AF - 45525City of Fridley, Mi.nn.
BUILDING PERMIT �vo 2� 9
Date: -
� ;
Owner: :�.�� �q .� Builder �� _
,� ,
Address Address �
CATION O LDING
No. ' � Siaeet P t
..._.�_— �
Lot _ Block .�...�. y tian or Sub- on ..,
Coraer Lot — Ins�tde Lot Setback � Sideyard I�
Sewer IIevation � ._ Foundation IIevation
� DESCRIPTION OF BUILDING
To sed �,, �
Front ��.. Depth Height ��� Sq. FL ���:�" 'i (:u, F'���� �
Depth FTeight —...��. Sq. Fk " Cu. F't.
Type of Construction ��:_ �._... Fst Cost �(.���""_'_"''�'o be Ccmpleted
In consideration of the issuance to me of a permft to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provlsions of
orc�inances of the city of Frldley. �
In conafderation oP the payment of a Pee of �� �, permit is hereby granfed to—
to construct the building or addition as described above. Thispe rmit is granted upoa
the express condition that the person to whom it is granted and his agents, employees and worl�ien, in all work
done in, around and upon seid building, or any gart thereof, shall conform in all respecta to the ordinances oP
Fridley, Minaesota regarding locatton, construction, alteration, maintenance, repair aad moving of buildings
within the dty limits and this permit may be revoked at any upon tio any of the proviaiona of said
ordinaacea � ± . � � �
Building Inepector
NOTICE:
Tids psrmtt doa not cowr 16s coe�lra�loe, Ieshlla�ien fer wie6�y, 'lumbtno, �a 6�a1�a, s�wr o� rrat�r. 8� wn to a�
th� Buildlne Insp�eto� [e� ap��al� p�rmhs for f6w It�na.
� � �.
�r � � �
`_ �, , _ ` ► , � r
APPLICATION FOR HIIILDING PERARIT
CITY OF FRIDL�Y, MINNESO`Pg
�raner's Name�` �' F��•� �'f C=�'i'`sei�0 ��Bu3Zder S�J�
�cldresa ���� ��u��/�� , S�
�AIS /�
,�°�9-.�,e�
LOCATION OF BIISLDTNG
No. �� !i / 3treet /�f!'17�`�f'-u°�y `�9-rv,�_,, Part of Lot
Lot .�.� $lock i Addition or Subdieision,���°!/�✓��s ���✓ °
!�C''s�G,�r�rar-
Corner T,ot Inside Lot - Setback d.c+fz �a cc'�av� Side-Yard i0 !
SE9rJ�R ELFVATION FOUNDATION ELEITATION
�pplicant attach to th3.s.form Certificate of Survey of Lot and proposed build3ng
location.
DESCRIPTIOIV OF BUILDING
To be uaed as : �� 7,��
��/�'C.� f',r,�*. NCr.��.2��. �ont,�Depth X' Z�r� a�s-Heigbt ��
� ��' e � a� �t iv� �' /��
sal. F�. l�� � 3r ��'4 Cu. Ft. 3.�0 ���'
--�
Front Depth Height
Sq. Ft. Cu. Ft.
Tgpe of Conetruct3on ��►� Eatimated Cast ��3� �� e� �
� � .�
�
To be Completed / ���.�
The undersigned herebg mak�s application for a permit for the work herein agecified�
agree3ng t,o do all work in strict accorciance with the C3ty 4rdinances and ruli.ng of
the Department of Buildin�s, a.nd hereby declares that all the facts ancl repreaentations
atated in this applic�.tion are t�ue and correct.
DA7� � ��D� �.� SIGNATURE
(A Schedule o� Fee Costa can be found on the Rev e Side.)
! �. b- �� -'��'� ^ � I
�►� . .� " �. • .
BIIILDIlVG PERMTT FEE SCHEDUI�
Section 2. The Inspector of Buildings ehall, before issuing any pexm3.t for the
erection of ang bui].ding or atructure, or for any addition to anp eid.ating build-
ing or structure, or for an� elterations or repa3ra to aay exist3ng building or
structure, upon applics.tion therefor, requ�re the peyment by the applic8nt for
such pexDmit of fees to the amount herein below set for�h and in the me�ner herein
proeicled ta-wit:
2.1. For a.n� such pe�mit for the erection of ar�y fire-proof building, other thea
a garage, warehouse, factor�► or grain elevator, or for the erection of aa�► fir�-
proof addit3on, for similar occupanc�, to an�► existing build3.ng ahall be s.t the
rate of �1..l�.0 for ea.ah one thousand cubic feet, or fraction thereof, in such
cubical contents.
