AF - 45558�1 r'�i
City of Fridley, Minn.
BUILDING PERMIT
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_
Date: ..- ---_._.....-----------.._...---•---•------___.._.._.._.___.._..---•--.._...----
Owner- -----------------.
Address ------••----.....
No. ...!_.-3.°��-
�t�'c��---.._,
Corner Lot ........._ .
Sewer IIevation
To Used as:
_�+.����%Z�:�"..........
...._._.... ....- .._ ...............� ......_
N° 4403
Builder /.....`� t .....��....o �'�./ _.
Address ........_ .........................�---� -
� --------- - -- -
OF BUItDING
Part of Lot
��..,r�..�� .................... Addition or Sub-Division ....._.............................................---�----...._..........--�--�---�--�--._.._._..------�-
Inside Lot ...%!C .............................. Setback �e�..�. ..�.._e -..------ Sideyard � �_..'. �� __~............._..--- • -...---....---•-
Foundation IIevation
DESCRIPTION OF BUILDING
P 6 / h`'
�ont ...��---.T=neptr, �C..�_� Height �_�.�.� Sq. Ft.l�_�� cu. ���./.�..� �
Front ........................ Depth .._ - �-- -. Height _.......� _.. Sq. Ft ---� -----...._.. Cu. F� ---�- -_....._ --
Type of Construction ..............................-�----................_... Est. Co�t..,��.��.a.l'_...�_....._.. To be Completed .....--------------....
That part of Eaet 190 feet of I�ot lg, Auditor�a Subdivieion No. 129, lyia�
3outh of North 75.6 feet and �orth of 3outh 150 feet thereoi, a� mea�ured
along the South and F�.st lines thereof. Snbject tc an eaaement for road
purposea over the Ea.st 33.0 feet thereof aad an eaeement for ut3lity and
ara3�e.ge over the �'eat 6.0 feet thereof.
In consideration of the issusnce to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the descziption above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
_. _. ` .... _F_..����.�'1.�..L"�?r������a.��-._.._...___
In consideration of the payment of a fee of $�� ..................... permit is hereby granted to.....--.--........._............._.
._..__._._._._.........._...._._...._...._.._...._........ to construct the builcling 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 worlanen, in all work
done in, around and upon �id building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, constniction, alteration, maintenance, repair and moving of buildings
within the city ]imits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. � �
B111Ifilrig I118�CtOP
NOTICE:
This permi� does not eover the eonstruetion, installaHon for wiring, plumbing, gas healing, sewer o� water. Be sure to see
the Building Inspeetor for separate permHs for fhese ifems.
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Land Plonnin9
LandSu�veyin9
.�oils Testin9
Ci'vil b Muniup�!
En�ineerin9
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ENGINEERING� INC.
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— En9ineers E Sur ve�yors — : `
37ad�ississi�iSt. N.E.
Minneu�/is 2/,
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�I�a� part of Eest I90 feet of Lot 19, Auditorps 6ubdiviaion
No, ].2q lying Scuth of North �'So6 feet and North of 8�uth 150
Peet thereoP, ae measured elong the South and East lines thereofo
subjeot to an easement for road purposea over the Eas� 33.0 feet
thereof and en easement for utilitq end dra inage over the West
6ofl Peet thereofo
!/rereby crrfi�y iliof lhis is o frue ond ca�r�cf �ep�esenfotian o�'a sor-vey qt'�Iu ba.�do�es �'�lre a6cre af�cr;6ed lQrrC, ond
nF'ifx lou�linn o�'a17 br�i/drn9s ,�on , ard o// risib/e �u oorhmen�s , r�'arn�, , fizrn or arl,to�d /and. As .wrveyed 6tJ, me ffus�'�`°a6y
a� /L`�G t�� ��;,f?`°�,: A.O. /9�'.
SUBURBl�h! ENC7INEE2/NG, INC.
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�iEA°T LOSS CAI.CBJ6�►TIONS ���A�'f1V9EN'f
WeathersQrips A�•�•V'�• Conscnaceiomm N�
Guide
liJindaws Dooas 12eference Oeac. Wall Inc. �/�ll �',eiliag
c No 1Vm 19.,i o— v —3
Fl.� ° Rooen I.�agth / �ideh � � HeigD�t �
Windows a Doors—�rackage �.�d Aeca
Wtdth Hel�bt No. of Lf�eal 8t. Area
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Int. wall
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�Potal Btu.
