AF - 47074c�ty of Fridley
AT TNE TOP OF TME TWINS
r
� �' COMMUNITY DEVELOPMENT DIV.
� ; V ��.�� ,
r � � pqOTECTIVE INSPECTION SEC.
� � �"'1 � CI7Y MALL fR10lE� 35�32
�'""�" ��� 763-571-3450
SuB�ECi
BUILDING PERMIT
NUMBEN REV OATE PAGE O�
9to-F�5 10/9/02 / /
JOB AODRESS 6201 Heather Place NE
/ LEGAI �OT N0. BLOCK TFACT OR ADOITION
oesca. la, lb 1 Heather Hilis North Plat �
2 PAOPERTY OWNER MAIL ADORESS Z�P
Michael Sherman
J CON7qACTOR MAIL ADDRESS Z�P
Meadow View Homes Inc 14621 Aberdeen St NE, Ham Lake, MN 55304
� ARCMITECT OR DESIGNER MAIL AODRESS Z�P
5 E
MAtI ADDRESS
33151
RECEIPT NO.
���!
APPROVEO 9�
SEE ATTACHED
SMEET
PHONE IICENSE NO
757-7320 20024837
PMQNE LICENSE NO.
ZIP PHONE IICENSE NO
6 USE OF BUILDING
Residential
7 CIASS OF WORK
� NEW 0 ADDITION ❑ ALTERATION O REPAIR O MOVE D REMOVE
8 DESCRIBE WORK
Construct a 46' x 51' Dwellin�; a 34' x 22` Garage; a 14' x 12' & 14' x 8' Deck
9 CHANGE OF USE FROM
TO
STIPULATIONS See notat�ons o:� p�an. Submit a verifying survey before cappiag. Prov�.de
a hard surface driveway. Provide sod ir� the fron� ar.d side yards. See City Engineerin
Department for sewer and water locations. Place silt fence a�oag west property Iine.
Grade swaZe a�ong east property line to drain to rear and to curb. Keep erosion
o�-site. ! Clean street if necessar5�. Scd and stake swale. Paid park fee of $1500.
SEPARATE PERIMlTS
REQUIR� FOR:
� � an�Q��S
����'�
B��� �
di88��g �11 for
a�� ��nY �ocations
������ �002
�X [.AMr
TYPE OF CONST
SEPARATE PERMITS ARE RE�UiRED FOF EIECTfiICAL. PLUMBING, MEATING.
VENTI�A7ING OR AIR CONDITIONING
THIS PERMIT BECOMES NULI AND VOID If WORK OR CONS7RUGTION 20NING
AUTMpRIZEO IS NOT COMMENCEO WITMIN 60 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONEO FOR A PERIOD OF 120 pAYS A7
ANV TIME AFTER WORK IS COMMENCED NO OWLG. UN175
I HEiiEBY CERTIFV THAT I HAVE AEAO ANO EXAMINEO tH1S APPLICATION 1
AND KNOW THE SAME TO BE TqUE AND CORRECi. A�� PqOVIS10N5 OF IAWS y��UpTION
ANO OROINANCES GOVERNING THIS TVPE Of WORK WILL BE COMPIIED � 149 305
WIT►i WMETNER SPECIFIEO MEREIN OFi NOT. TNE GRANTING Of A P�RMIT s
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEpMIT FEE
PROVIS ANV OTHER STATE OR IOCAL LAW REGULATING CON- @
STR ION OR TME PERfORMANCE F ONSTRUC710N �p1�273.%S
Q� ^� PLAN CMECK fEE
G
/ Lic .se S(
S�GN�TUp F CON'AnCTOR R AUTHO IEO AGENT �OATE� uc em
N4TUAE O� OWNEA ��F pWNEp BU�IDEp� iO�tEi
STA�LS
$5.
