Surcharge = $ .SO MUM $15.SQ Tatai = $ } 't. � '1'HI51S AN APPLfCATTQN FQR q pEluVil'i'.NOT V/�[,@ �Jr('['[L, pROCESSED I hcreby apply for a plumbing permit and I acknOwledgC that the information above is compIctc and accuratc; that tl�e work will bc in conf c with the ordinanr,� �nd Codes uf Ih� Cily ol Fridlcy and with thc Minncsota Con.struction Codcs; that I iu►dcrstand this is not a pcnnit only��n app j��un for a p�cmil ;�nd work is not to s�tart without a permit on site; that the work will bc in accordance with thc approv plan i n cJ�/s�'y(j f all work which rcquires rcvicw and approval of pians. Sr�'i��� DY' .dlY��e� ..��7rT�"+r �r���!�l� � nnnrr �r.��n _ \ �, r�_ � /.. . . �.... - --- I � r/1' s�,'r MPItOV�D DY City of Fridle� Building Insnec�ions Department 6431 YJniversity Avenue N�, Fridley, MN 55432 763-572-3604 FAX: 763�502-4977 UAT� 443 Lafayette Road N. � MINNESOTA DEPARTMENT OF (651) 284-5005 St. Paul, Minnesota 55155 �BOF� & IItiIDUSTRY 1-800-DIAL-DLI www.dli.mn.gov TTY: (651) 297-4198 � January 14, 2010 Earl & May Niewald 1180 Hathaway Ln NE Fridley MN 55432 RE: Chair Lift - Elevator ID# -17549PT09-28R Residence: Earl & May Niewald 1180 Hathaway Ln NE Fridley 55432 _ Dear Sir/Madam: Minnesota Statutes Chapter 16B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. Sincerely, CONSTRUCTION CODES & LICENSING .� �� Tim D.1Narren State Elevator Inspector �{cE-2) �. Julkowski, Ronald, BO, City of Fridley Ability Solutions - - This information can be provided to you in altemative formats (Braille, large print or audio). ElFormCE2R An Equal Opportunity Employer