Required sq. $t. E.D.R. or aq. in�. QV.A. �der �aea y,(m
F7.� oom I i.ength,� / 1Nidth a� 1$ei�6t ✓
Windows and. Doors-Crackage and Area
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ip 2 � i �
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�t.eqr�ired sq. ft �A.R. or aq. ins. i�l.A. fi�ead`r area
F1. R�m � Len�th o�Jideh i Heiglh¢ %
Windows and Doors—Crackag� aa�d �lsea
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Is�filtration I � ,
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1Net esp. wall
a�,e. Wa�O
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OF �IUiS.�INC�,S � ��•
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Eap. wall �
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Total Btu. S
laequired sq. ft. E.D.R, or sq. ins. W.A. Leader area
F1.1 Itoom I 1.en�th '�/idth / EIeight f}/
�audows and D�r�—�CracPsage and Area
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R�c�r�d sq. �t. E.D.IZ. or aq. i�as. W.A. l.eader area
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�� I�'iltration
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L�xp. wall
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il Re�asiraed sq. €t. E.D.� �r sq. i�s. W.A. L.Emdec area
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City of Fridley, inn
BUILDING PERMIT N° 5 9� 0
nate: '`� �- "�i+� " ,,�"', .:
Owner: � � �` � + Builder .
Address Address — —
�. LOCATION B ILDING �
No. �Street .�����'�'�-+!`-- Part oE Lot
���� ^-���
Lot _ Block
�����Addition or Sub- ' n .�_—
Corner Lot T� Inside Lot ^� Si�back Sideyard .�.�—.
Sewer IIevat3on � Fo dation IIeval3on
DESCRIPTION OF BUILDING
To � U ' as: / �
� Front �`� Depth ,.,,��a:� Height �G•� s4• Ft� y�� �y1-� Cu. F't.�I���=1�
� t Depth Ii i Sq. Ft. Cu. Ft
Type of Constructi "�.� F�st. CdSt �.,,���^�To be Completed .�..
�
Ea conaideration oP the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance wlth the description above set forth and in compliance with all provlsions of
qrdinances of the dty of Fridley.
�
In consideration of the payment of a fee oP $.�.'.� '—""r� , permit is hereby grattted to
' to conslruct the building or addition as described above. Thia permit is granted u�n
_� the express condition that the person to whom it is granted and lus agents, employees and worlmien, in all work
done in, around and upon said buildwg, or any part thereof, shall conform in all respects to the ordinancea of
� Fridley� Minnesota regarding loca.tion, construction, alterahon, maintenance, repafr and moving of buildinga
wri� th�e dty limits and thfs permit may be revoked at any �u�� tion.�f�+ of the provlsions of said
v
-••ol'ca.�OT
NOTIC�
This permit does eof �over t6e eoaslrucNoe, tnslallaHon fer wiring, plumbing, gas fieatieg, sewer er water. Be wro to see
fin Buildhig Inipeeror for asparats permNs for thaw haea.
�i.-! .'�^'r..>:b
� � A��.,
✓�_ � •
APPLICATIO� FO� BITII,DIIITG PERMIT
C3TY O�' �'RTDI�EY, Nt�I�NESOTA
�tner's Name �01� I��,U �-
S A ,M �
Rddress %� �� /T �9 Ye f `;/%. E Address
LOCATION OF BUI�DING
No e �� �� atreet /�A Y� S Part oi Lot
Lo�t Block `��_ _ Adciition or Subdivision`
Corner Lot inside Lot ` Setback� Side-Yard
SEVTER ELEVATION POUNDA^1ION ELEVATYON
Applicant attach to this form Certi�icate of Survey of Zot and
�
�roposea building 1dca�ion. � -
DE�CI�IPTYON O� BUILDiN�
To �e used aso
�e - �Q r�.5 � �ront�Depth �� Heigist �D /r7�
�
Sq. Ft. Cue Ft.
Front ep-�h �„Height
Sq. Ft. Cua Ft.
Type o� Construc�cion _/" �'',a M, e _ Est�mated Cost
lo be Completed
,
7Che undersigned hereToy makea application for a permit iEor the work
here�.n specifiecl, agree�.ng to do all work in �trict accor�ance w3.th
the City oi Fridloy Ord�tnances and ruling o� the Departcment of Build-
ings � anci �iereby decla�ces tlzat all the facts and �epresenta�ions
s�ated in this ap�l3cation are true and corr�ct.
D�TE � _ o� •��— [� � SIGNATURE �/.� ��0�
(Schedule og Fee Costs ca� be �ouna on the Reverse Side).
�r� _ �
� � r„`�, �•.1 � �
�_ - .
DUILD�NG PERMIT L''L�E ��DULE
Secicion 2. The �nspector of Buildi�n�s ahall, be�oge 3.ssui�g any
pe�:�ai'c �or the e�ec•�ion o� any buil.ding or s�ructure, or for any
addition to any oxis��a� �OUildlri� or struc�ure, or for any altera�tions
or �ce�a�.rs to any ex�.s�t�.ny building or s�rucicure, upon application
�orefor, require �he pay�►ent by �the a�plicant for euch permit of
sees to �he amount herein below set �orth and in the mariner herein
prov�.ded to-wito
2.�e �or any such p�rmit for the erect�.on o� any fire-proo� building,'
o�chesc 'than a� garago, wa�c�Y►ouse, �actory or grain elevatoac, or �or �the
erec��.on of any f�r�-p�oo� addition, �or s3milar occupancy, to any �
exis�t�ng buildirx� sha11 be at the rate o� $1.9�0 for each ono thousand
cub3,c feet, ar fraction thereo�E, in such cubical coatents.