GROUP IOCCUPANCvLOAD
CU R
OFFSTREET PARKING
IG�AAGES
SUFTAX Fire SC
$74.65 $149.30
SAC GMARGE
�1�2��.��
TOTAL EE
$2 02.70 + PF
D IS i5 VOUR PERMIT
�/a_-�r'.,��
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AaaN t3
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Owner Narr�e b AQarae: _,�._ Tei. s,�� 1� 'i,��c r�-.:---
Contrxtoc �• � INN tJC�19E * a c�tla �l �� �
�: � Y�. � ���- ��a c�
'�� ?Ag
atmG, ro thi� �ppr��ic,�ti _on, a ce�t;�ba o1 swwy af che ,
lot, with the propa�Qd const�ucdon dr�Mm ort R�o �cale,
CITY OF FFifOLEY Efhctive 1h/200Z
Q4S1 Llniwrsi�t Ave 1�„ f�idl3y. MN 86432 {7t1) Sn�iO4 8id� i�tsp
�iNG6L FAWLY At�D OUPLEXES R-� AND Rr+Z
�UItDtNG PERMITAPPL.IC�1Ti0N
:��.5����17� /$/o DEBCRJPTION Of M�A�C�
� I sT �.�.,� /8z8
ww�,u�►: �a, � w� s� H.�a�;.,�..... �. � -
oaw►� �►: e�n % wiacr �� �r�e� sa. �. � xd�.�7. �,��
oECKa�en: �+1'��. .,._ wra�.,t y ��� �. �. atlox,�=�•�
o�t: / 8 . �� s-
- /�� x.S� .7G = /a3, �57. s�s
. Cn+�ruction Typs: �T lh [�lo �A v� i� tA � C��stknate�c��ost i����' ��`�.�G3. i'°
„ .. - � . � ..._
Drivaway C►'urb Cut Wklth Neotbd: _�t + 8 Ft • Ft x 3�, ■ 3
c��: 9_ a,� �ucntvr: To�. � �ti 3-��-7� C�
Cai �T�j 6'1�r3Q041ot PMr11t F�N U a1a�f in appt vr R 71f�71-1�'1 If Winq d�dit eard a�fd Wo vrql
cati y�ou Tor card numl�a
CRY U8k ONLY -
P�mit Fea ��� 3. 7S'Fes schedub on Revarse side �
. l�. 3 0
Firo Surcharge � .001 ot Pen�nit Valuallon (1110th9�6)
s� s�,rc,�e � �� � s- �.sas�,000 va�uAtt�
s�ac cnsr� s i.rAO. � s�2oo �ersac u�
License Sun:harae S�� �5.00 (St�t�e Lioet�ci R�ider�is! Contractors)
Dctvev�y E.�a�ow S Alt, 'A" or Alt "B' Abcrve
Eroabn Control $ $45Q.00 Consenratiat Plan Revlew
Pat1c Faa 3_�l.S"d0. � Fee Determlried bY�EngMee�in9
Sew�er Main Charge $ Aproement Necessary ( j Not Neoea�ry ( j
'toTiti s • � snPUUroNS:
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NE1M � �
ADON ( ]
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CITY OF FRIO�EY
d431 Univrrsity Ave NR, �idlyy. MN 6d43Z
�IGt4 RA�AIi.Y � DUPLEX� R�'I AND R�
. - , ; ..,. .
_ , , ... .. . . .
SUB�CON�'RA.C'€OR �LIST� � .
Efhctiv 1/1/20C2
i�a) �.�o� aa� �,.p
Address � � 6 � `NC.�1. „ChD 1�' �r�► ��Q � Pe�miit # � . ' .
Qeneral Contractor r�eadow.VieW �I�oc�ies•, : In�yyn6�'• '' Jeffrey �L. �n�z � •
'Plumb(n� Contractor � .� ,. . . � .. .�db 'Garin Rliuqbirig;, Inc:. • � � � -
•Heatin9 Contractor : � . : • A:ir .rie�Yianical, �Inc. � ' � .� .� .