2.2. For any such permit for the erection of any fireproof garage, warehouse,
fae'tor� or gra.3n elevator, cr for the erection of a.� f3reproof addition, for
sim3.].ar occupancy, to ax�y existing build�.ng shall be at the rate of �7..25 fo�
each one thousand ev.bic feet, elgss3�ied as "fireproof" by Section 502 of the
Minneapolis Building Gode.
HOIIS'E�S
___._._
2.3. For ar� euch permit for the
than a garage, urarehouse, factory
addit3on, for similar occupaney,
each one thousand cubic feet.
GARAGES
erect3on of any non-FireprooF bu31d3ng other
or grain elevator, or any not�fireproof
t,� a�► ex3sting building. Permit �7..00 for
2.y.. For any such permi.t for the erection of an�r non-fireproof garage, warehouse,
factory or grain elevator, or for the erection of any aon-fireproof addition, for
similar occupancy, to any existing build3ng or for each such building or addit3on.
Ninety Cent$ for ea.ch one thousand cubic feet or fraction thereof, in the cubic�l
con�ents thereof with a minimum of �4.00.
For the purpo8e of computing fees for building permits the cubical contents of any
buildin� or add3tion to a ua3forna height throughout by multiplying the ground area
covered from a point aix (b) inches below the floor line of the 'basement or cellar
to the average height of the upper surface or to the average he3ght of the roof
surface of the mai.n gable of a pitched roof.
2.5. For repairs or alterations to an existing structure, the fee shal7. be at the
rate of �3.00 for each Five Iiunr3red Doll.ers (�5�.00), or f°raction thereof i.n the
cost of all propoasd work.
2.6. In no case aha7.1 the fee charged for any permit as set forth in Section 2 be
less than �L�.00.
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Form BD5 � � `w .," +• LI",�p.�s. �i�% • �(!)I �� � T < i r \
HEAT LOSS CpLGUTATfONS BOILDIN6 DEPARTMENT �V� �' "` ���''��� 60LQEN VAILEY� MINN.
Weatherstrips A•�•H•�•� Construction No. Insulation
l�indows Doors Guide
Reference Out Wall Int. Wall Ceiling � Roof Floor Kind How Applied
e�-� e 19
FI. � Room � Length /'� Width / Height � FL � Room � Length Width Height
Windo�rs and Doors—Crackage and Area �/ Windows and Doors—Crackag and Area
Width Height No. of Lineal ft. Area f/r Width Height No. of Lineal ft. Area �+
No. of pane of pane lights of crack aq. ft. C No. of pane of pane lights of crack sq. it. �3 r�1
°�� . �� � � J.�.�'
Coef. Btu Coef. Btu
infittration
Glass
fxp, waU �,� J s+' ,
Net exp. wall
Int wall
Floor
Ceil.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. � p Room � Length {Nidth
Windows and Doors—Cracka and Area '
�Width Height�No. of Lineal ft. I Area
No. of aane of pane lights of crack sq. ft.
Infiltration
Glass
Exp. wall � �
Net exp. wall
Int wall
Floor
CeiL � �'7
Total B ut
Required sq. ft: E.D.R. or sq. ins. W.E6. Leader area
�/ FI. �,,� �,y�1 Room � Length ��► Width
t�indows and Doors—Crackags and Area
Width Height No. of Lineal ft. Area
No. of pan�of pane I Iights I of crack I sq, ft.
i I s:� �� .�°� /� /rJ
�
Inflltration
Glass
Ex�
Net exp. wall
Int. wall
Floor
Ceil. �
Total B .
Required sq. ft. E.D.R. or sq. ins. �U.�. Leader area
C��
��
�ef. Btu I
� �
' He�ght
I
e �" �
��`
Btu
Glass
Exp. wall p•,�
Net exp. wall
Int. wall
Floor '
Ceif.