2.�2. For any such porm�� �or the e�ec�ion of ar�y fire-proo� garage,
v,aagahouse, �ac�oicy or grain elevato�c, or �or the erection or a�iy ��re-
praog �ddi�taon, zo� s3milarc oceu,pancy, �co any e�c3stirig bui3.diJng sha11
7oe at the ra�to o� $�.25 �vr �ach ome thousand cubic �eet, classi�ied
as "�ireproo�" by �ection 502 0� th� M�.nneagolia Build�.ng Code.
HO� 3
2_ 3. For ariy such permit for the �rec�t9.on of any non-fi.lceproo� build-
inQ c�cher than a garage, warehouse, �ac�ory or grain elevator, or any
non-eireptcoo� addi��on, for aimilar occupancgr, to any exis�ing buildingo
Perrmit $1000 for each on� thousa�d cubic feet. �
G1�GES -
2` For any auch �eTCmi� for the erec�ion o� any non-fireproo�E
g�rage, warehouse, �actory or grain eleva�tor, or for the erect3on of
any nom-fireproor addition, �or oirniiar occupancy, to any exi�ting.
building o�c �or each such building or additione Ninoty Centa �or each
one �ousand cubi� ieet or fraction �hereof, in th�.cubical content�
thereof wi�h a m3.niznuna o� $4.00.
Por �he pur�ose of co�pu�ing fees for bu3lding permite the�cubical coa-
ten�s o� any buildi.$�g or addition to a unifo�m height throughout by
multip].ying the ground axea covered �om a point aix (6) inches Ioelow
�he floor line o� �the basement or ceilar to the average he3ght of the
upper surface or ico che average heigh� o� the� roof surface of the ma:la
ga'�le of a pitehed �coo�=.
2�.5,_., �'b�c repairs o� alte�ations to an exis�ting stsucture, t�se �ee
shala be at �he �a�e of $3.00.per each Five Hundred Dollars ($500.00�
or �raction 4hereo� in �the cos� o� all proposed worl�.
2�.6_0_ �n no case aha11 the fee charged for any pesmit ae sot fortii 3n .
Sect�.on 2 b� f�ss
_ . tl�� $4.00. �,-,
.��. _._�.
�
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�U�.�u�Ts ���iair�� o�' �tz�.� �o� . �ua�a� ?�2� �9. �. �a�y�;s:
�a��i ���r� .�'�ay �, `��x�11 �� th� � :�. e ���?�. o� 1�e�lt�
' �� $. ���� ��' st'���i�� ����13�� ��r���e���r� ea�.s�ai
�,� it����i��.� ����it��n� ��i��� ��a� .��m�T�c�x3 I���;i+�a�
�'1��. �n ��� ���+���i.
� :� ���r�t�� �a�r �F�� �nv���:�.�at�c��i c�� � ����a1ai�� 6�y tt�e
�x�n�a��sc�� �i��a����nt �� �i�a1�� �lc�.� ���.1�.�� � w��� ������i; ��a��.�.�.��
vn�.�� � r��w��ca ��€��.�� ��� �m�rie� i����.oa� �1.�"� �r� ��d ��ra�r�,i #���.�t�
w�g� r�� 3,�a�'�$t�, �u�-vCan�,��� u��.�a ��.���t �h� b����.� c��' �a�!-
�a�r ���re� e�� �ra��r, �� �►�r�'�y au�m�.���c�.
�� ����. �"=�an�l� �. ��r�a, ?�2� �� �. t���►�� ������ �ia� a�
�i�an� �:��9 d b��a��� :�ii T� ���a �t�3.��1�� (�a�i�i1�,� +�����C�:�y) w�►�.ct�
t�i� �������a�ta ����rr�a��n� �i �aa�1t1� f�,t� ��as dt��: ��► e�v�.����a��l
crrradi,t�.aa�� �u���r��.��� t�ai� ��c��. `����: T��i�sa�� L����r�m��� c��
�I++�aalth ��o� a R�a��:� s�p�.� f�c�m �.h� ��.-i���� �a�ll. �� 73�� ��«� �,,�
�1ay�a ��. �Q� �ea����.s and ���� �.� �� b� t�c�;at�.��. '���i� ��s���aae�
t�a;s � �r�.v��� ��t�r �rrrd 8���� ��r��� ��,�t°rvu�h m�3�ei�a1 �ar��,���
�e�r an� wa�er ar : ��i1.ab1�. �i��. �u�� �c�p3��a��i t�� ���
�hiid�� E�e�� :n��.�° �Iay�d a��und ��c� ��r��i.i�p �1��� 18c�t� t���.