'Sewer/Septic Contractor � � � . casper�•s bccavating,� I�ic._.� • , �
`Water Contracfor � � � � �sper��:s Elccavating, Inc.%R•.A..•'t�lacGlov�r Constn�ction
� � � . � � CQridor ' Fi rep��ace and $tbne � ' . �
•Fireplace Contracto� . �. � . .. . . . . � �. , . .'. .
''Lawn S�rinkler Contractor. . � � . ��A�' � � � � �
. . . . � ��A . • , . • �
'Swimming Poo1 �Contractor � � � � � � � ' � . � � . �
Excavating Co�tractor �� � �sper•'s �avatirx,�; Iric./1t:A;.• MacGlover Coristniction
. •�
Masonry Contractor ,7.z.� Masonry,. �.Ync: , ' � � . �
lnsutation CorltraCtO� . : lJord'ic��In$iilation; Inc: . � . , • • . , . �
�.-:-` � . .
. , ,
Blacktop Contractor ' , . : �ino-Lalces Blacktop, Inc. . �
� .
Stucco Contractor � � � . � � � . �. N�A. .� � . . .
Roof Contractor . . � �riors .by 'Wendell ' ' ' . � ,
� '.�� ' . . • • .• ��' � .. �
`�eparate permits are r,equired. , � �. . - � � � . . � . � � � � �
N�TE: ALL oontra�tars must be.licensed �a�d InBUred.� � ,'. .
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Ai,TERNA,TE
O�tE & T'�'VO FAIYIIL'Y D'��YELi,XI�TGS
..�5'1'Rl'CTIO�S: Thi� ��Itern:�ti�•e m:��• h�� uxc�! fur onc- utid t�+u-frniil�. d��•e1linLs built tu oiert th. C:it�y�nr�' I requirem.•n,, u,
�linncsot:i ltulet, Chaptrr 767U. Complat�� I'arts A. [l. and C. Cl��arl�• m�rk plans �►•i�h: in�ulation R•�ala;�t: ��inJ�n� anJ �k�I�.��c t�.
,�lu�s; �iza and q�pe o�' equipmant; �yuipmtnt cunu�lt: ancl Iocation o�' vapor rvtarJ��r und ��•inJ��as:i barricn. ��I�r� .!::.,ilc�
,nrorma�iun can bt tound in the ,1li�u�d�v�e E����r`r�C'u�/.� summaryr sl�a�•tt u��ail�bl�• I�om th�� Alinn�suta D��pazm:r.t ��t C�m:��.r��
l'art A. BUIi�DYNG �N'�'E�Op� �
't�e:i: propoted er.velope joint sealinr optton -�1 Q�Pr.tcripii�� I�aulkiny. �atk�is. �ic.) O I'.r�;�rm:u�.� �iett �r 7u'u.u�'�i �unp '.0 )
'hc�k iher���l en�;rgy ca��:.d;,tiu� optlo� usel � �{ "Cooklwuk° I�omplot. ���orkthc�t belo+�-) O AlnCheck metho,l lou:kh rop�nl
O I'�rl'arn+an�t (�ttach U•��alu<<rkulationt) O S�•tt�ms ��n�l��sit ni���h��.l I�ua�h �nai; s�;�
�`Coo;:book" �'�'or.l:sheet
::p I
.�:�i ?.
.�;r �
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,
I ��TNUCTIt i��
(;h�rk iwm'l�) �h:�t Jcai}n m�ctt un .11i�tuutuu k.•yrur:��::�::� lial
t�� the �iyhl 11ust m�c� �II il.ms w u:� "C'uukhual" u; u��n
InJi�ate �ru�.rt�J ��all t�p� un tabl� hcl�����
InJi��lo 11'inJ���� U•�•�lu� unJ Suu���.
vcrilj iuwl ��inJo��• IinrluJin` ar�•r ul'all (�wnJatian�+�inJu��xl
anJ du��r ure:� ii eyu;,l ur Ivs3 than allw�aM� �n�nu��.