Total B .
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area �
' FI. ��'���„� ' Raom � Length �� Width � Height�
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Aree �l
No. o�� of pane lights of crack sq, � r i i� Lr � I
a� r°'..--
�
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� � � �� � _ �`�' .4- Coef. B�- -
Infltration (,�,�,�
Glass � � ���}i�j
Exp. wall
Net exp. II � p
Int. wall
Floor
Ceil.
Total Btu. ;Q,��
Required sq. ft. E.D.R. ar sq. ins. W.A. Leader area
FL � Room � Length Width Height
l�i�dows and Doors—Crackage a�d Area �
No. �Width Height No, oi Lineal fr. Area
of pene I of pane f lights' I of crack � sq. ft.
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Floor
CeiL
Total Btu.
Required sq. ft. E.D.R. or sq. i�s. W.�. Leader area
Coef.l Btu
.� - � -- -
A.''I`FU�C�"�=�.fJt�! f''C:i ,'3T1�'i,D �PIG D� .s_i1'
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ADDRESS
LflCA�ION 4F BiJTT DI.+G . , .
N0. ' D o �EET PART OT� LCf1�
LOT � BLOC �i AD�ITiON OR SUSD�iTISION ���� ����
C012NE13 LOT INSIDE LOT�SE1'�ACK SId3E-YA�
SEWER EI,EVATION �OUiVIiA�IO�d EI,E4'ATIQN .
Applica�.t aCtacts to this fo�m Two Cezti�icates of Survey of Lot and proposed
building $ocation drawn on these Certificates.
. DESCRIPTIO�i OF BUZLDi�TG:
To �e Used Ae : . - -
Front ,�7 •� Depth ,�iieight t�r'� �
....� -�-.-�. •
�„ �
Sq. Ft . ���� Cu. Ft . �-�✓', `
� Front � Degth Height
. . Sq. FC. _- Cu. Ft .
�f ' ,!
Type of Construction ``-�`_�����°� Es�imated Cost � y� J ___
.___.___�r
To Be Completed
The undersigned h�reby makes a�plication for a pe�mit for the wosk i�erein specified,
agreeing to do all wark in strict accordanc� with the City of Frid?ey Ordinances
and rulings of the Department of Buildings, and hereby declares that all the facts
an3 representations s[�ted in this app:.ication are true sud c9rrect.
DATE / � �„� SIGNATURE�./�.O ,//� � � l'�
-�� -_ -
(Schedule of Fee Costs can be found on the Reverse Side}�
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BUILDING PERMIT FEE SCHEDULE
SECTION Z. The Inspector of Buildings shall, before issuzng permits for the
erection o€ any building of structure, or for any addition to any existing
building;or structure, or for any alteration or repairs to any existing building
or'structure, upon application therefore, reqeire the payment by 'the applicant
for such permit of fees to the amount herein below set forth and in the manner
herein provided to-wit:
Ur..iform Buildin� Code: Type 1,2, & 4- $Z.75 for each one thousand cubic fzet, or
fraction thereof, in such cubical contents. Type 3& 5-$1.50 for each
one thousand cubic feet.
For the purpose of computing fees �for building permits, the cubical contents of
any building or addition to a uniform height throughout by multipluing the ground
area covered from a point six (6} inches below the floor line of rhe basement or
c�llar to the average heidht of the upper surface or to the average height of the
ro�f surface of the main gable of a pitched roof.
For regairs or alterations to an existing structure, the fee shall be at the
. rate of $3.00 per each Five Hundred Dollars ($500.00) ox fraction thereof
in the ccst of al1 proposed work.
In no case shall the fee charged for any-per�it as set forth in Section 2 be
l;es s than $5 . 00 .
NSSSD Gonnection Charg�s based on location- Area 1 or 2.
e r)
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c�nroF
FRIDLEY
DATE:
TO:
FROM:
SUBJECT:
PLANNING DNISION
MEMOR,ANDUM
June 8, 1990
Barbara Dacy, Planning Coordinator
(�Michele McPherson, Planning Assistant
Proposed Fence Construction at 1201 Hathaway
Lane N.E. ; Orthodox Church of the Resurrection
of Christ
I was contacted today by a representative of the above-referenced
church regarding zoning code information for the height of fences
in the front and rear yards. The representative requested that
this information be sent to him at the above address. This
information was placed in today's mail.