hlrtd �I�� A�na�: �.caa� �{���l�x� �lu� �i e�a� ���* occup��� �� t+��e
c�w�i].ir�� �i�s �i3,d a�c�� %av� �hs b��.�i� a£ sa�i��� s�war a�d
��r�: b��i��i�� s:�a�� u�s,�n th� ����t. �h� �L�� %nf+��ce�d th�
�tat� �o�� �►� ���i��i ��i�� �s��ba�� �ra4 il����c�� u��_ t'�,� ,��€1
an�t eha� ��� ���3a�� �r�a� c��� ir����t�d �.�h �a�s. T�� �'�i��.��
no�,rd af �1�a1�� �.����3.�a��o�a �c�v�L� ��i� �`��.�����,�
�9.v°� �w�11��� ca�i�s €��.s� t�+hia�� ��i� Aa���i�a� ��.an
�la�b e� �h�.�'� ��aur ��c� eu&���t��,rd i �d ��r►�le��lg� �►c�c���i�d.
�'Hr�o c�� �;n� E�z t�v� be� �m��y £o� �'�� �a�� ����� ��a�s . �n� ��a
�c�ua�� '�a� '��e� ���y far �h� pas� ��c m�C�s. Ai1. �c��= af thQ��
s��•s�a���rd un�.�� w�r� �rr�d�n�:c1 �'arr ��e� e�cu��� �tnd w���
����e�d �s o��r�d �r ��� BQa�d t�� t��a�th. �'�� ����� ctw�lL�.n�
�� se�11 b��n� �e�a��:�d �y �n e�.d+�gly� �en�i�n ,a� �i3,� ],9 y� eid
son« T��,s c�t�e�1l9.�a� uni� i� �orrr���t� t�r mun�.�ipal. sarii�r��y a�w��
��l ��t�:�� 7:h� �++c�uusa €��� Q�tz��1y ��d� �d �q�ip��d w�..�� �r���r
��e� t�a ��,�� t�►arte��=
'�ub,�s �hi��lia �r�vest� a��4�
April 7, 1���� �a�o � �
�arba�e �an �ac�.l�.t�.�:s. �'���� wa� n� �vidara�� 4� any �ara��� �r�
the parc�.s�s.
� canev�l�aticr� c�i�h a r�pres�ntati�e �£ the A�n�r��an
Le�ic�n rev�alec� that ali �Y�c� �t�b..s�ax�dard uni�� w9.11 be rc�nvved
�ram rh� �r��m�.s�� i��r Pt�y �,� i�6�+.
t1p�M c���s�3.on�i� 1+�r�* ��a o� 732� N. '�. H�yes ��,�
it w�s ��a��s� �hat se�a ei h�r n�a��t��ip�s had s�e�u rats i.� C`h�i�
�rards. �`u�����r quae�ic�nin r��*�Z�d �l�aC �t�e�e r��4.�t�bors �1so
Y�aad d��s which w�r� b�9.n� �ad rauts9.de aad t�ie� 3.s ��� protsable
at�rac��c�ra £ar �k�� arv�ie��t har�ra��. Mrs. �ur� a�,�o adm�.���d t��
s�� �i�c3 nc�� b���e �.n �h� A���9.can L,e��ofl area �mr s�n� ��.me arn1 w�s
a�a� a�wa�e tha� t�;�s� dwellir� units were vacan� •- that sh� �ad
,�us� �,ssum�cl t�,�,t �t�3� was �ahere t�e� c�i�.�.d conta��ed h3.s �.11nes�.
51�� �lsa► �ss ��� �w��� �h�� �hs� s�3,e1 � �aets �a�r� a radent a�tgac�3.c,n,
as �r�ze �>W�.�h6�rs s�i�c�s� tzous��Ceep3.n� �aas r�mt p�r�perly �nai.n��.�.nc�r�.
�r€�m �1�� ap���r�aa�e �r� h��c I��nae or► tt�e da� o€ �ur
su�tr�y, �irs. v��� �3.�E-►� �1� raai�. �o �.00� �r�4.o h�r c� hc►t�sel�e��9.n�.
