AF - 45930�
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City of Fridley, Minn.. N° 8261
BUILDING PERMIT
nate: J"1� 23, 1965
�r: &�11IE JOHNSON �� S�ME
Ad�ress Addre�
LOCATION OF BUILDING
No 6951 s�et I3ICgORY PLACE p�t oE �t
Lot ? Slock 3 Adcittion or Sub-Divisian Ortmane 3rd
Coraer Lot Inaide Lot g 3etback �� � Sideyard 10 � I1T•
gewer IIevatfon Foundation IIevation
DESCRIPTION OF BUILDING
To be vsed as:
nc�e].li.ag �r3�� ne�w 2 2� Ae��t,t ZD sn. �-t. � a�. �t18,1o0
Att. Ga.rage �t 22 �p� 22 ���t 1� gq. Fk �8� Cu. Ft 4,8l�0
Type of Construction FTeme ���7.5 500�00 To be Completed
House and Garage
In �deration of the fssuance to me of a permit to construct the bwilding described above I agiee to do
the proposed work fn accArBance with the dr�scrlption above set forth aad in compliance wi a�l pravisions oP
ordinances oE the dty oP Frldley. .� !/ {7 .� _ t°1 �
In camsfderal3� of the payment of a fee of ��3 •� , permit is hereby granted to �� JOHNSON
to canatruct the buflding or adclition as d�cribed abave. This permit 4s granted upon
the exp� condttion that the peraon to whom ft is granted and hia agenta, emplo s and worl�en, in all work
s
done in, aratmd and upon eaid building, or anypart thereoP, shall coffiorm in respects to the ordinanc� of
FrYdley� B�innesota loc�tfon, conatruction, alteration, maintenance, rePair and movlag oP bufld�►ga
witbin the dty ]iadts��� pernoft may be revoked at any time upon violai�on of any oE the Provlsions of said
or3inant�es.
1�?T�AT G. JENSEN Bu�� ��
NOTIC�
1'6b pemde doa uet eonr ths eemteuaN�, � �er �rGte9� P���9. Ya 6a�i�, �w►a' or wafsr. B� ara to a�
Ha Bntidine I�toe im' apu+t� Wrm6s foe th�a hwa.
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OWNER'S NAML
�DDRESS
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APPi.ICATION FOR BII'tLDING PERI�T
CITY OF FRIDLEY, MINNESOTA
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LOCATION OF BOILDING__- �
_ .-�+ �� � �'!� � ,, .
-,.. N0. � STREET `�� �' /yt� ,�S � � � - �'t' . PART OF LOT
> _
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L4T ��BLOCR w ADDIZ`ION SUBDIVISION � .9r _� � , , .
CORNER LOT INSIDE LOT �� SETBACK �,�A � SIDE YARD ,.�,� ¢`��"�
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SEWER ELEVATION � � FOUNDATION EL�VATIO� '
�
Applicant attach to this form Two CertificaCes of Survey of Lot and propoaed
�uilding �ocation drawa on these Certificates.
DESCRIPTION OF BUTLDING
+.i '
To be Ed as; r �
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�' Front , " �„ � Depth � Height _ �
_�
Sq.. Ft. - � , �T Cu. Ft. -� � - , �'
- . ,. - _ ,
�A• �' Front ,,� „� Depth �.�- Height ��'
� Sq. Ft. �� .�( �� Cu. Ft � �'��r��
� ; ; � ,�
Type of Construction �' �� ��,� �� r Estimated Cos � ��'-`,��
_ � � �, -�
To be completed �
The undersigned hereby makes application for a pera�it far the work herein
specified, agreeing to do a11 work in strict accordance with the City of
Fridley Ordinances and ruiiags of the,Department af Buildinga, and hereby
declares that all the facts and representationa stated in this application
are true and correct.
, � .
DATE_� �� ° F, � -°: � �i SIGNATURE
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(Schedule of Fee Costs can be found on the Reverse�Side).
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B�DING PERMIT FEE SCH�DUI.B
SECTION 2. Tiae Inapector of Buildings shall, before iaeuyn� any permit for
the erectioa of any bu3lding or structure, or for any addition to any existing
building or structute, or for �ny alterations or repairs to any exiseing
building or structure, upcn application therefore, require the payment bq the
applicant for such petmit of feea to the amount her�in below set forth.and in
the manner herein provided to-wit; °
2.1. For anq auCh pexmit for the erection of any fire-proof building,
othei than a garage, warehouse, factorq or grain elevator, or for the ereceion
of any fire-proof addition, for. aimilar occupancy, Co any 2rtisting building,
ahall be at the�rage of $1:40 for each one thousand Cubic feet, or fraction
thexeof, in such cubical contents.