NIl++I/ dn
M-90-404
/ �
��
_ i
DATE:
TO:
FROM:
SUBJECT:
Community Development Department
P G DrviSION
City of Fridley
September 3, 1991
Virgil Herrick, City Attorney
�'Barbara Dacy, Community Development Director
Vestibule and Carport Addition to the Orthodox
Church of the Resurrection of Christ, Inc. at
1201 Hathaway Lane N.E.
Father Magram submitted an application to install a vestibule,
canopy, and carport on the front and west sides of the single
family home at 1201 Hathaway Lane. As you recall, this house and
location was the subject of a variance and special use permit
regarding conduct of church activities within the home. The
carport and canopy would have architecture that is similar to that
of a synagog (see attached plans). The structure can meet all the
setback requirements. If we were to issue the permit and a
homeowner complains regarding the appearance of the architecture,
is there anything in the code which would have enabled us to make
some type of comment about the architecture? The property is
located in the R-1, Single Family Dwelling district.
Since I wil]
1991, please
you have an
BD/dn
M-91-645
be gone Tuesday and Wednesday, September 3 and 4,
contact Darrel Clark if you have further questions or
answer.
��, Z�
sue�ecT ' P O.
c�ty of Fridley 2�. 0 8 7
' , AT THE TOP OF THE TWINS g U I L D I N G P E R M I T CEIP
f
� L
� • COMMUNITY DEVELOPMENT DIV. � � ,�� /
v PROTECTIVE INSPECTION SEC. a D
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� � /"'{ � CITY HALL FRIDLE� 55432 NUMBER REV DATE PAGE OF APPROVED BY
�"""� � �'� 612-571-3450 910-F15 9/30/91 / /
JOB ADDRESS 1201 Hathaway Lane NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 3 1 Parkview Oaks SHEET
2 PROPEFiTYOWNER MAILADDRES$ ZIP PHONE
Orthodox Church Resurrection of Christ 1201 Hathawa Lan N
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO.
8 USE OF BUILDING
Dwelling
7 CLASS OF WORK
O NEW . C� ADDITION ❑ ALTERATION � REPAIR O MOVE O FiEMOVE
8 DESCRIBE WORK
Construct a 20.5� x 6r Walkway and a 7� x 6� En and a 120 sq. ft Carport
9 CHAN(iE OF USE FROM TO
STIPULATIONS �ee notations on plan. All footings must be a miniunum of 42 inches below
grade,
�A'�'°�����
Befiore digging call for
all util�ty bcaiions
454•0002
REQUIRE� B� LAW
'SEPAR�,TE PERMITS REQUIRED FoR
WiRtNG, HEA►TItVG, PLUMBII�G AN� SIGNS.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR E�ECTHICAL, PLUMBIN(3, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONINd SQ: FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT
ANY TIME APTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STAL�S GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WOfiK WIIL BE COMPLIED ��� $4,632 �X� $2.32
WITH WHETHER SPECIPIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqM1T FEE SAC CHARGE �4. 63
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATINCi CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ��X�� S 72 • OO Fire SC $X�$
PLAN CHECK FEE TOTAL FEE
�� $78.95
SIGNATUREOFCONTRACTORORAUTMOR12EDAGENT IDATEI e WFIEN P OPERI V E H IS YOUR PERMIT
.- 3 /d �
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SiGNATURE WNERi�FOWN BUILOERi 10A � rl/•TE
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Oan.stn�cticn Addre�ss: � Z v�
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EffeCtive 1,/1/91
Z
Iegal D�ip�tiari: L o`t � 6 I o c( C t Pa Y� v i e k/ d et Ic S
owner xaa�ee & Aaaress: altthodoxch�lvel� ReSilv�ect�vnl o-� cwU��t ,� Te1. #.5��-�/-�oo>
�tractar: l� Te1. � s/
AddY�ess: S �R �
Attach to this applicatian, a Oertificate of S1uv�y of ti�e
lat, with ti�e prvposed oaristzvctian drawn ari it to scale.
