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AF - 45629� �1 �� City of Fridley, Mirm.. BUILDING PERMIT Date: 1�Iarch 7 1969 N° 10127 ��.� �� pwaer; Alfred J. Sorgenson g�� Clemron, Xntc. Adaress �,d�� 4411 Central Ave . N. E. LOCATION OF BUILDING No. 7507 S�t Hayes St . N. E. � Part oE Lot Lot ._._ 3 __ Block 2 Addition or Sub-Divlsfan .r pon' s 5 th Addn . Corner Lot _ Inaide Lot X Setback 35' Sideyard 10' 36' Sewer E1eva13on .� g�5 • 69 _ 888 .69 Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling �t 34' Depth 26 � Height 12 � Sq. Ft 884 �, �, � 10,608 Garage_, Front 34 � Depth 24 � i�eight 8� gq. �, 816 �� 6528 Type of Construction Frame ��, �� $21y000 __ To be Completed SEWER LOCATION - 166' South of Manhole WATER LOGATION - 1552' South of Ma.nhole In consideration oP the f�uance to me of a germit to const the propoaed work in accardance with the description above aet ordinances of the dty oP Fri�ey. a descrl�d aboVe I 8gree to d0 4P��ce with a'll. proviaions of In conafderat4on oP the payment of a fee of $ 26 . 00 � p�t is hereby granted to Clemron, Inc . to conatruct the building or addition as descrlbed above. Thiap�� t is granted upon the express condition that the pessfln to whom it is gra.nted and h3s agent�, employees an� workmen, 9n all work done in, around and upon eaid build9ng, or any part thereof, stxall cbnPorm 3n all respects to the ordinaac� of Fridley� M�nnesota regarding location, construction, altera.tion, ma3ntenance, repair and moving of bufldinbe within the dty limit� and this perrmit may be revoked at any tiine upon violation of any oE the provis�tons oE sa4d ordivanoes. _ �/ Official �� . Muhich NOTIC� ihis permi� das uot eowr fhs eoe�teodioe, Inslalldtoe fee whlee. plumbiee, gu 6eatieg, s�wu er walse. B� wro to sss t6a BniWieB In�or for sspuat� psrmlta Por th�s tt�m�. � • � _. 0 APPLICATIOld FOR BIIIIu�INC PF�MIT CITY OF F�IDLE7, PIINIVF�OTA - - 01�i'a �S NAME _. A1Pred J. Jo�gensen �I�g� Clernroa, Inc. e �� DDRE�S �{.7.1 Cent�e.l .�ve . N.E. � -° � t�� LCZCATION OF BIIILDING �' N0. r75�' STREIIr Hayps-N.E. . LO'i' 3 BLOCK 2 AUDITION OR SIIBDIYISION DoA � s 5th Add• COR'C� LOT INSIDE LOT X SETBAf.'� 35 SIDEXARD 10-36 SE'W�t ELEYATION TOP OF FOCTING CuPb miIIt3s !I. � 6�� Applicant attaeh to thie for� Two �ertificatee of SvrvQy of Lot and propoaed building location drs.wn on thee� Certificates. DESCRIFTION OF B[IILDING To Be IIsed Ae: Split Foy�r - No garage Residence ' IIAper L�vel Fro.nt 3L�. � Depth 26 � Height 8 �� Square feet 881.� Cubic Feet !� f r f.: �� `'oWeP Le'v�l Front 3�1-� Depth ?�. � Hei�h�= ��5� � ,�< � ;-R �e" Square feet 816 Cubic Feet (�., F�; � Type of Conetruction F'Patt�e Estimated Cost_?_1i�0�_n0 To Be Completed 7-15-69 The undersi�nned hereby makes application for a permit for the work herein epecified, agreeing to do all work in atrict accordance with the City of Fridley Ordinances and rulings of the Department_oi Buildings, and hereby declares that all the facts and �.�:�r�eee�tationa stated in thie application are true and correcte DATE 3-6•69 �iGNATURE (Schedule of Fee Coste can be fourid on the Rever deo) � � % , �'�`� 4 v . w i ° :a,: � ;�:_ �� -� '�' , -� r�� `��-� � � � �,m' � F�.-.'R° k BIIILDING PII�'!IT FEE SC�ULE SECTION 2o The Inspector of Buildi_nge shall, before iaeuing peraita for the erection of any building or etructure, or for �.ny addition to any exiet,�ng st�ucture or building9 or for any alteration or repaire to �.ny � eaieting building or etY°ucture9 upon application therefore, �equire the , a pe,yment by the appliaant for such permit of feea to the amount herein below eet forth and in the manner herein provided to-wit: a IIaiform► Buildir� Code: Type 1, 2, &¢��1075 for each one thoueand cubic feet, or fraction thereof, in such c�bical contents. TYpe 3� 5- �10 50 fo� eacYa one thoueand cubia feet e � For the guxpoae of computing feea for building permite, the cubical aontez�te of any building or addition to a uniform height throughout by multi�lying the ground area covered from a point ai$ (6) inchea belaw the �'loor line of the baeement or the cellar to the average height of the upper eurface or to the average height of the rooi eurface of the main gable of a pitched roof. For �epaixs or alterations to an euisting �tructure, the fee et�e.11 be at the rate of $3.00 per each iive hundred dollars (i500.00) or frac�i,on thereof in the cost oi all propoaed worke In no case aha.11 the fee cha,rged for any permit ae set forth in Section 2 be �.e�e tnan 85 000 � NS�SD Coxuiection Charges based on location - Area 1 or 2. ! �- � ^ � . � _ , � a � _�� Lart4Pl�r,r"n,� !mD Sus��i� .Sorts Test�ry Cia� b M�,n,apr�l �� % � . - �' o �875-l�i�oy s[S N.E. Mum�pnris3�. ENGI NEERI NG� 1NC. �� fld�ttd�606b — En9ineers � Sur vec�ors — cesrta,�icate o� ��awe �o: �,c ��.