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CHIMNEY AND STACK YERIFICATION
The undersi.gned hereby veri.fies thai the existing chimney or stack; �-
1. 'Has .been. careful ly._ exami ned. � Yes (, )
2. Is free from�rust or deterioration �� Yes ( �
3. Has no foreign objects lodged within Yes ()
4. Is securely supported . Yes ()
5. Meets all current Code requirements for size and
- �a�ai= ��i;-�:���ec-reu ---- - - —
6. Has, Total heating BTU's of
All other BTU's
TOTAL
Rema rk s
No ( )
� � �
No ( )
No ( )
Yes t ) Hr� � )
Company
Signed By
� �C
�
�
SUBJECT P
c�ty of Fridley ` 2�. 4 2 8
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
� � •
� `L _.��� COMMUNITY DEVELOPMENT DIV. � „�, {j�� �
r � � PROTECTIYE INSPECTION SEC. ����/'
� _ �
� /"'� � CITY HALL FRIDLE� 55432 NUnnBEA REV DATE PAGE OF APPAOVED BV
�"""� � ,�� 612-571-3450 910-F15 7/2/92 / /
JOB ADDRESS 732g Hayes St.reet NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 19 Auditor's Sl]ll, #1.29 SMEET
2 PROPERTY OWNER MAIL ADDRESS 21P PMONE
John Madsen 7328 Hayes Street NE 780-8332
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS 21P PHONE IIGENSENO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
�1 NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Constxuct a 10' x 12� Shed
9 CHANOEOFUSEFROM TO
STIPULATIONS
Shed must be a zniniaium a£ 6� £xom x'eax �� yard; a mi.nimum of 3' from
side ya�;d; be securely anchored by either on a�oundation or tied dawn
with anchqr ties, and be a maximum of 14� high.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBIIdG, HEATING, TMPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. fT. CU. fT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTFiUCTION
OR WORK IS SUSPENOED OR ABANpONED FOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMEIVCfD. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALlS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 9E COMPLIED $'�OO $. SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEpMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. S19e OO Fire SC $. %O
PLAN CHECKFEE TOTALFEE
$2�.2�
NATU O CONiPACiORORAUTMORI2EDAGENI IDATEI HE PR RL V LI ED THIS IS YOUR PER T
, ���-- � �/°�-= - �� � -�Z
NATURE OF O EP �IF OWNER BUILDEF� IDATE� BLDG INSP na7E
NEW [ )
ADDN [ ]
ALTER [ j
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Const�uction Address: � .3 �2 � v�.d.��� s .S�P /� �.
Legal Description:
Effective 3/1/92
Owner Name & Address: oin� ��'/'J � �'e� Tel. # �f�� 8� � �
Contractor: � 2� � � MN LICENSE #
Address:
Tel. #
Aitach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
LI�ING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DIICK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: /� x � 2 �SSX��/�
Corner Lot [] Inside Lot [°Fj Ft. Yd Sexback Side Yard Setbacks
Ty� of Construction: (�na� ��abw.� Estimat� Cost: $ `7C�� '°
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Ne�ed: Ft. + b Ft = Ft x$ _$
DATE: 7/ 'z— APPLICANT: TeI. # %�O � �� �
���L��
Permit Fee $ �� �� Fee Sche.dule on Reverse Side
Fire Surcharge $ �`%D .�1 of Permit Valuation (1/lOth%)
State Surcharge $ - � � $.SO/$1,000 Valuation
SAC Charge $ $700 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement N�essaiy j] Not Necessaty [)
TOTAL
STIPULATIONS:
� �L'.��
.
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing �rmits for the erection of any buiiding or structure,
or for any addition to any existing bnilding or structare, or for any alteration or repair to any existing
building or strucb�re, upon application therefore, require the payment by the applicant for suc6 permit
of fe,es 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,IX)1 to $25,�
$25,Q01 to $50,()00
$50,�1 to $1�,000
$100,�1 to $SIXI,(a0
$5�,001 to $1,0OO,ODO
$1,0()0,001 and up
FEES
$15 (Minimum Fee is $15 plus surcharge)
$15 for first $5(K? plus $2 for e�ach additional $100 or
fraction thereof, to and including $2,000
$45 for first $2,000 plus $9 for each additionat $1,000
ar fraction ther�f, to and including $25,Q00
$252 for first $25,� plus $6.50 for each additional $1,000
or fraction ther�f, to and including $50,000
$414.50 for first .$50,0� plus $4.50 for each additional
$1,000 or fractaiion ther�f, to and including $100,000
�39.50 for first �1�,�0 plus $3.50 for �ch additional
$1,(�f0 or fraction thereof, to and including $500,000
$2039.50 for the fust $5�,000 plus $3 for each additional
$1,000 or fracbion thereof, to and including $1,(�)0,�
$3539.50 €or the first $1,�,� plus $2 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A" : Removal and replacement of curb �nd gutter only - Driveway width plus 6 fat times
$13.50.
Alternate "B" : Removal and replacement of curb and gutter and install a 3 faat wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for const�uction will be issued a minimum of 24 hours from the time of application to allow
for proper review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the lc�cation of the foundation once it has it has been
construct� will be r�uired before proceeding with the framing.
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�; �uditorts �ubdivieion �
} That part of E�st � I90 f aet of Lot 19, ..
:�s � No i29 �Yin� �th oP Nortb �'S o6 feet a� Nor�g�f linee�t ereof,
_ feet thereof, as measuz'ed slong the South encl
'� r aes over the East 33.� ��e�
' Subjeot to an easement for road pu P�
' thereof and an easement for utilitY end d�'8�81�e over the Wet�t t; �
�'. 6a0 feet thereof, . .
� boor►ndories �i'�e oboxe of�suyb�d ��� `± :
�ecfi fhaf ihis �s a fi ue ond cvrr�cf �e�'esenfofinn o�'v sN"Vey � d knd As surve ed Gcf ine Nus-��- �f .;.,
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�'� lowfion a�'a11 b+�ldm9s , �0� � �oll ris'�b/e e�rcroa�imen�s � _
�, �/�; „� _, -���, — A.0.19�1. • SUB UQBAN ENGINEE2/NG , INC.