T.�DLE FOR DETER:�II�l�G �►1.�:
�;�eimum AI►o«•abtc Total IVinduw an Duor Arca as
f'crcrnt�&e of CxposeJ 1�'all t:% t�%
'al: i ypc (SfandarA Fr�min�):
� I�a. R�I) intulatiun. 2 It•7 shcstl
1 ?��. R�:•: intu:a:ion. _�::•: ah�ad
�?�b. ft•I� insul�tion.: R•S sh�atl
t ?s6. R•I�l in�cula�ion. � IZ•S >hc:��l
� ].�6. IZ•?: ina:.l�tiun. � R•S �h��tf
' ?�h. I<•:I IA>uI:1lIJ11. 2 �Z•� >�I�:IIf
111 }pc (AdvanccJ Frsmin�):
?.�6. R•I') insulatiun. < It•S �h�ach
?.�G. Il•I') inxulali��n. : (�•3 thvsth
i?�h. It•? 1 in�ulatiun. < I�•S �I��1th
?�r,. It•31 ina�l��i�n. 2 It•3 sh.ath
\Yinduw U•►•alu�:
10�X1 SS�S
���indo+�� � door art�
lJ1UAI 11'1:
I 6•/.
�.�.. . ...-.,. .
O.i I 0.�� 0.3J
o.sa n.su o.{a
M�eimum �vcra c 1ti'indow
• O.S2 O.JS 0.39
O.SS O.SU U.Ja
U.SS U.J7 0.�{!
0.60 O.S? , O.d6
5ounc:
18•/. I 20•/.
2�:,� I:,•,. � ��.,. I z8•,�
n w•indoK•t):
0.70 0.?7 0.23 0.33
0.2i 0.?6 0.'� 0.3?
O.I6 0.2.1 0.?2 0.? I
0.71 0.2�t 0.36 0.?�
0.25 0.?S 0.33 0.3'
0.]� 0.?9 6.?7 0.:5
7
. Q AStlfti►!� Ifr93 tlandb�ok
� � - o � '1- �i
� grua� ear 3 ��•all �rea ES A 0��'�18LE (from table �bo+•��
2
v11NN�SOT.�1 �NERGY CODE - WHICH RULES MAY l USE ?
T1'NE OF RESIUENTl,�L BUILDl�C
Uccachcd IZ•3 oGCUpancy !•pnd 2-f•rmily d»ellin�t
E�amplct: sintle f�n�ily, t��fn homc3. duplexcs
,��taclirJ !t•7 oceupnney dwrllines
C��mpl.�: tripl�x w���nhousct aitJ t���• hou;:;
i;•t u..up:�nr�� builJiu�t uf.! sturict ur Itts
I:� �r:�;�le� .unJ.�:i::niu:ni u: :iparunen:i
:c.l �,:�up:ut.; buil�lin�i u►et.1 swrie, hi�l�
APYLICAI3LE RULES
:r 767?: �r
:r 767u "C�t��on• I" ��•ith statuwn d
Ch�; �:r 747U �+ith eith.r "�'s�
Ch:; ::r lu1•1, .nr
�r:.:-•. •u'il t�ilh�•i:l::r•'l':�:
- -p -
1•.�... • '�1'�i
1" Ot
ui�A a.'k! �en1i13tiJn
3" c:��:tiunt
(' ur "�'�tr..�n :" ;:..•r..•i::
-- _ ' �l.s:
. �I•r .x�. .UEP�RESS �J12IZATYO�,T pROT�CTIOI�T
,:��� ��ri�n uccd: � p�t��l'��ir��;��� �auipment (��+�i�i�•te schedul�s bclo��•l Ca �'u fi���l burnin, eauinm�nc �
, ---_
-_.�
�"�k� ����`��� EaFIAUST! A1�KE•liP A1R SCHEDULE•
�::�� I. Cumpl�t� di� ('r,�uhr�.,viu�� f;�rri,�u�.vir,5�/�.�.(�,/: h��loa•. Onl�• c•quipmene Exhnust devices o�•tt ]00 ctiu � Fla►►�
��•ith � ti' (Y���) nta�� hc scl��t�J und�r th� "Ca<<s�ryl" altrmat�. cfr�
