AF - 47099'~ � : : �,� _
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` ��TGiNEERiNG Co. Il�c.
�..���Ni�ER �
ENGI NEERS AND SURYEYORS
1.hNQ suRVEYtir+o SOtL!} TE8TINO
CIVIL i�. MUNICIDAL ENbINHERIMO LI.NO PI.ANNIfVd
�41g -g67N AvENUE N.
MINNEAPOLt$ 22,MINN.
OR T- 4014
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E. A.RATH6VN - REC315TEF2E0 irANC? �URVEYOR - MINNE`30TA REOISYRATION NO, 3"79S
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Village of Fridley, Minn.
� �►° 1858
BUILDING PERMIT
Date: . . . .�i�� " " " " ' . . �. 9.� . . .'s��. . . . . .
Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Builder . ��,���. . .�. . .u�. . . . !,��Ir'.�.�'. . /. . . . �����"��Y�: . .
Address...................................... Address .............................................
�iCATION OF BUILDING
�C' � � . . . Street . . . ��`.'��-°E�''�'. . . . .��.,,�G: • . . . . . Part of Lot . . . . . . . . . .
I�'o. .......... .................
Lot .....�...... . Block ..... �.... ...... . Addition or Sub-Division .��`�... .... ...` ... '%'�yi
. �
Corner Lot ...1�..... Inside Lot ........... Setback .. 3....... Sideyard ..�0 .......................
DESCRIPTION OF BUILDING
To be lised as:
� ' /
,� . . . . . . . . . . . . . Front . .�. Q. . Depth i�. � '�. Height . %� S . Sq. F`t. . . . . . . . . Cu. Ft. . . . . . . . .
..................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........
� OQ fi
Type of Construction . . . . . �`. . . . Est. Cost .,1. . . . . . . . . . To be Completed . . . . . . . . . . . . . . . . . .
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
.....................................................
a c �`��''C.�
Tn consideration of the payment of a fee of $. .� �: �., permit is hereby granted to .�d�`:'�� .:..
. . . . . . . . . . . . . . . . . . . . . . . . . to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employzes and worlunen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
F'ridley, Minnesota regarding location, constru '; alteration, maintenance, repair and moving of buildings with-
in tne village lunits and this permit may b oked at any time upon violation of any of the provisions of said
ordinances.
� ......�:.�. ..... ............. Building Inspector
NOTiCE:
This permit does not cover the construction, instaliation or afteration for wiring, plumbing, gas heating, ,
sewer or water. Be sure to see the Building Inspector for separate permits for these items.
City of Fridley, Minn.
BUILDING PERMIT o � ������
Date : ............�..�......`..'.'..'y.._...._.��'.�....�...�...�..�.--. .�._c.:."_............._...----�---
� R 1-r "!
` �
Owner .. . � -~„" "",
--•� x --�' -- . ...�....._
.. . ._
Address �..-�;�,,,�_ ;,�' ,
....��--•-•---- . . ................. .�" ,....._.._ ._.
. 4�7s.5�
_,
,
Builder - �� �...----- � .. ....�.. - ........ ........1_....---
Address. -...-�- --�- -- --�-�-.._....-.-_.---�-----�� ............. �---��-� � � -- �-
- -- - ---
�;�,,� �.00ATI� BUILDING
/ , ,.
No. .�-�-f�-- -� - Street __� ..����.'.?--�,....---..:.._.<_... - -.._.......__._. Part Lot ._.--------- ............__._.---.. .: :.......... .............----
' ���
Lot ..._...----�..._....._.__ Block .....----. .,�.�_........._......._ __....... Addition or Sub-Division -- � ----v�.�,�.� . ......._ ':�"'�r.--r-�G�:'�.^�',�
1:t� .
Corner Lot --------.-�'''.'"�.. Inside Lot ........_._._ --.._..... _..... Setback .----- ..:.........._....._...----..._.... Sideyard --.--......I.�.+�
............................ � ... -...........
Sewer Elevation
Foundation Elevation
D�SCRIPTION OF BUILDING
To be Used as:
f,i:� ,! _ .. � . ..
; Frot�t '�...._.. Depth _ _ __ Height , ... _.. Sq. Ft. �.__ ,
_�.:. , ..._..,.:.
- Cu. Ft.
. �
,.._ ,.
_ ..... _ . .. . _ _ Front _.. _ _.._ Depth _ _ _ _ ._ . Height _ _ _ .._...,. _ Sq. Ft. _.._.. _ Cta. F°t.
Type of Construction -.: '� � � ` � "'
, . _— , -.F..�...r . �=- Est. Cost� �_:', !._ ___ To be Comp�eted .. . ..
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�j . � :J i � - �, , .._ .., , .�
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
, i ��'�"r`
In consideration of the payment of a fee of $_� ............................ permit is herebY granted to....._..._......_...-__---------......_..---,.
-..