DE�C9tIP'1'I�T C� II�l'
�} ,c� l� I � �� � • �,�t-i?�C; /'��
I.NII�1G i1Tt�: �� Width iieight Sq. F't.
Ie��qth
�RAf�E 711t������[,es�gth Width Heic,�t Sq. Ft.
�ngth ��� � Width � Hgt/Gran�d Sq. Ft. / � �
Corner Iat [] Inside Lot [✓] Ft. Yd SetbacJc ZS � Side Yax+d cks g7 /
Zj►pe of O�uctian: � F�tim3ted Qo�st,: $ _���
Approx. oc�pletiaa�► Date: /�0 �� � �-f �-��
PropoE-�d �iveway Width If New Openir�g Is Desired: Ft. $ S
�
Width + 6' See Bac�c Page
n�: �. 9 '� I �c�rrr: �. # ,���-/vo �
CLTY OBS C1�II,Y
�C,
%� �` �
Fpsmit Fee $ ---��
Fire Svrci�rge $ �/. ��.3 --��`v�
State S�axge $ �/�`
SAC Q�arge $ ,� �'>� '
Drive�ray �a+ow $ --
Park Fee $ �
Sew�er Main c�atge $ °—'
��A� L'r1 � �
�w s _
s�a�s:
�
F+ee �le an ReverEe Side
.aol x Permit valuatiaaz (1/loth $)
$.50/$1,000 Valuatiaai
$650 per' SAC Unit
Alt. "A" C�' Alt. "B" Above
r�ee DetPSm� *� by � r�Y-ir�
14g�ent NeoessazY [ ] � �]' [ ]
�
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,
E:_i1���i��,rj;_a;.y�y� �r: _ �:i:r� U :
�e Chief Buildir�q Official shall, befose issuing peaaits for the erectiaai of at�y
buildirg ar� stt�u�c��e, a�r fa� any adciitian to any e�dstir�g buildirr� a� stn�cture, or
far any alteratian a� repair to any existir�g buildin! or etn�n�e, ��PPlication
therefore, i+equire the paymerit by ti�e aipplicar�t for euch petimit of fees to the �t
heze3n belcw s�t fort2i atid in the mar�er i�ere�tn pzwided to-wit:
'�L V�iLiJE
$1 to $500
SSOi to g2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
���
S15 (Mini�m F�ee 3s $15 plus a�i�an�e)
$15 fa�r first $500 plus $2 for eacii additianal $100 or
fract,iad'i tl�eof, to �r�d includir�g $2, 000
$45 far first $2, 000 plus $9 for eacii sdd.iticnal $1, 000
C�' frdCtiC�] thereof, to aT1d iT�Gluding $25, 000
$252 for first $25,00� plus $6.50 for eac� additiaa�al $1,000
or fractian thereof, to and i=fcludit�g 550, 000
$414.50 for fit5t $50,000 plus $4.50 for each additianal
$1, 000 0�' fractic�ri therepf, tp ani includ3r� $100, 000
$639.50 foY'fizst $100,000 plus $3.50 for eadi add.itional
$l, 000 or fracticaz thereof, ta and includirx3 $500, 000
$500,001 to $1,000,000 $2039.50 for the first $5�,000 plus $3 for each additional
$1, Q00 or frdCtian thet,epf� t,p ard jncludi�g $1, 000, 000
$1,000,001 arid up $3539.50 for the fixst $1,000,000 plus $2 for eac� additional
$1, 000 ar fractiaci tiyereof
�tIVE�IY �;i�RffiSIGi�T �W
(abnc:rete Qu�b Sttiee�ts �lY)
Alternate "A" : R�ov-al atri r�laae�es►t of a�xb ar�d gutter anly - Dr3veWay width plus
6 feet t,imes $13.50.
Alternate "B" : R�oval and re�laoe�oent of atrb ar�d gutter and ir�tall a 3 fovt wide
appYOach with 6 itrh dept�h -�'iveway width plus 6 feet tiioes $15.75.
• �• •` •.�� . , .r ;�r�i,�. ; y . �
P�rmits f°r �ic� will be 3s-s�ierl a minim� of 24 2�s fi� the time of
applicatiaci to al].ow for proper review of the proposed s�re arid of th+e
�ian site.