i;:p _'. Compl�t�• Frli<<��.+�•<</:�,(��•u� .{i� Sch��clule on �he ri;ht iYdir�ce or pa+�•�r • cfm
vc�ntad or suli� I'ucl atmo�phc�ri< <•cnt spac�� he�ting equipn�cnt is s�I�ct�J. I. cfni
C�,� � 5�� � C0,118UST10.�' �QUlP�1IE�\'TSCHED
` (check nll types proposed)
Spa�t hc�cing - non�olid fue! Bl Scalyd co�iibustion • Y Htlrtli - nn s
11'ater
' If umc
flow is
� h �/{�M lYr1
O Dir��cr or pu+vtr �•rnteJ Y•
Aemos hericall venre� N
- nonsolid Cu�l (� Saal«! c�n►buttion Y Sp�ca heatinr - solid fu�
� Diract o� u��•cr �•eqc�J Y 1Yactr heatin� - solid fw
Acmosphtrically venced N Hearth - sol d fuef
erically ti•rnted sulid turl or direct or po»•rr vent�d nonsolid tutl sp�ca h�st��g
aired fer each individuai e�haust davice ++•hich exceeds 300 cubic frtt prr minute.
Part C1. '��NT"YLATYON •
0
O Sealcd ca;nbustion 1'
• O Oi�ect o� pu��•er vtattd Y
Atmos hericall � venred �
I 0 A�mus hericaU�• �•enc�d Y'
I O Atmot hericall�• vsnted Y
O Atm�sphe�ieaflv �inteJ Y
s lnscal�rd, then make•up air co mzccti
VE��TIL.�TlOV QUA�TlTY
(lvlech�nical vtntilotion must be provided per tl�a luger quantiry ealculaeed belo���)
I� 9, �� g 1 cub(c tcct x 0.00383 lminute •�� cfm (� s IS ctm/bed�oom) t 13 cfm �
olumt of habitablt rooms ' nurttber of bedsooms
`�. 0 v� M wr
heek method(s) propused -�
�n aeseripuon or location -�
ENTII,ATION latak
i DESIGNED Exhau;
7 S cfm
YENTIL.1T10,V FAN SCHEOULE
O E�haust o�ly � Balanctd (I�tat reco��er�• ventilator, air e�cham:er, ete.) �
Ma��-c� ►3�.¢- Sc cw Q,,. �, TOTALS
s-v ctm
c 3 s cfm
S c
. �
crm
ctm
�rement of Conipli�nce: Tl�e p�oposCd b�ildin, dr;ign r��prestnted in �has�� docume�ts is contistent ui;h �h� buildin= plans.
:c�!�ca��c:^�, ora uth�r�:alrulationt submiucd ��•ieh the permit apPlieation. Tht proposed buildinY has bren de�ixn�d to mee� the
.�uircmtnts ot the hlinnasot� E�trgy Codr. •
� r; cr.... ����- �-- _.._ u �7 G 3- y s y• 7� y�
�plicant (print nam�) SiSnatute — Date• ,. Telr�hone numbtr
�i rt C2. '��NTI�ATION (Submtt P:irt C2 upon comnletlon ofs�•sten� �•critic:►tiont)
Sic: :�;lJr�ia: ' • pcmiit Kur.�c;-
�
Jc;crip�ion or location
.�SUREO latalcC ctin C
:FORhJ�NCEt Exh�usc cfin c
1�encilacivn race muse ba measure� and vtrilird +vhcn the perfurma.