En ineer's �'
l��= 3G� �
S�: �-� /e� .
��o BORI LOCATiON � ^' I�� - e Minnesota Well and Boring H �� a�� '� I
itAINNESOTA DEPARTMENT OF HEALTH Sealing No. L�
co��ry Name WELL AND BORING SEALING RECORD Mi��esota u�iq�e No.
g"a��}�, Minnesota Statutes. Chapter 1031 or W-series No.
(Leave blank d not knownl
Township Name Township No. Range No. Section No. Fraction (sm. � Ig.) Date Sealed Approximate Date Well
��s���v /4 l4 ,4 ������ orBoringConstructed ����
�a
cN7�umerical Street Address or Fire#N,umber a,n},d City oF Well or Boring Location "]
l��� ����+� a: 4t��� ta ad .',aa �"�r1' d�.�� Depth Before Sealing �� ft. Original Depth •� ft.
Show exact loration ot weA or bonng Sketch map of well or bonng Siatic Water Level ❑ Accurate
in section grid wilh'X-. location. showing property lines.
N roads, and buildings. ❑ Approximate
_� � � �_ �Z, � q+� �� �
� _�- -�- -� J� Z ❑ Single Aquifer ❑ Multiaqu�fer ft. below above land surface
a
i i i i V
—�— — J — — L — —� � CASING TYPE - .
w� � � � E �� �
� � � � �
-r -�- -r- -r
� � � � � �Steel ❑ Plastic ❑ Tile ❑ Other
SrMe
_i i i i_ �
_ _ i_ _� _ _�
S Screen (rom to ft. Open Hole from to R.
� � `"�� � OBSTRUCTIOWDEBRIS/FlLL
PROPERTY OWNER'S NAME
Tc�� i{i�d�:�n ��; ��� ��e �d�.��o�
Mailing Address ii different than property address indicated above.
���a
GEOLOGICAL MATERIAL I COLOR I FORMA ONF I�OM I TO
If not known, indicate estimated formation log from nearby well or boring.
��'�.t � � l �
REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING
G�7ii R'��,�L � s'�. .i�ri'�.�a;i� iJS�-.;;.Y.ha:��,fiEF
�����t� .�c��� �4� �r������
�.emt���� z"res� ���.�. �a�-:�;�.
❑ Obstruction � Debris ❑ Fill
ofdebris/obstruction ���� M ��-�����-����.�.i €! �'�'� `�'
uction/Debris/Fill removed? �,Yes ❑ No
K"
❑ Removed � Not Preserd ❑ Other
CASING
Diameter Depth Set in oversize hole? Mnular space indially grouted?
� in. from � to � ft. ❑ Yes � No ❑ Yes ❑ No ❑ Unkno
in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unkno
in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unkno
METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE NOLE:
�No Annular Space Ezists
❑ Mnular space grouted with tremie pipe
❑ Casing Per(oradon/Removal
in. from to
in.from to
Type of perforator
❑ Ott�er
GROUTING MATERIAL
ft.
ft.
❑ PeAorated ❑ Removed
❑ Pertorated ❑ Removed
material �°���s'�� from � to � ft. yards C`+'
from
from
from
to ft. yards
to fl. yards
to ft. yards
� ���l�=j �. �� '� � � -� ��� � -�� UNSEALED WELLS AND BORINGS
�(�°�'��� ��' ���� �� ����"�r"�� Otherunsealedwellarboringonproperty? ❑Yes �No
���� �����►� jy�+��"� ����� LICENSEDORFiEGISTEREDCONTRACTORCERTIFlCATION
���'� ,� '�-'",'��'� �,�a ��°� ��s �,! �.�'� � This well or boring was sealed in accordance with Minnesota Rutes. Chapter 4725. The infortnatlon contained in this report is
true to fhe best of my knowledge. ;_-
s�4��.�3 e�4 �@il;� �,1� �.? 3,3�� �`T���
��` Conhactor Business N License ar Regi tron N.
� � � � ��
���
G Authorized Represe tive Signature Date
i.oc,v.coPY H ���7� �3�� ���.�r��
Name of Person Sealing Well or Bonng
C - '�` y_.r
a�e�e��
c�ty of Fr�a�ey
AT THE TOP OF TME TWINS B � I L D I N G P E R M I T
r
� �
� ; v _��__ � COMMUNITY DEVEIOPMENT DIV.
r � � PHOTECTIVE INSPECTION SEC.
i = ,
� �"'1 � CITY HALL FRIOLE� 53132 NU►�BEA pEV OATE P�GE Os
�'""'� � �'� 612-571-34b0 9t0-F15 10/20/99 � /
JOB ADDRESS �328 Hayes Street NE
t LEGAL �OT NO. BLOCK TtiACT OR ADDITION
�ESCR. Pt. 19 Parcel 146 Auditor's Subdivision �F�129
2 PiiOPERTY OWNER MAIL AODR�S$ 21P
Daniel Zibell
3 CONTRACTOR MAILADDRESS ZIP
Midwest Tim.beroof Co 1001 Cliff Rd Burnsville 55337
4 ApCHITECT OR DESIGNER MAIL AODRESS Z�P
5 ENGINEER MAILADDRESS , ZIP
8 USE OF BUILDING
Residential
7 CLASS OF WORK
PHONE
7997
PMONE
�'ERMIT NO.