2.2 Fox any such permit for the erection of any fire-proof garage,
warehouse, factory Qr grain elevator, or for the erecC3on of�any fire�proof
addition, for similar occupancy, Co any esieting building shall be at the
rate of $1.25 for each one thousand cubic feet, classified as "fireproof"
by Section 502 of the Minneapolis Building Code.
flOIISES
2.3. For any such permit for the erectioa of any non-fireproof
building, other than a garage, warehouse, f�ctosq or graia elevator, or
any non-fireproof addition, for similar occ�pancy, to any esiseing building -
permit $1.00 for each ane thousand cubic feet. .
GARAGE3
2,4. For any such permit for the erection of any non-fireproof garage,
warehouae, factory or grain elevator,.or fox the erection of any noa-fire-proof
additiou, for eimilar occupancy, to any existfng buildiag or for each such
building or addition - ninety cente ($0.90) for each one thous.aad aubic feet
or fraction thereof, in the cubical�conCenta thereof�with t�e minimum of $4.00.
For the purpose of computiag feea for bvilding permite, the cub3cal.conteaCs.
of �nq building or addition to a uniform he�tght tliroughout by multiplyi�g the.
grouad area covered from a point siu (6) inches below the floor line of the
basement or cellar to the average h�fght of the upger aurface or to the average
height of the roof surface of the main gable of a pitched roof.�
2.5. For repairs or alterations to an exiatin� s.Cructure,.th� f�e ehall
be at the rate of $3.00 per each Five Hundred`Dollare ($500.00) or fraction
thereof in the cost of a31 propoeed work.
2.6. Ia no case shall the fee charged for any permit aa aet forth in
Section 2 be less than $4.00.
STORM REPAIR DAMAGE FEES:
Reaidential;
Eatimated Coat of work up to $500.00 -$5.00
Estimated Cost of work over �500.00 -$10.00
�mmg�,,,c,i�I� Estimate�ost of worl�`c up �o $509.00 - $I�0 ��$ �_,
Estimatea _ �ost of work over $500.00 - $2l. _ ,0
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cirr �oTS LANQ SURVEY$R � £ �¢
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` 70POGNAPHIC M�nPtqc ., 11EGISTERED UNDER, LAWS QF S,T,4�[ QF M1�iNEiOtA ,, -
- - LiCENSED��Y QRDINANC[l�CI L�TY OF qINM[R►041i.,.- -� �. � � , ., � ��f
3300 LYNDALE J1VE. $O: MINNEAPOLiS g. M�NlV ; = v� � '�-�`� �;'�
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-. ° Lot �7, Biock 3, ` OSTMAb/'S THIRD AD�IfiION, Ario�Ca Co�ty, l�n�so�a.. , '�
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l�s su�ueyed by me thi� 19th day cf Janua�y 195Z-_A. D�. � Y� '
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City of Fridley
� 4T TNR TOP 0' TII� TwIN�
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rL-------� cowMuN�rr oevc�o�eNT o�v,
� � � MOT�CTIVR 111M�tCTlpry O��T,
` f �---` � Cm ►u►l.� siuo�Rr �M�
i......J`.� .J W-s�O-JNO
Job eaaresa
ner
Contractor
Kind of Bui
Comu etion
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53-8� �-915.51
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6951 N. E Hickor3r Place
Dominic A. Cruciani
MIP� EdE�,�,!�5�0
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Frame
6-12-71�
PLUMBI�Vr, PERf9IT APPLICATI��J
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Res.
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10,00
Plumbing Fixture Rates: N0. RATE TOTAL
Number Fixturea x $2.00 �
Future Fixtures _� x $1.50
New Fixture-Old Open. x $1.50
Catch Basin x $3.25
Water Heater-99,000 BTU x $3.00
Ground Run Old Bldg, x$3.25
E1ec. Water Heater x $2.00
Gas Fittin Fees:
lst 3 Fixtures x $2.00
Additional Fixtures x $ .75
Gas Ra,nge-199,Q00 BTU x $5.00
Repairs & Alterationa
See
Description: Install Gas Grill �ode 5.00
State Surcharge Class "A�' Surcharge u�0� .50
TOTAL FEE $ 5.5�
The undersigned hereby makes application for a permit
fvr the work herein specified� agreeing to do all work .
in atrict accordance w ith the City Qrdinancea and rulinp
of the Depaxtment uf �uildinga, and hereby declare that
a11�th� tacts and representationa atated in this
applicafiion are true and correct.