ot' j�inrs �n tht buildin� conditi�na�i en�•rlupe (t�om Part :i).
crm c
cfm c
use� in lieu of tht prticripti�
t TOTALS
! crm
� ctm
:tion tur tltt stalin�
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NEW [ ]
ADDN [ ]
ALTER [ ]
CITY OF FRIDLEY
6431 University Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�Construction Address: ��� -� � c e
�� ��7�
Effective 1/1/2003
(763) 572-3604 Bldg Insp
(763) 571-128T Fax
Legal Description:
xOwner Name & Address: � w i(;c;.v �owc�. � Tel. #�,s.�-7S7� �'3a o
Contractor: � MN LICENSE #
Address: Tel. #
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT "
Length Width Height Sq. Ft. "
Length Width Height Sq. Ft.
Length Width HgUGround Sq. Ft.
Construction Type: Estimated Cost: $
Driveway Curb Cut Width Needed:�Ft. + 6 Ft =�o2Ft x$ _$ '�' ` 1�
�
DATE: �`� 0 APPLICANT:,,,�� ...,i�'D Tel. #��� --So/ —41��
� � .
Call (T63) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$
$
$
$
$
$
$
$
$
CITY USE ONLY -
Fee Scheduie on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation �
$1275 per SAC Unit � �
$5.00 (State Licensed Residential Contractors) Z
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ J Not Necessary []
TOTAL $ STIPULATI�NS�
,
, ,
, .
, �
,
� .
�
: `
(�----1
2b�
_
_
C[lYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
May 1, 2003
Meadow View Homes Inc
14621 Aberdeen St NE
Ham Lake, MN 55304
Re: Final Inspection at 6201 Heather Place NE, Fridley, MN
Dear Sirs:
A final inspection was conducted on May 1, 2003 for the completion of the dwelling
at the above address. The inspection noted the following items that need to be
completed before the permit can be finaled;
1. Provide sod in the front and side yards by June 1, 2003.
2. Provide a hard surface driveway by June 1, 2003.
We will expect the above items to be completed on or before the scheduled date
and a reinspection called for. The dwelling is approved for occupancy.
If you have any questions conceming this matter, please feel free to contact me at
763-572-3603.
DJ/mh
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 l�'AX:
: 6201 HEATHER PL NE
: T000064
: HEATHER HILLS NORTH PLAT 2
: LOT lA BLOCK 1
: ELECTRICAL
: RESIDENTIAL
: ADDITION/ALT'ERATION
571-1"lif7
PERMIT NO.: 2004-01753 ��a � r
DATE ISSUED: 10/05/2004
VALUATION .
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL A SAVERS SWITCH.
# INSPECTIONS 1
APPLICANT
HUNT ELECTRIC CORPORATION
2300 TERRITORIAL RD
ST PAUL, MN 55114-
OWNER
MICHAEL 5HERMAN
6201 HEATHER PL NE
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
application and know the same to be true and correct. All
provisions of laws and ordinances goveming this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date
ELEC PERMIT FEE - MIN (RESI)
STATE SURCHARGE, ELEC FLAT
TOTAL
PAID WITH CHECK # 118132
S�;PARATE PERMITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE.