30423
,
RECEIPT NO.
o Br
SEE ATTACHED
SNEET
LICENSE NO
)147336
LICENSE NO.
IICENSE NO
❑ NEW O ADDITION O ALTERATIpN {� REPAIR O MOVE O REMOVE
B DESCRIBE WORK
9 CHANQE OF USE FROM
STIPULATIONS
[Z•]
Underlayment must comply with¢ the State Building Code.
TVPE OF CONST
SEPARATE PEIiMITS ARE REOUIREO FOR ELECTRICAI, PLUMBING. HEATING,
VENTI�ATING Oii AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION IONING
AUTHORIZEO IS NOT COMMENCEO VYITHIN 80 OAYS, OR IF CONSTRUCTION
OR WOHK IS SUSPENDED OA ABANDONEO fOii A PERIOD OF 1T0 OAYS AT
ANV TIME AfTER WORK IS COMMENCED. N0 DW�G. UN
I MEFiEBY CERTIfV THAT I HAVE REAO AND �XAMIN�O THIS APPLICA710N
ANO KNOW TNE SAME TO BE TRUE AND COF7RECT. ALL PROVISIONS OF LAWS VA�UATION
ANO ORDINANCES GOVERNING TNIS TVPE OF WpRK WILL 8E COMP�IED
WITH WMETMER ECIF�ED HEREIN OR NOT. THE GRANTING OF A PERMIT $1486
DOES NOT P UME TO VE TMOFiITY TO VIOLATE OR CANCEL TME pEqMITfEE
PROVISION F AN TM ATE Ofi LOCAL LAW REGULATING CON-
STRUCTIO T PE ANCE OF CONSTRUCTION �S4.00
S�GNATUpE 0� CON'aACTOA OR�fMOAi1ED eGENT � IDATE�
SO.FT
OF f STF
STALIS
SU RTA;
$.74
OCCUPANCYLOAD
CU f T
' PAFKING
GARAGES
Fi SC $1.49
TO FEE
0 .23
VA�I TMIS IS YOUR PEpM1T
�o_�/-
OiTE
::
f:`;: .
4 .
NEW ` [ ]
ADDN [ ]
ALT`ER [ �Y
ConstructionAddress:
Legal Description:
� �,3 �' � �, � d�rs�t� �✓ � � � ra • s �a � 3 6�� Effective 1/1/98
CITY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R 1 AND R-2 �� 3
BUILDING PERMIT APPLICATION � �L:� �--
Owner Name & Address:
Canaactor: �l.n �+
Address:
,:-_. _
_
,�< I.I''�ING AREA:
GARAG� AREA:
DECK AREA:
OTHER:
.�����.:����
-
I
� - -�
h!�!�%���
�
Tel. �
MN LiCENSE � � �/ � Ji�,�
Tel. # �o/� BD�i�f�
Attach to this application, a Certificate of Survey o� the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
Length Width Height :`- Sq. Ft.
Length Width � Height • Sq. Ft. �
Len th � Width Hgt/Ground Sq. Ft. -
��� f; Q�'���c� S� � C��l✓� [���
1
, l �Y��
Construction Type: Estimated Cost: $ s
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � � � . APPLICANT: w� Tel. �f � PL �017 i �`,
�
Pe 't Fee
Fire S harge
State Surcharge
_ SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
.,,:-:
� _
S`��`' -
$ =��
�/� �
$ � %`% �
$
$ � G� �
$
$
$
Sewer Main Charge $
TOTAL
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 [ ] Not Necessary [ ]
$ + � . . ����
STIPULATIONS: ��
/ , � �� �
�/ �
City of Fridley
AT TME TOP OF THE TWINS
i �
� �
� ; y ����� � COMMUNITY DEVEIOPMENT DIV.
r � � PROTEC7IVE INSPECTION SEC.
� _ .
� �"'1 � CITY HALL FRIDLEv SS�32
�'""'� � ,'' 612-571-3450
SuB�ECT
PE
�U ILDING PERMIT � ' 5 � 6
RECEIPT NO.