A Oerkificate of �vey of the lot, �3r�g the locatiaai of the faa�datiaaz a�ce it has
it has been t�rill be zequuired before prooeeding with the framiryg.
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sue�ecr P
City of Fridley � � �� � 3 �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
r
; � RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r � v � PROTECTIVE INSPECTION SEC- 1 9��
� �
� � �'�'1 � CITY HALL FRIDLEV 55432 NUMBER REV DATE vAGE OF pPVROVEO Br
�.---� • •,' 612-571-3450 9t0-Ft5 4/29/97 / /
108 ADDRESS 1201 Hathawa Lane NE
1 LEGAL �aT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 3 1 Parkview Oaks Fir t d SHEET
2 PROPERTY OWNER MAIL ADDRESS Z�P PHONE
Russian Orthodox Church 1201 Hathaw -
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO
Same (Church Members
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
5 ENGfNEER MAIL ADDRESS Z�P PHONE LICENSE NO
6 USE OF BUILDING
Church
7 CLASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION O REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Buildin 22 S 2nd La er
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the 3rd.
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAD
SEPARA7E PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WOfiK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WOfiK WIIL BE COMPLIED
WITH WHETHER SPECIFIED HEHEIN OR NOT. THE GRANTING OF A PERMIT �1,364 �.C')S
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEpMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ��FS.7S Fire SC �1.3C)
PLAN CHECK FEE TOTAL FEE
� �`���6� %l �rs OceP-2 c��'% $47. 79
SiGNATUAEOFCON�RACTOAOAAUTHOAIZEDAGENT IDATE� WHEN PqOPERLY LIDA D THIS IS YOUR PERMIT
- �`'�� fy - �-
ti
SiGNATU:iEOFOWNEAiIFOWNERBUILDERI �DATE� BL �NSP �1aTE
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CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: � � �%� �l4 �!� a '� ��
Legal Descriprion:
Owner Name & Address: J v�i^ � �'-.��-�
C�n�C.tOr. � L �!E S �-' k ( � t �� � c �l l•'��2Get" (.�
L � �� , I`• •'c'
�
Effective 1 / 1 /97
�� ��
�d��/ � �-� y� 2
Tel. � ,� % �f - � � � 1
1VIN LICENSE #
Address: � � G � �l � �X �%VQ .�/ l�7�`S /f�s`"v �� �t� 2 Tel. # `2 � �- S' ���
LIVING AREA: �
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction dra.wn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
�� ��
Length � Width � Height
Length 2 6 Width 2�. � Height
Length Width Hgt/Ground
Driveway Curb G�tt Width Ne,eded:
DATE:
Permit Fee
Sq. Ft. �
Sq. Ft. --��
Sq. Ft. �
�' �
� ��, w
��a co�: � �� ��� r 1 3�'�, �
(Fee Schedule on Back) �
Ft. + 6 Ft = Ft x$ _$�
�<<�-2 9�� � APPLiCANT: ��- ��� �(°�'� Tel. � 2��- 5' 7 j Z
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ ��
� / .3C
$
$
$
$
$
$
$
� , �7�
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$950 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
. :�
BUILDING PERM[T FEE SCHEDUL��
1'he 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 amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $5�
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50, 001 to $100, 000
$1�,001 to $500,00p
$500,0p1 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $1(� or
fraction thereof, to and including $2,OQ0
$62.25 for first $2,000 plus $12.50 for each additional $1,OQ0
or fraction thereof, to and including $25,000
$349.75 for first $25,0� plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,0(?0 plus $6.25 for each additional
$1,Q00 or fraction thereof, to and including $1(?0,000
$887.25 for first $100,0(� plus $5.00 for each additional
$1,.�0 � or fraction thereof, _ to .and including $5(J0,(�0
$2887.25 for the first $SOO,Q� pius $q..25 for each additional
$1,000 or fraction thereof, to and including $1,0OO,OQO
$5012.25 for the first $1,0�,000 plus $2.75 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 feet tunes $13.50.