----�•_-.•--•-.-----•-..-.--- ............._............._........ to construct the building 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 workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any tirne�upo�� lation of 8ny of the provisions of said
ordinances. l t
Building Inspector
NOTICE:
This permit does not eovsr the wnstruction, instaliafion ior wiring, plumbing, gss heating, sewer or water. Be sure to see
fhe Building Inspeefor for separafe permifs fo� t6ese itema.
4
� ��
BUII.DING PERMIT
�.. ���Viliage of Fridley, 111�"I�nn. No 2 51 g
Date . . . C . .%. ��. . . . .� . :� . �.�!. .�i. . . . . . .
�����.
Owner . :-.� . � .� . .�,��''"a''�,i:�;d,.+. . . . . .
t '
Addres�s�.��l .......................................
Builder...........................................
Address.........................................
LOCATION OF BUtLDWG
No. . . ,�: .'..,� . �. . . . . . . Street . . . . � L�� {�.°,�.f��`i��','�+l�.. . . . . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . . . .
� t .....�
Lot .......�...... Block ....':":�......... Addiiion or Sub-Division .:�. `
/ ( Z�"�„� �} . .....
� t �
Corner Lot . .. {. .�„� . . Inside Lot . .... .. .... . Setback .. .� � .. , Sideyard . .. .1:... � , ����, ,
v
DESCRIPTION OF �UILD�NG
To be Used as:
....' ................ Front ........ Dep�h ........tIei�ht ......... Sq. Ft. ........ Cu. Ft. ........
• • • . . . . . Front . . . . Depth . . . . . Fieigi.t . . . . . . . . . Sq. Ft. . . . . . . . . Cu. Ft. . . . . . . . .
_ Type of Construction . . . . . . . . . . . . . . Est. Cost . a.. . . . . . To be Completed
. �� �,�•�f.;. .,` .�. . . . . . . . . . . . . . . . . . . .
.. ^� � F " � �� r��"'r°'_ ' :.'^+C.J "" " �, `�^ ft �, f r
;, i� !
.�
In consideratian of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
h
'7's . . . ... .. ......
: �,;, ' ° .-+ - _; � , �� u .r_.
Tn consideratiorl of the payment of a fee of $. . permit is hereby, granted to `� �
.. �, ._. ..
.....................
.. to construct the building�s�d°dition as described above. 'T'his�� nt � on
the express condition that the person to whom it is granted and his agents, employee's.,,andj worlune , in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this pexmit may be revoked at any time upon violation of any of the provisions of said
ordinances.
,!` ,t ' ' ,
. . . . . ,- . = �.t. . . . �. . �..� .., . .. ._._. . . Buildine Insoector
1110TICE: t :�. `"�,,,j
�'his permit does not cover the construction, insta Ilation or alteration for wiring, piumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these ttems.
.�
•..'�T�t�
Addrass
APPLICATION FOR BIIILDING PRRMIT
CITi � FRIDLEY, �TA
�� � _ � _ �_
� LOCATION OF BiIILDING
No. � Sta�ee� P�rt of Lot _�
a
T,ot Blocic , Addition or S�b.Div.
Corner Lot Inside Lot Set Back Side-Yard
SF�"R ELL+�TATION FOUNDATIDN ELEVATION
Applicant atta.ch to this Porm Certificate ct'P Survey of Lot and proposed building
location.
DFSGRIPTIOI� OF BUII�ING
To be used as:
F�ont Dept�h Height
Sq. Ft. Cu. Ft.
F�ont Depth Height
Sq. Ft. G�Z. Ft•
Type of Conetruction E�timated Cost
To be completed
The undersigned hereby makes application for a permit for tbe work herein specified,
agreeing to do a11 work in strict accordance with the City Ordinance$ and ruling of
the Department of Buildings, and hereby declares t ell the Pacts and epresenta-
tions sts.ted in this epplication are trus and corr . ._
� ,
DATE SIGNATURE
(A Schedule of Fee costs can be found on the Reverse S1de.)
-�„a--�..>
�
•
� . , �
sue�ecr RMIT NO.
City of Fridley 2675 3
AT THE TOP OF TNE TWiNS g U I L D i N G P E R M I T
r
� � RECEtPT NO.
� �
COMMUNITY DEVELOPMENT DIV. � � / �/�
r �~ �� PROTECTIVE INSPECTION SEC. �� 7
� �
I . �
, � /'��1 � CITY HALL FRIDLE� SS�13i NUMBER NEV DATE PAGE OF APPRO�ED B�
�""�''� �'� 612-571-3450 9t0-Ft5 2 / /
J09 ADORESS
621 Helene St
1 LEGAL LOT NO. BIOCK �RACT OR ADDITION SEE ATTACMEO
DESCR. 8 7 Donna � S Lakeview Manor SHEET
2 PROPERTY OWNER MAIL ApDHESS ZIP PHONE
Mar Sheridan - 4
3 CONTRACTOR MAIL AOORESS ZIP PHONE UCENSE NO
Four Seasons Roof'n
d ARCHITECT OR DESiGNER MAIL AOORESS ZIP PHONE LICENSE NO.