� �,�r��. T -� �-- Ct " f �..% � �., I r� ,^ ..� � � �� , � ��. 5 / 7/ 5" � � NapTH 0 ' LOT -3---� L��A � OD UTICtT�N EASEMEl��T D N'� „ �IQDiTIC�N ANDKA► �;i�l'�J?Y I fi�dr� �rfi�'y fY�oi hiis �s o Irue asd aarrtcf �r�sm�ofuan o�'o su�wee� �'Nx �s �'ilie a6r� aEsr�ibd /aid, a�d ��lawf�aa ey!'o!/ drrild�s , fhnan , a►�d d/ risib/t a�v»arJimmfs ,�f 'oy, {ia�n �.�.�d �d. as ��y� �y m� rfas:..._ d� a�'� ��T A.o n�. 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F Z v ^ ►� : � � o � b � 8 "�'� : � iQ k k � h X m �p � pN y�;Q � �p � �p (� N � � � . i7 Cy1 O � O � O CN7� g p $ r� �n � � � � � � 7�/ � � , d y � y � � O r � � $ M �- ` o� ao .. q� . � O O � y q � � a G � o, a � z a �. � a ° � ~ � (� i� Ry �. lO ��y, 0. a '� � ]. �• v, Q' oa b g . � �I � . _ � • •_ u � � •. �'- y , ' �., � � � � � .� n � aaM � ��'1 fyy � W .� O ".7 � � p t�/! QQ � C � �oo�a, a � � � �o �. N � � �� `-y'' � VJ ,�� Q d � �zo� � � s �, � < a�' � � �e �oo� � y xx bd "a � � ] t� � n �' q '�O C � � m o � n� d a n � M � 7 ~ O h � d ~ m � � � ".'7 �J � � � a� �� n m 5.:' o ., � � � ti � r. .. � '. � n ,� ..� w `� � "" O O �c.oc � �. I- W t0 d � M � .�.� � � c � �� x� �� a � t� � R� �� a M � w � » � N � � � �w o• �s � � • � � �t � � . � . r � '� �; � O ," � � r � � s � d � - � � � � , o � M . � I a s �. � � ' �y � '+;. Q' � �� 7 � � �' � �� , � � � n d \ V `C�� .�� .:�w .. ` �`a � �� aF � � �. � b � o �p : o : � • � s ; M . � . � � . � : ��. . � � � � � �p,n M w � p8'� � � c•r � i� �o � 4� � �,! � � � � � � � w � � � o � � a � � � � '� � � � �� ° `° � � � � � � � . `'. '° . �ao ��: � �: : �� p a 52 � . . ov ZS . �, . . � . 0 � 0/ IC N ' �,'� IC k iC D! k • � � � � � � � � � � $ � 8 �S !� $ � � g 8 � � � � � � � 0 0 • � � � O � � � � � C', D � � � m �^ ` / m C r f17 O z � g w � o a � � � �. x 0 � � 0 � 00 . -` �� .■..' : ■.., . : �N� � = �� v�� : �� ----- ..� ❑❑ I f p cr a � � A � K M � M � w b � � a � � w S c r � w � ca'c � tlbATtR c�csers usiwus MTM � �� s�� DRINK. FOUNT. 5l11N0.5. DAAINS GTQi !�►511�6 AUfO W� � � G1S RANGE c� OPENINOS .. Z. " � � � �. a � � �� a ,��, � �� "��R �. � � �� m � b ��b 8�� C,,. o ' � Cp�Qo r �ad � o � ti .� � � � �� c°�op'�� A � �.Q � �r � m �� I 3Z � � �o �� &� � � Pi. � � w � � � � � �. � � n � �. � � � � � � �� M. � b 0 � � � p HOUSE HEATtNG TEST RECORD ADDRESS ��° �APT. R C BURB � OCCUPANT OWNER sg�•�, � HEAT LOSS DATE HTG. INST. ^AS C0. METER BAD # SOLD BY INSTALLED BY Eleetrlca) Work By Gaa Line By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DE N COPIVERSION MAKE —_,.,�_ � x� MAKE OF BURNER Modal _i'��I �l�ei � y ~ � Model Sxiol /� � � Max. BTU Rating INPUT ��, MAKE OF FURNACE Model NTROLS � THERMOSTAT t ug Vent Size _ .� A Valve IND OF LINER I' IZ� �p NONE Limft Droft Hood Rsgulomr Limit SstFing Filters Size Number Fan Setting ��i�Dr Chimney Loeation Insida � Outaide Pilot Ty� �_ Chimney Construdion Pilot Make �, Pilot Model Smoke Bomb Wiring �' � Pilot Timing �� Droft � Test Ta `�i�' 9 �. L.W. Cut Off D r Presaure Lighting Inst. Preasure �� - Psr nt -CO �� J�Data Tssted �' -� Input CFH <0 S`" Pe��•� s2�- � pany 4esting Staek Temp. Percent CO �� Namo of Tester Form 235 s �9 Date: A pwner: A Adciress 1 City of Fridley, Minn.. BUILDING PERMIT ea No. 75 07 Stceet �ayes Lat 3 _ Block 2 Coraer Lot — Ina�tde Lot Sewer IIevatian To be Used as: Type oY o, In the � LOCATION Street N.E. ,�d�� 5ame F BUILDING � P�rrt of Lot Addition or ub-Di� —. Setback � Foundatto ioN oF Bu� 0 � s/�� N° 10 �`� 6 �� \� \ � Depth � j Height _1.Q�-. Sq. 5.�6 � C�u. Ft 5..�7ti(1► Depth I�eight . Ft Ca. Ft �, �3, 000. 00 To be Completed Sept . 