20.00
0.50
20.50
NEw [l
ADDN [j
ALTER [ j
Construction Address:
� s
�
�1 �ii�
CtTY OF FRIDLEY
6431 University Ave NE, Fridley, MN 55432 (763) 572�604 Bidg insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
�
�C -�
Legal Description:
Owner Name & Address: I� � r� Tel. # 1�" �� :�Z��%��
Contractor:
MN LICENSE #
Address: Tel. #
Attach to this application, a Cert�cate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LMNG AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: G, t1'i�
�,.— _
� I v a�; cSZS
Construction Type: �ri�rn�,�I� >`Jl>,t�� Estimated Cost: $ �,
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
� ���-- � �%
DATE: � � �� � � APPLICANT: ' Tel. # �� `- �%
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763�71-1287 if using credit card and we will call
you for carcl number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
�
$ �'cir
$ ,40
� 2� �
$
$
$
$
$
$
CITY USE ONLY -
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th°lo)
$.50/$1,000 Valuation
$1450 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 [ ]
TOTAL $ � I��S• CD STIPULATIONS:
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COUNTY 0F ANOKA
Public Services Division
H{GHWAY DEPARTMENT
1440 BUNKER LAKE BLVD. N.W., ANDOVER, _MINNESOTA 55304-4005
(763) 862-4200 FAX (763) 862-4201
October 28, 2005
Kim Miller
6201 Heather Place
Fridley; MN 55432
Re: Unauthorized Work In Anoka County Right of Way
Dear Kim,
It has been brought ta our attention that work within Anoka County Right of Way has
been done. An Anoka County Wark Within County Highway permit has not been issued
for this work. Anoka County does not allow rock within the right of way, this rock shall
be removed immediately and the ditch section restored to match existing depth, slope and
grade. Anoka County owns 50 feet of right of way east of centerline CSAH 35 (Old
Central).
If you have any questions feel free to contact me at 763-462-4216. �
Sincerely,
-- 1,, �!��%�/' �
Randy B�ttinger `
Traffic Engineering Caordinator
Xc: . City of Fridley
Terri Klein, Permit Technician
_
Affirmative Action / Equal Opportunity Employer
:_:.� ::��.
_ � ,:�,�,.�,�..�
Building
Inspections
763-572-3604
DATEz, ) 1 1 `V��'
SITE ADDRESS �
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
❑ OWNER �ONTRACTOR
.,
Pernut No.: 7 - D�
Received By:
D���IAY 4 200%
ADDRESS: CITY STATE ZIP
PHONE: �SJ � �_�- � � �
NAME:
STATE LICENSE #_
ADDRESS:
PHONE
FAMILY/NE�
Renewal By Andersen
1920 County Road "C" West
Roseville, MN 55113
License #20130983
651-264-4777
O ADDITION ❑ GARAGE/S}
❑ BASEMENT FINISH ❑ ROOF
❑ DECK ❑ SIDMG
O SWIMMING
DESCRIBE WORK BEING
SIZE OF IMPROVEMEr
ROOFING
NUMBER OF SQUARES _
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
O Aluminum
❑ Other
WINDOWS
IN EXISTIIJG OPEMNGS �Yes ONo
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED IvUMBER OF WINDOWS �
ALL FEES ARE BASED ON VALUATION,INCLUDiNG THE COST OF LABOR A1�iD MATERIALS:
TOTAL JOB VALUATION S N�Taa� U.B.0 FEE �CUPANCY TYPF
C�1
LENGTH
❑ HOUSE ONLY
❑ HOUSE 8c GARAGE
O ATTACHED GARAGE
O DETACHED GARAGE
❑Soffit
❑ Trim
❑ Fascia
LOCATION OF WINDOWS
f STATE ZIP,
❑ DRAIN'I1LE
O OTHER
WIDTH
Ft.
BASEMFNT RFMODELING SlI�3MIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION [NCLUDiNG DECKS,
ADDITIONS_ 8c PORCHES SUBMIT:
l. Sitc Plan/Survey showing the existing structure
and proposed project.
2. Two sets of consm�ction plans
3. Energy Calcuiations
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Cwb Cut Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
TotAI Due
$
a .o�
$ o`�.��
S S. (5�
$
$
$
$
$ � .
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)
$1550 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 payable to: City of Fridle Att�c6
TH1S IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be 'v
conformance with the ordinan and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not ;
permit but only an application r a permit and work is not to start without a permit; that the work will be in accordance with the approvec
plan in the case of all work w h requ' view and approval of plans.
SIGNATURE OF APPLICANT RI T NAME ►� pq'I'E �