20138780
5 ENGINEER MAIL AOORESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroo ouse and ara e(lb S) Tear-off
9 CHANCaE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAp
SEPARATE PERMITS ARE REQUIRED FOR ELECTRtCAL, PLUMBING, NEATING.
VENTILATING OH AIR CONDITIONING.
THIS PERMiT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SQ. FT. CU. FT.
AUTHORt2ED IS NOT COMMENCED WITHIN 60 OAYS, Oi; IF CONSTRUCTION
OR WORK iS SUSPENDED OR ABANDONED POR A PER100 OF 1T0 DAVS AT
ANY 71ME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV TMAT 1 HAVE REAO AND EXAMINEO THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAW$ yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPlIEO @
WVTH WHETHE�i PECIfiED MEREIN Op NOT. THE GRANTING Of A PERMIT $1334 �y.66
DOES NOT P UME TO ORITY TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CHARGE
PiiOVIS ONS f ANY O ER TAT R IOCAL LAW REGULATING CON-
STRU 10 OR THE P O OF CONSTRUCTION. ��FS.]5 Fire SCi �1.33
7 j� PLAN CNECKFEE TOTALFEE
� / ZZ ° License SC $5.00 $52.74
SIGNATUFIE OF CONTRACTOR R AUTHOAI2ED AGENT IDA � WHEN P� ERLY IDA,iE THIS IS VOUR PERMIT 2
L ,�c-�
�S�GNATUAEOFOWNER��iOWNEABUIIDER� tDATEi �� ' /
~ � BL iNSD q6tE
NEW [ �
ADDN [ ]
ALTER [ J
ConstructionAddress:
Effective 1/1/98
� : CI'I�Y.;OF FRIDLEY .
� SINGLE� FAMI��„AND DUI'LEXES R-1 AND R-2 ��r�
BUILD.ING. L�F.�tMIT �1I'PLICA'�'IO,N +. . , �� � (�"I
.. r � - sr�+hR L,*yr,��?tt'r.`�f�6r �-` � -- ji�+ ��� .. .���.�� ?rJ�tiS�,!�M,� �4's t� -t/
t �e F. x J�� {� F +� # �.
� -�' ` 4' t'�`f�t�. ° „��'�-,�s_ji��fs. � .- •:�� .. . � i�Kt�'lE.�`a:t:d y. >I ..,-sj� ' .
/A � r �� ,'� �����Y_+t -.:��� ti . . - . . � r� �::•. . " . .
. , :�; . . .
Legal Description: � .
Owner Name & Address: f���1 �`l P� I c� a Tel. #i ��j `T/—�� �
Contractor: �y� �J t' �j e-C.s rs'n S� o d-�� � nl IQe.r!�! ��,� %� 1-�' -MN LICENSE # d� �� 7
Address: /`� 3 d L V1 ( U P�/� r�u ��/ S /l�� Fr ► cl lu� Tel. ���5'� `7 ��n
� �' Attach to this �application; a Certificate o�.Survey of the ;� +,.
lot, with ttie � proposed: construcdon drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER•
. DESCRIPTION, OF IMPROVEMENT . .
�ttg�: . Width Height Sq. Ft.
�ng� � . Width Height Sq. Ft. .
� � � � Width - � � HgtlGround Sq. Ft.
�.�.�,� �.e c�_I��,�IarJ� /6
• - � : � ..: :
. , 1��.�
Construction Type: �i2� ,e�� Estimated Cost: $ . �
. .... � . . . , . . (Fee Schedul e, on Back):� , .
Driveway Curb Cut Width Needed; Ft. �+ 6 Ft = Ft x$ _$
� �
DATE: . ��O APPLII
� . . .. _ . �. ... . . . te =.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge ;,; ; �
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge �
TOTAL -: . � , . .
STIPULATIONS: ;
Tel: # ''�-I�'�` cl �611I
- Tz.�'� S�sl7�l�t'ir:��' ,
� / ��� .. .•�',. . :�... !•.q�.%q/yAI .- '. ...'..: . •.1 . '
$� `7 �� ►: 5� Fee Schedule. on Reverse Side.�
$ � f . � �. � `.00l of PernaiC Valuation (1/lOth%) .
$ � �o o $.50/$1;OOO�Valuation
$ � $1000 per SAC Unit �. .,
.>, . f. . � . .... . : . . . .. __ r�+k��•''i't! � : .', � °`,i�� ��. ..
$ _ :���p 2 $5►.00: (State Licensed Residenii�l Contrac �� . �. � ;�A ��;;c, ,
.. ��:, � �
$ _ .. ,.3:;��� �t. �"A" or�°Alt: ��B" Above . �.i t����;� �
A
$ �y ► � $45�.00 Conserv�don P1a�, I�eview =
,l.�,�,�..; �.•�;�:;.,� rc �� ..r.�,� xf.:
$ ; =:�Fee Determined by Engineering
,
$ °< � , _ =.:�r�,� =pgreement Necessary [. ] . . Not. Necessary� [ �] «��;;:,.�����:;����r :
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