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To be used as� *
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Fridley, DrIinn., ���+'""'' s � � , 19�
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D��C��'a'".�011\T OZ+' ��JI�Y��G
�`� Height� Stoz�lea�Manner of Conetruction 9�'�d�'�s�
.� .� � � � � � . � ,�. �
To
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Estimated Cost.
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the 'building �� described in the �.hove statement. This germit ie granted
upon the express condition that the pe to whom ft fs granted, and his agente, employees a,nd worl�nen, in a11
the work doae fn, around aad upon said building, or an.y part thereof, shall conform in all reapects to the ordi-
nances of Fridley, Minn., regarding the conetrnction, alierafialon, ma.intena.nce, repair and moving of i3uildings
within the city limits, and thie permit may be revoked at any time upon violation oP any of the provisions of sa.id
ordinances. :k
" �` � ` ' �- ' �'•�.. Inepector oP Buildings.
1�GR , � .1vT AT�TD SV610R,N �TATEll�NT
In consideration of the issue and. delivery to �� by the Fn�p�cior of ��aildin�s o� �idley of
the a�ove permit, I hereb,y agree to do the proposed vr�orl� �n acc.oi�.ance avit�. the c�escription
above �et forth and accordimg to the provisions of �he or�,ina�c�s c�f �riclley, and, beiag first dudy
swo�, I hereby state and say that the facts stated by a�se �.nd eontainec� in. tb.e above pex�o.it are
true as therein stated. '
''��:°_ � {� ��� �P �� r.-?4'-,�7s�'�.�-.�+a�x.. _
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Subscribed. and swora to before me at Fridley,
day of � � A.D. 19 '��'�
�fl�lYl0S0'�a,, tYl� �
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"'ty of Fridley, Minn_
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Adar�ess Address
� LOCATION O ING
No. ���,�� s�t Part of Lot
�-- -- Bl� Addition or Sub- on ...�._.._._ �
Corner Lot _ Inside Lot —.. � 9ctback Sideyard .-p,,� _ . — --
Sewer IIevatton — ._ Foundation IIevation
DESCRIPTION OF BUILDING
To U
Front �� Depth Height Sq. F't. ���:� Cu. Ft��
nt Depth IT ght � Sq. Ft, Cu, F�
Type of Conatructton ��.' Est� C'� t'�� �o be Completed
/�'�\
In coneideration of the issuance to me of a perrnit to construct bwlldfng descriixd above, I agree to do
tha ProPosed work in acc�rdance with the drescription above set fo ia compliance th all pravlsions of
�dinaaces of the dty oP Fridley.
� ' G'- Zs
In conafderatton of the payment of a fee oP $,��� , pern�it is hereby gra,ated to
to construct the buflding or addition as d�cribed above. Thiape rmit ia grented upon
the exPress conditfon that theperaon to whom it is granted and his agents, employ�s and workmen, 9n all work
done fn, around and upon satd building, or anY pa� thereof, sixall conform in all reapects to the orainances of
FridleY, Minnesota regarding location, conatruct4on, alteration� maintenance� repair and moving of buildings
ordinan� dt3' limii� and this permit may be revoked at any t�me u�O�n viol�s�f any of the provisions of ssid
Buildi�g Inspector
�'` �1 NOflCEs
'f6b peemtf doss aot cerer f6s cees�eneNoe, testall�lee he rrideg, P��+�& 6a haHna, sswu er wafs�. B� wre to ss�
da &rfidtq losputer foe ap�rat� pormtls for thKS kems.
sue�ecT PERMI _
City of Fridley 2 8 9� 9
AT TME TOP OF TME TW�NS g � I L D I N G P E R M I T
r
; � RECEIPT NO.
� • COMMUNITY DEVEIOPMENT OIV.
� �V � '
r � � PROTEC7IVE INSPECTION SEC.
1 = .
� /'�'1 � CITY NALL fRIOLEr SS��2 NUMBER REV OATE PAGE Oi APVROVED B
�'""'�' �`' 612-571-3450 910-F15 3/8/99 / /
�oe aooaess 7345 Tiayes Street NE
1 LEGAL ��7 NO. BLOCK TFlACT OR AODITION SEE ATTACNED
DESCR. Pt 21 �1ud. $ub. �%129 SFIEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PMONE
Joe Morana 7345 Ha es Street NE 784-5709
3 CONTRACTOF MAIL ADORESS ZIP PMONE LICENSE NO
Needham Construction 1983 Sloan P1 STE 4�5 Ma lewood MN 55117 776-5500
e AqCHITECT OR DESIGNER MAIL ADORESS ZIP PMONE LICENSE NO.
201143425
5 ENGINEER MAIL ADORESS Z�P PMONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION � ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Gara e(19 S) Tear—off
9 CHANOE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. HEATING,
VENTI�ATING OR AIR CONOITIONING.
THIS PEFMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING SQ. FT CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONST/iUCTION
OFt WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAVS AT
ANY TIME AF7ER WOiiK IS COMMENCEO. NO DWLG. UNITS OFFSTfiEE? PARKING
I HEREBY CERTIFY TNAT I HAVE READ ANO EXAMINED TMIS APPLICATION 1 STAILS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UpTION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED @
W�TH WMETHER SPECIFIED HEREIN OR NOT. TNE GFiANTING OF A PERMIT W 1� 628 �• 81
OOES NOT PqESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI TNE pEqMIT FEE SAC CHARGE
PROVISIONS OF ANY OTNER STATE OR LOCAL lAW REGULATiNG CON-
STRUCTION OA TNE PERfOFi NCE OF CONSTRUC ION �54.0� Fir �', �1.63
PLAN CHECK FEE TOTA FE
Licen e $5.0 $61.44
S�GN4TUpE OF CON'FACTOp A AUT110 �ZED AGENT IOATEi N P P LI AT IS R��=M
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S�GNATUAE O� OWNEp��� OWNEABU�IDEpi iD�fE� 5p n�rE
NEw L l
ADDN [ ]
ALTER [ l
ConstructionAddress:
Legal Description: _
Owner Name &
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
01'HER:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R 1 AND R-2
BUILDING PERMIT APPLICATION
ct�l �S
Effective 1/1/99
��e � /�a a � ��l� � ��cs �� �� Tel. # `%�y�.�; �,�
��� MN LICENSE �� Qf ����...5�
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:, .. �_ �v �.� 5��� _ �S �'dl�S��o��v��Tel. # ? �C S�d�
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Attach to this application, a Certificate of Survey of e
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
�n� Width Height
�n� Width Height
�n� Width Hgt/Ground
, _
, � �
Sq. Ft.
Sq. Ft.
Sq. Ft.
• T /1P
Estimated Cost: $ �� � � ��
Construction Type: �� d'�'O�t- - ,_
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � � �1 � % % APPLICANT: Tel. � ���-.Sr_S' �(�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
� STIPULATIONS:
$ �oo
$ 3
$ ��
$
$ �v�,
�
$
$
$
$ (
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residential Contractors)
t�1t. ni,n Oi i�t. nBn Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
�. � t -
BIJII.DING PERMIT FEE SCHEDULE
The CYuef 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 l�low set forth and in the manner herein provided to-wit� �
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $SOU plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for fir�t $25,Q00 plus $9.00 for each addidonal $1,000
or fraction thereof, to and including $50,000
$574.75 for first $SO,OQO plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Courb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Drivevsray width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction 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 location of the foundation once it has it has been constructed
will be required before proceeding with the f�aming.
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