1, ],� , \ �� \,� '�. sideratf of the issuance to of a germit to construct the �d work a rdance with description above set fo�a of the dty Fridley. � ^ described above, I agree to do npliance with aII provisions of In consfderation of the payment of a fee of 1�5 . 00 , permit is hereby granted to Alfzed Jorgensen to construct the buflding or addition as described above. This permit ia granted upon the express condition that the pereon to whom ft ia grentsd and his agents, employees and worlQnen, in all work F`r�i�ey' Minn ota �arding loca�o�n,g�nstr�iiction, atlteration��aint�en�an�ce� P�and mov ng o� d�ing�af witYiin the dty limits and this peranit may be revoked at a�y time upon violation of any of the provisions of sa�d or3inan�. � B�din� Ins�ctOr M(THI NOflC� Tlds psrmtf do� aet �erer ths eoe�teoetioe, leshllatlon io� whieA, phimbteg, ea 6satinp, ss�ru or wmr. B� wn to se� th� Buildiep lespsetor tor ssparata parm6i for theas itfmt. �l � 1 � APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITiON BUILDING PERMIT � � � � , �j �� / � �� • , /,1�; �` ,�-_��_,_� i�• �.�%Gr�..�r'/�y . � r /� � %�'� ; � � � / �/� , � / NO : . O STRE] �: BLOCK CORNER LOT: INSIDE LOT: %� SETBACR: ,�G2� SIDEYAR.D; ° a J Applicant attach to this form 1�o Certificate� of Surveq of Lot and propoaed building �ocation drawn oa these Certificates. To Be Used A�; HESCRIPTION OF BUILDING � � � Front• Depth: � �' Height. % � •�� ...�,..,. / � � Square Feet : lP Cubic Feet� o�%� 8 Front• Depth• Height: Square Feet; Cubic Feets 1�►pe of Conetructio :�.� Estimated Coat:_$ -�� 4'�� r -�-�--+�-�� To Be Completed: ,� Q The undersigaed hereby �akes application for a permit for the work herei,n speci�ied, agreeing to do all work in sttict accordance wittr tt►e City o� Fridley Ordinances aad sulis�gs of the Depas�en� of Buildinga, aad hereby declares that all the facts and represeatatioae stated in thie application are tstiae aad correct. � DATE r � � �.� � ,�� SIGNATURE : , (See Reverse Side For Additional Iaformation.) .�'� � y� �� -., �/ �9 ^ ��— er�.��/ � � � � o — � � �� 2 � 4 BUILDING PERMTT FEE SCHEDULE SECTION 2. '�h� Inspectoac of Building� sh�ll, before �.s�uing pezmit�s fo� the er�ction of a�y buildiag or st,c�ac�ure, o� fo�r axay sdditipa to �ay existing building or structure, or for any alteration or rep�irs to any existit�g building or stiructure, upon �pplication �herefore, �equire the payment�by the agplicant for such permit of fees to tlze amount� herein belaw set forth and irx the m�tuies herein prae�ide� to-wit : U1�IIFORZi BUILDIATG CODE o�►pe 1, 2& 4-$2.15 for e�ch oaie thousaad cubic feet, or fraction thereof, in such cubical coatenta. lqpe 3� 5-$1.85 for each oae thousaad cubic feet. ADDITIONAL INFORMATION For the purpoae af camput�ng feea for building p��cmit�, the cubical conteats of any building or additiau D is detexvai.ned by �altciplying the g$ouad area co�vered from a poin� �ix (6) inch� below tise flooa lixae of the bas�t at th� cellar to th� average heighte of gh� up�er s�a�faca or to th�� a�e�cage�+ �heiglat of the roof eurface of the m�in g�bl� of � pit�d rvof. For repaire or alterationm to �n �istiuu� �truc�r�a �th� f�e ��all b� at the rate of $3.00 per each fivre hundred doll�� ($500.00) or �xaction thernaf in the coat of all propo�ed work. . . Ia ao caae �hall the fee ch�rged for �uy p�x�nit as �et �or� � Sectioa 2 bn lesa th� $5.00. VARIFICA3°�ON OF FOiJAiDATI0A1 D�TE: ,Petmits for s�an�tructican will be iasued a m%a�i�m of 24 houre fsom ths ti�e of application, to allaw for paoper review of the propoeed s�ructura aad of titia commetsuctioa eitee A Certifi4d Suxvey of the lot, ehawin� t,iae location of the fouadation, once it ha�_�besa aonetsucted, will be requir�d before proa�edia� �ith tise fsamiag. CERTIFICATE OF OCCUPANCY Application for a Gertificate of Occupaacp �hall b� made ten (10) days prior �o tlne use or oceupan�y of � atructure for which a buildi�g permit ha� been ., �seu�d; and eaid qtructure ehall not be used or occupied uatil a Cartificats of f'tcc�peac� hae b�ex� iesued. w I 1 � � ' � �� ' � .1' � � � � �" �'a �,��' �ep7`G �ros7� /�7�9 � � � � � �� .� � � � � � � �� .V =:.� � .',� -.