Alternate "B" : Removal and replacement of curb and gutter and instali a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Peimits for construction will be issued a.minimum of 24 hours from the time of applicarion to allow for proper
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 been construct,�t:i
«�i!1 h� required hefore J�r�ceeding �vith the framing.
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CITY OF
FR[DLEY
FRIDLEY NiUIYICIPAL CE1�iTER • 6431 UN[VERSITY AVE. IY.E. FRIDLEY, MN 55�32 •(612) 571-3�150 • FAX (612) 571-1287
November 2. 1998
Father John
] 201 Hathaway Lane
frldley MN 55432
Subject Plantlr�gs at 1 ZD-] Hatt�away-LaRe
Dear Father John:
PW98-187
The maple tree removed durir�g water serv[ce repairs to the above property in 1997 wUl be planted
next year wlth the Ctty's next order of trees. The tree wlll be planted as close to the right-of-way line
as possible. As I explalned to you on the phone, the Parks departmecrt no longer has enough plantirwg
to flll an order every year and so has moved to a two-year cycle for ordering trees.
Since we have confllctIr�g stories regarding where and whether or not the Amerlcan Cranberry and
Arbor Vitae shrubs were replanted at the tlme of the repair work, one of each of these shrubs will be
prov[ded to you when they become available In the spring. Planting of these shrubs wlll be your
responsfblllty as the property owner. the City w[!1 not do the planting. The shrubs are to be planted
on your property to keep the right-of-way free of additional obstructtons. Our Parks department wlll
contact you prlor to dellvery so you can be prepared to plant on receipt
If you have any add[ttonal questlons. please contact me at 572-3551. •�
Sincerely,
]on H. Haukaas
Assistant Publtc Works Director
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FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When reqlacin�a an existins� furnace, the undersigned hereby verifies that the
ver�ting has been examined and is free from rust, dete�ioration, obstructions,
and is securely supported and firestopped where required. Yes () No ()
The venting system is plastic/PVC and meets all cuRent codes and manufacturer
specifications inciuding sizing, length, number of elbows and termination. Yes () No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances. '
The existins� combustlon air is sized and installed to meet the current codes
and manufacturer's specifications.
When required to Install a new combustion air. it will be sized and installed
to meet the current codes and manufacturer's specifications.
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
When installinsa a new ventin�a svstem, the undersigned hereby verifies that
it is a listed assembly and meets the cuRent codes and cnanufacturer's
specifications. This does inciude AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes () No ()
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 c�des. Yes () No ()
Aaallance Tvae and Size/Common V�nt and Vent Connector Information
Appliance #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 Appliances T-�otal Btu Fr�a# ___ -.
Common Vent Type Vent Height � Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Conne�tor Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS• (Describel
HEATING CO:
Signed By: Date :
CITY OF FRII)LEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 l+'AX: (7631571-1Z87
.
PERMIT O:: 2004-01231 ` '
DATE ISSUED: 08/02/2004
ADDRESS : 1201 HATHAWAY LN NE
PIN : 243024310048
LEGAL DESC : PARKVIEW OAKS 1ST ADD
: LOT 3 BLOCK 1
PERMTT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 400.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A GAS WATER
HEATER.
# ELEC WATER HEATERS 0 # NEW FIXTURES (EXIST OPEI�TINGS) 0
# GAS WATER HEATERS 1 # GAS DRYERS 0
# GAS RANGES 0 # OF NEW FIXTURES 0
# WATER TRMT APPLIANCES 0
APPLICANT
NORBLOM PLUMBING CO
2905 GARFIELD AVE S
MINNEAPOLIS, MN 55408-2173
(612) 827-4033
OWNER
JOHN MAGRAMM
1201 HATHAWAY LANE N
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 know the same to be true and correct. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a pemut does not presume to give authority to
violate or cancel the provisions of any other state or local law
reg�a. ' cons ction or the performance of construction.
Applicant � _ _ Date
Bldg Insp
PLBG FIXTURES (NEW OPENINGS)
PLBG FIXTURES (EXIST OPENINGS)
WATER TREATMENT APPLIANCE
WATER HEATER - ELEC
WATER HEATER - GAS
GAS RANGE FEE
GAS DRYER FEE
STATE SURCHARGE, PLBG FLAT
TOTAL
PAID WITH CHECK # 28783
SEPARATE PERMITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE.