NUMBER REV OATE
910-F15 11/1/00
10B ADORESS 7328 Hayes Street NE
t IEGAL LOT N0. BLOCK TRACT OR ADDITION
DESCR. Pt 19 Auditor's Subdivision �i�129
2 PiiOPEiiTY OWNER MAIL AOORES� ZIP
Dan Zibell 7328 Hayes Street NE
J CONTpACTOR MAIL ADORESS ZIP
Eastwood Construction 182 A Ryan Lane, Little Canada, NIN 55117
4 ARCMITECT OR DESIGNER MAIL AODRESS ZIP
s
8 USE OF BUILDING
Residential
7 CLASS OF WORK
MAIL AODRESS
❑ NEW O ADDITION ❑ ALTERATION �7 REPAIR
8 DESCRIBE WORK
Replace Windows; Reside House
9 CHAN(iE OF USE FROM
TO
PAGE O� AVPROVED B�
� /
SEE ATTACMED
SNEET
PNONE LICENSE NO
651-486-8018
PNONE LICENSE NO.
20218577
PMONE LICENSE NO
O MOVE O REMOVE
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather
resistive barrier be placed over exterior sheathing to protect the interior
wall covering. Exceptions for this provision would be if sheathing is an
approved weatherproof panel or when the siding is an approved weather
barrier. Vinyl siding is no� a weatherproof covering unless the manufacturer
st�.tes this in their application guidelines. Call for inspection of wrap
before covering.
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
SEPARATE PERMITS ARE REOUIREO FOq ELECTRICAL, PLUMBING, NEATING, ' rrc vr wry;
VENTILATING OR AIR CONOITIONING.
TMIS PEiiM1T BECOMES NULL AND VOIO IF WORK OR CONSTpUCTION 20NING
AUTMOR12E0 IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 pAYS AT
ANY 71ME AFTER WOqK IS COMMENCED. NO. DWLG. U
I HEREBY CERTIfY TNAT I MAVE iiEAO AN� EXAMINED TMIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE ANO CORRECT. A�� PROVISIONS OF LAW$ yALUATION
ANO ORDINANCES GOVERNING TNIS TYPE Of WORK WILL BE COMPLIEO
WITM WME7MER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT �i8y�FOO
DOES NOT PRESUME TO GIVE AUTNORI7Y TO VIOIATE OF CANCEI TNE pEqM17fEE
PROVISIONS OF ANV OTMER STA7E OR LOCA� lAW REGULATING CON•
STR�CT�faN OR THE PERFORMANCE OF CONSTNUCTION $3O�I . ZS
T
- �c�- � ^�n Lic
OA AUTMOAiZED AGENi IO�TE�
SO. FT
STAlLS
5.00
GROUP OCCUPANCVLOAD
CU FT
OFFSTqEET PARKING
GARAGES
SUR7AX
$9.20
SAC CMARGE
Fire SC $18.40
70TA�FEE
l$339.85
J PERM17
-2 -Z�b
NOV-01-2000 11�30 FROM CITY OF FRIDLEY TO ���� � 6514940575 P.01iO3
N�w � 3 � ��9 ➢45
ADDN [] CITY OF FRIDLEY E�ctive 1/1/2000
ALTER (] SINGLE FAfVI�LY AND DUPLEXES R-1 AND Ra2 �7�� �r2-3604 Bldg insp
BUILDING PERMITAPPLICATION
Construction Address: �_�� , � . .
.. Legal Descript�on:
�Owner Name � Add►�ess: ' . �
"C'el. #
COt1h'�CfOr_ ���� �'�ar�`�r �, �
- ��� MN LICElVSE #��gc ��
Address: � 1
Tel. # _ f �;5� _4�'!0 °�1$
Att�ch io this appiication, a Certiflcats of Sutvey ot th�
lot, with fihe proposed construction drawn on it to scal�.
DESC�t1PTlON pF iMPROVEMENT
LIVING AREA: Length „_ Width , Height _�� S. Ft.
q
�AI�AGE AREA: l,erlgth _. Width � Height � S.��
q
DECK AREq: L�ngth � Width � Hg�Ground Sq, F�,
OTHER:
Construction Type:_SIl�,'��.�2►�t��4� p�� Estimated Cost � �c�, 1� �()
, , , ,__ .
�`Driveway Cur� Cut 1Nidth Needed: Ft + s Ft = Ft x� =�
i
DATE: (L,��O .�„ APPLICANT: 1
— Tel. #
C1TY USE OIVi.Y - Call (?63) 572-3604 tor Permit Fees if mailing in applicat�on
P�rmit Fee �%�.S � Fee Schedule an Reverse Side
Fire Surcharge/���1� $ i� .001 of Permit Valuation (1/1pth°/q)
State Surcharge j,���$_ -_ $.50/$1,000 Valuation
SAC Charge $ $1100 per SAC Un'rt
Licens� Surcharge $ � �C� �5.00 (Sfiate Licensed Residenfial �ontractors)
Driveway Escrow $ Alt. "A" or Ait. "B" Above
Erosion Gontrol $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering '�
Sewer Main Ch�rge $ Agreement Necessary [] Not NeGessary []
`� TOTAL $ ���3 �; ��
7
STIPULATIONS:
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