� c �. � � � �t � � � � � � �� Q- � � . i I i Land Planning s��i,t!,%L�� 68�5 Highway No.6S IV.E. Land $urveying � • • � Minneapolis� Soils -Testing �� / .) �� • Minn. SS432 Civil Engineering /�� " Telephone i84-6066 Municipal Engineering Engineers � SLiY'V@3%OTB Area Code 612: Certific�te of 5urvey for ,4L,��'�'L7 �J��G�1`./��1 25 � �� . S-- I; , � I�on �' Iron ! � 6 �I /� ?A' ` � II i, ; . � � i . a'1' Ov�rhdr►cj d I ' '. u ' �° ��, � • o' � r�'►dru� � {M, ! � � � � �► f \� a + `w � o � . � � ,�., � , —_ -�`a f' Q � � �i . � � v � • ' W G, �- � � � ' � �6. o , ;.. „ , t` r - -- - � . (�_i _ _ __ _. � ; i C`�� .F��d � L3� i I �� stq z � N / P� - � � � '. � N� � � � __ __ -_ --_�__�� — — �. _.._ ._._ _ � , � � _._ �: �� /. � ! ron 1►^on - I�ti.Cj-- 2"i • y� ki: .,: 1 � f:'..�. . . 1 � � �� e.. . � „ m . � O � , .� � Denoi°e� Dra�r�c��-��: � lU`�il►�t� �c�9evnev�►-� L4T �j , �L�C !� 2. , D�d�l '�' �' �1�� '� �� , 1 hereby ceHifY that this is a frue and correct represenfation of a surveY of the boundories of the above , doscribed land� ond of the locotian oF all buUdings� thereon� ond crl,l visible encroachments, if any� f.rom or on said Innd. As su�veyed by me this �O'�''day of Apri � A.D. 1970. 5U�UR8AN_ ENGINEERIN6� 1NG_:__,__-�-- _�-- _- - --� _ _ - --- -E,�g(�g.� � - f_-� surveyors - _ -- - -- --- - - - — - - ` - - r � �� - � %�s� i �� .=�� ' s / � dy �L.�S. � �c, L r/• . c: ��/6t � °1'� 5 . C. • r � sue�ecT PER City of Fridley o 2�669 AT THE TOP OP THE TWINS g U I L D I N G P E R M I T � � � EIPT N � ; L __�� COMMUNITY DEVELOPMENT DIV. r � PROTECTIVE INSPECTION SEC. /�� ',� � '_ ; / �l �"'1 � CITY HALL FRIDLEY $5432 NUMBER REV. DATE PAGE OF APPROVED 8Y L""� � ,'� 612-560-3450 910-F15 � � JOB ADDRESS �5Q7 Hayes Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO DESCR. 3 2 Don's 5th Addit � SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Alfred Jorgenson 7507 I3a es Str e 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sussel Compan 1850 Como 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING R2SICZP.T1't13�. 7 CLASS OF WORK �] NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Complete attached 24' x 24' Gaxage (Foundation slab existing) 9 CHANGEQFUSEFROM TO STIPULATIONS provide a hard surface driveway. SEPER�4TE PER�M�ITS ��t�QU�RED. FOR I�tIRtNGe HEATiNG, PLUI�fB{NG � ANfl� �S{C{�S. SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. WOOC� FL"�3IR@ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R�- ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 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 BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2�000 �..00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � �`I.�..00 � PLAN CHECK FEE TOTAL FEE 49 � i3y � Po��/ $12. 00 SIGNATUREOFCONTRACTOR RAUTH RIZEDAGENT IDATEI HE PROPER�Y VALIDATE HI IS Y UR PERMIT � 4.. SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BLD INSP nATE L APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME :��/ch2 ��6Hc,2.� sak. BUILDER: c�v � s.¢.X °C� annx�ss : 7�0 ? f��, es �7` �1./�'' annxESS :/,�sv CoY,•� o/�-�. NO•. STREET: LOT: BLOCK: ADDITION: CORNER LOT:. INSIDE LOT: SETBACR: SIDEYARD; Applicant attach to this form �o Certificates of Survey of Lot and proposed building location drawn on these Certifica.tes. - BESCRIPTION OF BUILLING � ` �� _ To��Used �As z �� f� 7�7`'a-�-� �,�' / � � `� - �:.j i� � � �, �" Front : a � Depth : j� - � Height • � ' Square Feet: Cubic Feet:, Front: Depth: Height: Square Feet; Cubic Eeet: Type of Construction: � ��"�- Estimated Cost: $ �� `` '�'�` �' To Be Completed: %D Q� The undersigned hereby makes applicativn for a permit for the work herein apecified, agreeing to do all work in stiict accordance with the City of Eridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE : �-- I I S IGNATURE : �- � 10-►�•-v (See Reverse Side For Additional Information.) / '.� ll `r � ( . - � ' � p .,,. - �, �' �° ' ' <� �� , � r� ._�� ' ' . � �UILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any additiou.to any existing building or structure, or for any alteration or.repairs to any existing building or structure, upon applica.tion 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: :� UIVIFORM BULLDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Tqpe 3& 5-$1.85 for each one thousand cubic feet. ADDITIONAL INFORMA'TION For the purpose of computi,ng fees for building permits, the cubical contents of any building or addition, is determined by �ultiplying the gYound area covered from a point si.x (6) i.n.ches below the floor line of the basetaent or the cellar to.the average heights of ,the upper surface or to the average� •height of the roof surface of the main gable of a pitched roof. For repairs -or alterations to an existi.n.g structure, the 'fee shall be at � the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed worke In no case shall the fee charged for any permit as set forth in Section 2 be less than $Se00.