0.00
0.00
0.00
0.00
35.00
0.00
0.00
0.50
35.50
.
Building
Inspections
763-572-3604
DA
BiTILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL. ADDRESS
STI'E ADDRESS � '
TfiIS APPLICANf IS: ❑ OWNER CONTR.ACTOR
PROPERTY O�VNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
PHONE: / T 6 3%.S" r C/ _ l L'i`�/ v
—�
NAME: OY . 6?`h `/C��iia��
STATE LICENSE #
AnDxESS: �E� �ss P—
PHONE _ �� >> � � � ° !a 3 ? Fax
SINGLE ANID, /NEW CONSTRUCTION
O TWO FAMILY/NEW CONSTRUCTION
O ADDITION ❑ GARAGE/SHF.1
❑ BASEMENT FINISH ❑ ROOF
❑ DECK ❑ SIDING
❑ MAINTENAI•tCE/REPAIlt ❑
DESCRIBE WORK BEING DONE:
SIZE OF
KNUMBER OF SQUARES % �
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
O Vinyl
❑ Aluminum
❑ Other
ADDITION
LENGTH
HOUSE OA1LY
❑ HOUSE & GARAGE
❑ ATTACHED GAR.AGE
❑ DETACI-IED GARAGE
❑Soffit
❑ Trim
� Fascia
WINDOR'S
IN EXISTING OPENINGS OYes �No LOCATION OF WINDOWS
OR FOR NEW OPEMNGS-DESCRIBE STZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF �
EXP DATE .S �
CI'I'Y �
6� r �t6 �! - oT�
S1ZE
STORIES
O WATDOWS
0 DRAIN TILE
❑ OTI�R
. �;�
Pernvt No.:
Received By:
Date Rec' d:
��y3 a
A� z�.s.re�a
M��� M �
BASEMENT REMODELING SUBNIIT:
1. Existing Floor Plan
2. Propos� floor plan
3. List of structwal members to be used
F�
FOR NEW CONSTRUCTTON INCLUDING DECKS,
,ADDITIONS. & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing strucwres
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:
(LTSING THE 1997 U.B.�EE SCHEDULE)
TOTAL JOB VALUATION $ � O oC3 OCCUPANCY TYPE
Permit Fee
Plan Review
Surcharge
Fire Surchazge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Conlrol
Park Fee
Sewer Main Charge
Total Due
$ (� �p :�� See Back Page for Fee Schedule
$ — 65% of Building Permit Fee
$ .� (.0005) times the total job valuation — Minimum $.50
$ , a .001 x Permit Valuation (1/10%)
$ � $5.00 (State Licensed Residential Contractors)
$ �. Q� $1450 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$20=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ Make checks pa_yable to: Citv of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclrnowledge tha.t 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 pertnit; that the work will be in accordance with the approved
plan in the case of all work which re�s��iew and anproval of plans.
SIGNATUREOFAPPLICANf � ,� �, PRINTNAME__,�QW1�fl1 N�S}(11.�9rDATE �f1 I�, /Q�
Page 2- Building Residential Application
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official sha11, 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 pernut of fees to the amount herein below set forth and in the manner herein
provided to-wit:
ToT�, v�.vE r�Es
$1 to $500 $23.50 (Minimum Fee is $23.50 plus s�chazge)
$501 to $2,000 $23,50 for 1�` $500 plus $3.05 fo� each additional $100 or fraction, to and
including $2,000
$2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fraction, to and
including $$25,000
$25,001 to $50,000 $391.25 for 1� $25,000 plus $10.10 for ea.ch additional$1,000 or fra.ction,
to and includin $50,000
$50,001 to $100,000 $643.75 for 1�` $50,000 plus $7 for each additional $1,000 or fraction to and
includin $100,000
$100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional$1,000 or fraction to
and includin $500,000
$500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or
fraction to and including $1,000,000
$1,000,001 and up $5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional$1,000 or
fraction
VERIFICATION OF FOUNDATION
Permits for constructioa will be issued a minimum of 24 hours from the time of application to
allow for proper review of proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the fram.ing. New Houses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, NIN 55432
763-572-3604
Fax: 763-502-4977