� V�RIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a minimu�m of 24 hours from the time of application, to allow for proper review of the proposed structure aad of the construction siteo A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceeding with the framing. CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupaucy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. � S � - •.'' �-�-a,s,l R .�: . T. : «r. . , . .�HE sussE� co. ` 1�850 COMO AVE. ST. PAUL ' CALL: 645-0331 � ermit by `=>� � �-'� � � Legal Description Lot T C�BIk ��" O�Add'H�"`� � r ~ O Value � Type Const, r f' n,"� i Slab: ❑ in �By Sussel ❑ By Owner Approx. 2-STARTINGS POINTS ONLY S. P. L. S. S. P. L. R.P. L. Alley • 7� � House F, Street _f��/' r r 1 �,�Cr. �� Qther O Sq�.iare With � � � ❑ Rods C�Mesh ❑ Sod Rem. • By �� o ►`' �-` 5•Bag Mix � .6•Bag Mix ❑,Tamping [t"� No Tam��i,n�g q't l� f�A.B.U.�`��' ,.� p Grade Point -B-�II�13IIff �' O. H. Dr. Offset �Z ' m .D. Location � � Bloc`ks ❑BPVavn�r–�By-Susse� Existing garage: No ❑ Detached ❑ Attached Yes Size oi existing: __ . x — Existing garage will be: O Left as is ❑ Converted to L.S. - By owner ❑ Removed By: Owner l7 Sussel [] Junk Musi Be Removed By Owner ❑ Specify other removals by Sus- SBI or oWner - trees, bushes, etc. O Show approx. dist. garage to house and all prop. lines Stakes visible • Cl Yes L� No Survey available - L7 Yes (> No � Special instructions from owner: . . .� .. ! • . 'e. . • . . � :e e . • i.`�^�' ?F ��+� : . � � P i � . e . . �1.,. . , r . , .. �� .. L.", 9�r� �.��''vi7. . WORK ORDER fJir��r �� r ) ';, ""Y.l J +�.i.',f.��(':.�r, �J• .=�, NAME PHONE #•' JOB ADDRESS � �n � ��.'' ;�'�-" �.: =- % NC BLDG CODE AREA l� �'�' (�LF' �� SALESMAN �� '-'% rA.? L(' ' CONTRACT DATE' �'.' 7''� SIZE��'� �� , FOR OFFICE USE ONLY CONTRACTOR JOB �# SUSSEL JOB # CONTRACT # ,uc� � � ; v�s � �;�, � . � �-, �� r� � LLt.:tc<.J ��-+^ F_' ,�% ��y<7�- %",� �C7 �9 (~ � /�J !� u � i�l� �� ! �' '� i`,t `°i� . PART OF Cf1NTRAf:T # —�__�. .] i� � ♦ � / `•�. I G> � '� `�-- ��_...�_.�._.... r � G •\ 7 �i_� � f-J rt I!�S r. . I •��ir ^.�_ nF, ^rt•r• .^,�;'�r-'t ir��?��( �� /arr:� In� .7��i r y.. C�nf �•;r.��.�� i-.,,►,r . b=c�yr• • _... . . ��'.-..�'1 %-�,��. �'.�c�°- F' rG :c _., l �c�r.al-iL�t�E'r? fj (. �r', � f 1 c >�.+ `'. .r- i � / �. � C /l r1 ?_:_! _�� 5�f' ...._.� -- `�' � � _. . � . � 6 e + DIRECTION SUBJECT P , City of Fridley 19450 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � r � � EIPT NO. � `L �_�_ COMMUNITY DEVELOPMENT DIV. �� f � � PROTECTIVE INSPECTION SEC. i1 ` � -.•_� ��'��,'� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROYED 8Y ti 612-571-3450 910-F15 5/6/88 / / 10B ADDRESS 7507 Hayes Street N. E. 1 IEGAL LOT NO. BLOCK TRACT OF; ADDITION SEE ATTACHED DESCR. 3 2 Don's 5th Addition SHEET 2 PROPERTYOWNER MAILADDRESS 21P PHONE D�n Park 7507 Hayes Street N.E. 786-5687 3 CONTRACTOR MAIL ADDRESS ZIP PHONE UCENSE NO. Roger Naidyhorski Const. 8155 - 59th Street North, Lake Elmo, MN �X� 770-3854 4 ARCHITECT OR DESIGNEH MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENOINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDINf3 Res identi al 7 CLASS OF WORK O NEW �J ADDITION �7 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 10' x 12' Three 5eason Porch.; l�side H�use; �;eplace window 8 CHAN(iE OF USE FROM TO STIPULATIONS See notations on plan �. SEPA�R�T� P'�FFMIiS REQ� � �� .�� C�d-� � '��n�"�� 9V+�i�f'h�1�, �i�9�Y�i59�, �°�U�� tu ��....'��y�� 3d , . .. r �� OG�i u�lilil�� eie,r� t1i��i��, GAS EtE• 6 .LEPIi�y� -'�-I.EC°TRIC�- �� a�� .. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NINf3 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOH A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STA�LS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUHTAX AND ,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S�-7 rSOO �`S. %S DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $IS9.00 %� C � ;PLAN CHECK FEE TOTAL FEE " � 'G � n. � $197.75 SIGN UREOFCON�RACTOR,Qi� AUTHORIZEOAGENT IDATEI WHEN PROPERLY� LI ATED THIS IS VOU�Pf ITA, (/ SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI BLOG iNSP p� 1�1 [ ] A�N [ l AL�R [ ] City of �idley R-1 AND R-2 Building Permit Appl ication EEfective 5/L88 Construction Address: /-S� � /� G� ��P S rs� �.�, Legal Description:_ Lo � � �% (� � �d � s''`� �t �� Owner N�¢ne & Ac3dress: � e�t ��r 6�°i T�. ��GS(�7 Coritractor: � �i..P� ��' �_ %� vs�{,�� Tel. #�7D3�'s'Y ��5: s'is�- �y�`� s � IU � � �f-� �' l � d � h , Attach to this appl ication, a Certif icate of Sl�rvey of the lat, with the prop�soed construction drawn on it to scale. ,J S--f c+ j a h �� N c� �Qt1�1� � I� -` Length �� Width � Height j�� 9q. Ft. �� D c�RAGE ARF�: Length Width iieight 9q. Ft. DEC�c ARFA: Length Width �_ Hgt/Groimd Sq. Ft. � �r8,:. �� d �G c --e � G r� --P � � � ' r.i�� i l��r� �e e � � �cJ �' h�o c� O�rner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks Type of Gonstruction: _ f�G �� '�.� N,. .� Estimated Cost : S%r%. .S'� o , Approx. Cflmpletion Date: �Z � 5��.�� -Le..9,� t?� x ��.�� .:�� A1t. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ Width + 6' See Back Page n�: S_ G �$��zc�r: 1�'� y l��. �� s K,' Tei. #%?Q 3�� QTY OSE 0l�Y Petmit �ee state surchar4e SAC Chatge Driveway Escraw Park Ftee Sewer Main Qzarge TOrAL STIPCTI,ATIONS: �p,.� $ � � �i� S � �� $ S S $ S � �� a`a� 3�� . �� ee Schedule on Reverse Sicle 5.50/51,000 Valuation 5550 per SAC Unit A�.� '�,° or Alt. "B" Above Fhe Determired by k�gineering Agreenent Neoessary [ l No� Neaessary [] � I�,��' �� l� �� '�.�� 1 �f'y l ��.�� M:=il-i�i� ' �:�� 4 a�� :�t:l��, ) �� The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the maruier herein pravided to-wit: R�'�AL VALUE FFES Sl to $500 S15 (Minim�n Fee is S15 plus surcharge ) � 5501 to 52,000 S15 for first 5500 plus $2 for each addi.tional 5100 or fraction thereof, to anc] includia�g S2, 000 52,001 to $25,p00 S45 for first 52,000 plus $9 for each additional $1,000 or fraction thereof, to and including 525,000 $25,001 to �50,000 5252 for first 525,000 plus $6.50 for each additicmal $1,000 or fraction thereof, to and including $50,000 550,001 to 5100,000 $414.50 for first 550,000 plus 54.50 for each additio�al 51,000 or fraction thereof, t�o and including 5100,000 5100,001 to $500,000 $639.50 for first $100,000 plus 53.50 for each additianal 51,000 or fraction thereof, to and including 5500,000 5500,001 to 51,000,000 52039.50 for the first 5500,000 plus $3 for each additional $1,000 or fraction thereof, to and including 51,000,000 51,000,001 a�d up �3539.50 for the first 51,000,000 plus S2 for each additional $1,000 or fraction thereof D�VEWA�► DE'PR�S?ON �,� (Concrete Curb Streets Only) Alternate "A": R�nwal and replavement o� curb and gutter omly - Driveway width plus 6 feet times 513.50. Alternate "B": Rc�naval and replaoemerit o�f curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. l+i��iaii��,y�� • " �a�.1��! � � • � Permits for construction will be issued a minimum of 24 hours f rom the time of application to allow for proper review of the proposed structure and of the wnstruction site. A Certif icate of S�rvey of the lat, shawing the location of the foundation once it has been wnstructed will be required before proceeding with the fraQaing. ' P:.. 1 _ ". "' _. "_' -_ __ . ' __'.�_�� .._ _ -� __ _"" ""� . _ __..� .._'_'_ . .. land Planning sf{�r'��{��, 6875 Nighway No.6S N.E. ( Minneapotis � lond Surveri�g �(l] ,,,��"1� r�j j�• Minn. SS4�2 Soils Te�t ing �� 1 Civil Engince►ing Telephon� 784-6066 Municipal E�ineering E�gineers & Surveyors Area Code 612 Certificate of Survey for � L. F�-�'-._ l7 ��L ��CE�`�-�`��=-��`J ,L ;, r_,� .... �t, e, .�: ,� J` ,� . � �; ,_ �` _ �-�►. 5 — .� . — i , { 1 � �. Eri,an�, ^.,� ri�c-rF�a•.., — ` N :.I,,� GV . (�, K; ,� �` i f -\. � � � 'l• '� � N 'r� v. :. . _ -� . .� fJ� � ' ��i� � � =Ii�o.G � 1 � 1 ( �}'lG �� d 1 i : : w . � �„r� P, t N �� - �� ' �r� � ` � -- - 1 - "''� '- -- -- --- -- - --. . .- - . - - --- - - -� t �G N i _, � 1ror� I � ?' � L1 � � I L-�C.� E.' { �� a o - 1�I.�j— �� `ircn �1 I O r f i ' I Iror, I - - Deno��e _; Urcainc:uaE:.. � l�i�►�t.� � ct�e�ti��tt J LOT � , (3LOC K 2 , DC>t`1 '� �� <'�t� i�` � T"I `7��1 s+ I herrby certify �hof this is a t►ue ond correct rep�esentotion of o survty of fhe boundaries of the above described land� and of the lotation of all buildings� fh�reon� ond oll visible entroachments� if any, from or on soid land. As su►veyed br me this IQ*� dar o/ Apr i � A.O. 19 70. Sll��U�R�AN ENGINEERING, INt. �". � -� - . - . � .. , .�;� �� - _ ;.,y.. t:�. , . - -- - �i i i .� _� Q ` o � � _` _ i � � � �� I � I I � � / � I � � a- �,-. � I �.. � i �� r� � 6� C � s � ? �' V � � � t — ; � � , 1 -------�- r. 0 � f \ E C . x �� r= � c ^ U (�1 � , S �; � , — ------ - � � -._. , . - -.. ._ — ',_� -- -- - y _- . � . � 1� j � •� � i 1 a� _ M , �. �, i � � � � �-: - - --� - - � - . ti � _ � �..�.__.�.� . .. __..- ---- ._�_._ o --�'' ;, _ � ° --- `' . � . ,- � � \d1 � ._� � � \1 � C ' 0 �C � � � T� C � � — � o � � �/ � � � -� r � �`.� o i ; � . SuBJECT ::�= �� City of Fridley � ^ j � AT THE TOP OF THE TWINS gU I L D I N G P E R M I T +�� '� � � ,.;-�,`: - -��y. ' ; � RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. i 1 V ��, r � � PROTECTIVE INSPECTION SEC. ��/ t i � ( �'��1 � CITY HALL FRIDLEv 55432 NUMBER REV DATE PAGE Of APPROVED BV �""� � �'' 612-571-3450 910-F15 9/13/94 / / JOB ADDRESS 7507 Hayes Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 Don's 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Don M. Park 7507 Hayes Street NE 786-5687 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION O ALTERATION C] REPAIR ❑ MOVE ❑ REMOVE X B DESCRIBE WORK Reroof House & Gara e(16 S uares) 2nd La er 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK Ofi CONSTRUCTION ZpNING SQ. FT CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT ANY TIME AFTER WOqK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ], STALLS GARAGES AND KNOW TNE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �SSO.00 . SO �OES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �L3.00 Fire SC . SS PLAN CHECKFEE T07ALFEE 24.38 �SIGNATUAE OF CON'RACTO AUTMOAIZEDAGENi IDATEI WNEN P Y VA ATED THIS IS VOU PERMIT �� %L� � �,,�,�L ��, I �°e��' `' S�GNATUR� OWNEA UF OWNEA BUILDEAi IOATEI �DG �N50 q4TE l- NEW ADDN ALTER [1 {� [l Construcdon Address Effective 1 / i /94 CiTY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-Z ��(� �� Buitding Permit Application `�� p 7 �� y�.S -S r s�i b �% 1J c� �j {'�l �.J ��^�"`{ �'L Legal DescripNon: Owner Name & Address: I..� r n{ 0`�1 ,��} �z i�c ��'� � yEs � � � �_ Te1. �°7 �� s'� �' 7 Contractor: �� L� L,2 N F� �, t� y t-r� 2 s ��c i MN LICENSE # Address: Attach to this application, a Certificate of Survey of the 1ot, with the propose,d consri�uction d�avm on it to scale. DESCRIPTIOAT OF IMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA; Length Width Height Sq. F� DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: ('��rz.,:'o � c�,�sL�- �` C��gc !G s� �� c�,�,� �,� y�2 Com�c Lot [] inside Lot [] Ft. Yd Setback Side Yard Setbacks Type of Construction: � S�i-i-� i Estimated Cost: $ v�C! G� Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Ne�ed: Ft. + 6 Ft = � x$ _$ DATE: �l - i � - �i y APPLIeANT: '�--�-� � � � Tel. # `7 � ' �G �� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ �3. c�r � �c $ , , L� $ - �� $ $ $ $ $ $ $ �y. �,o Y11 � . F� Schedule on Reverse Side .001 of Permit Valuation (1/10th�) $.50/$1,000 Valuation $$00 per SAC Unit $S.(m (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.(� Conservation Plan Review Fee Detertnined by Engineering Agreement Necessary [ ] Not Necessary ( ] BUtLDING PCRMIT FEE SCHEDULE "1'hc Chief i3uilding Ofticial shatl, l�efore issuing permits for ihe erection of any building or siructure, c>r lor any addition tc> any existing buiiding or structure, or for any atteration or rcpair to any existin� l�uilding or su-ucture, u�a apPlication therefore, require the payment by the ap�►ticant for such �ermit c�f fu:s tt� thc amc�unt tierein f�elow sci t<��ih aad in the inanner i�erein Provideci to-wi�_ "1'O"I'AI_ VAI.UE � i c� �soo $SO1 to $2,000 $2,001 to $25,OQ0 $25;001 to $50,000 $50,001 to $100,000 $10�,001 to $500,000 $500,001 �o $1,000,000� $I,OOt},001 and up r-r_cs $15 (Minimum ITce is $15 pius s+urcharge) � 15 for fizst $500 plus $2 for each additional $ t00 or fraction thereof, to and including $2,000 - $45 for fi,rst $Z,OpO plus $9 for each additioaal $1;0�0 or fraction thereof, to and including $25,Q00 • . $252 for first $25,00p ples $(.SO for each additional $1;OOQ or fradion tfiereof, tp. and inciading $50,000 -. $414_SO for first $50,00p plus $4_SO for each additionai $1,000 or fraction ti�eof, to and including $100,000 $63950 for Srst -$100,0(� plus -$3.50 for each additional � $i,000 or fraction th�eof, to and includiug $SOt3,000 $203950 for the first $SOO,ppQ plas $3 for each addirional $1,000 or fraction thereof, to and including $I,IX}0,000 $3539.50 for the first $1,000,000 plus $2 for each additional $1,OU0 or fractioa �thereof - DRIYEWAY DEPRESSION ESCROV� (Concrete CS�rb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $I3.50_ Alternate "I3°: Removal and rep(acement of curb and gui#er and install a 3 foot wide approach with 6 inch depth -�Driveway width pius 6 feet times $15_75_ VCRIF[CAT[ON OF FOUNDAT[ON Permits for construction wi(1 be issued a minimum of 24 hours from ihe time of application to allow for proper review of tt►e proposod �cture and of the construction site_ A Certificate of Survey of the lot, showiag tlie location of the founciadon once it has it has been conslructc;d wi(1 be re;c{uireci i�efore nroceediag with the framing_ ° -.� Building Inspections 763-572=3604 DATE cS~`�S�O SITE ADDRFSS �� THIS APPLICANT IS: PROPERTY OR'NER/ TENANT CONTRACTOR BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS s�-. ❑ OWNER �CONTRACTOR ,. ✓l. '� c 4,� - Permit No.: Received By: „�+1��C'DaM ADDRESS: CITY STA7'E ZIP PHONE: d- SUBMIT A COPY OF STATE LICENSE #'�O�o�(!v �J`% EXP DATE �'!�$ YOUR STATE LICENSE ADDRESS: �',�i (o �`�- A-L.e �' CITY Lt e�o� ' L STq7E� ZIP� VdITH APPLICATION PHONE 7$3 -°7�(0 � Q��L FAX %i� �� $/� PROPERTY TYPE SINGLE FAMIL' O TWO FAIvID,Y/f PERNIIT TYPE TYPE OF WORK: O BASEMENT FINISH ❑ DECK �] DESCRIBE WORK BEING SIZE OF IlVIPROVEMENT oR OF1NG NUMBER OF SQUARES GARAGES � � �/J PROPOS£D SIZE: T� PROPOSID HEIGHT: SmIlVG ❑ Vinyl ❑ Alumimm� ' ❑ Other . WIIVDOWS IN EXISTII�IG OPENWGS'f"�i'� DIdo OR FOR NER/ OPENINGS-DESCRIBE SIZE OF OPEND�iG CHANGES & TYPE OF WIIVDOW TO BE IldSTALLED �d'ROQF ❑ SIDWG O SWAM�I�JG POOL U � HOUSE & GARAGE O ATfACI�ll GARAGE O DEfACHED GARAGE ❑ DRAIN TILE ❑ OTHER OSoffit � ❑ Trim ❑ Fascia � (� F.�°-�' °e `'�°� S �.�.��. �l�a� r HEIGHT BASEM��1T REMODELING SUBNIIT: I. F.xistiag Floor Plan 2. Proposed floor pien 3. List of structaual mpmbers to be used F� FOR NEW CONSTRUCTION MCLUDDdG DECKS, ADDITIONS_ & PORCHES SUBMIT• 1. Site Plan/Survey showing �e existing struchues � ProPo� ProJ� 2. Two sets of construc�tion pians 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ %, �j'1�g OCCUPANCY TYPE Permit Fee $ /5 �j, o�S --- Plaa Review $ Fire Surcharga _ $ %- RS Surcharge � _$ �i - �% � License Surcharge $ ��. OG SAC Chalrge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ �'%(�, � 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 Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks paya6le to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-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 Friilley and with the Minnesota Construction Codes; that I understand this is not a permit but only an applica.rion for a permit and w k is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work hic requ' vie d approval of plans. SIGNATURE OF APPLICANT PRINT NAME ��t � DATE �� ~I Page 2- Building Residential Agplica.tion BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any buildi.ng or structure, or for any a.ddition to any existing buildin.g or shv.cture, 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 tawit: ' VERIFICATION OF FOUNDATION Permits for construction will be issued a min;mum of 24 hours frorn the time of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of t�ie lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv City of Fridley Buildin.g Inspections Departrnent 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977