�. : �_a,,.____. _. �, �
aE_1 C°u.,�cp� � , �¢�`�'�.:.�a.�,
'Sienature l�F'�,A�:'� Date
1
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sue�ecr ` PER
City of Fridley _ 18 9 4 7
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
� �� R CEIPT NO.
� 1 L___�� COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. �D Cf b��`
� . � G4 / �
i_--- � ��'�',,� CITY HALL FRIDLE� 55432 NUMBER. REV. DATE aAGE OF APPROVED BY
i �� 612-571-3450 910-F15 5/12/87 / /
10B ADDRESS 6951 Iiickory Place N. E�
1 LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. '] 3 Ostman's 'I'hird Addition SHEET
2 PROPERTYOWNER MAILADDRESS 21P PHONE
9nith, Sto'eyi,ck, HTenzel 6951 Hicko � Place N.E. 571-5Q88
3 CONTRACTOR MAIL ADDfiESS ZIP PHONE UCENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Constxuct 20' x 12�.Deck.
9 CHANOE OF USE FROM TO
STIPULATIONS See not�,tion� Qn �lan,
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���E P et`o�' d� �
���t�JG' �� R�UIRE� FpR ��iE �'�� call r�qi ufilr�r�s
, �IEATING, PLUMBING ,qIV� ����aF�EC�p
SIGI�VS. �E��9R�p B�� � �te.
_ _ 1� �,� �,,'
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOF; A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. • NO. DWLG. UNITS OFFBTREET PARKING
I HEREBY CERTIFY THAT I HAVE FiEAD 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 SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT $1�650 $,S3
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEFiM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERfORMANCE OF CONSTRUCTION. $28.00
LAN CHECK FEE TOTAL FEE
�7e �� $35e03
SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT �DaTE� WHEN PROPERLY V•I ATED T IS IS YOUR PERMIT
.�� la�� S—ia—�� � � r� �,
SiGNATUREOFOWNERUPOWNER ILDERi iDATEI r,,� h BLDG �NSP ppTE
p� � � City oP Fridley
ADDN. L l R-1 AND R-2
�yT�g. [ ] • Building Permit Applioation
Effective 4/1/86
Consiruatioa Addresa: ��S) -E-4tc�cvi'i�-r Q� �R►���.Y . Mti► SS`i3�
Legal DescriptioA: Lo-� 'Z Qlo�,l� 3� �st�-u-�-.` � TI�..�N� d��r� �-.-.
Owner N�ae & Addresas ���^'� �:� i��,� ��►�\ t+�e..►�a.�e P�. __ Tel. i�'11-���
Coatractor: Tel. f
Address:
Attach to this applicatioa, a CertiPicate of Survey of the
lot� with the proposed construation drawn on it to scale.
DESCRIPTIOA OF II�PROVEMENT
LIYING AREA: Leagth Width Height 3q. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECB AREA: Length ��- Width la �• Hgt/Ground 5°� Sq. Ft. a�o
OTHER:
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Coraer Lot [] Inside Lot [] Ft. Yd. Setbaok Side Yard Setbaak
Type of Constructioa: ���"'-� Estimated Cost: $���
Approx. Completion Date: � � �
Alt. A Alt B
Proposed Drivevaq Width If New Opening Is Desired: $ �
See Back Page for Euplanation
DATE: � s APPLICANT: Tel. �
CITY IISE ONLY
Permit Fee $ ia��.� Fee Schedule on Reverse Side
Plan Cheok $���� 254 of Building Permit Fee
State Surcharge � �� �.50/$1�000 Valuation
SAC Charge � � 525 Per SAC Unit
Park Fee $ Fee Determined bq En�ineering
Sewer Main Charge �
T�� � � � � Agreement Neaeasary [ ] Not Neoessary [ ]
STIPIILATIONS:
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BOII.DING PERMIT FEE SC�EDIILE
"�he Chief Ba�ilding Official shall, before issuing permits for the erection of any
ibuilding or structure, or for any addition to any existing buil�ding or structure, or
for any alteration or repair to any existing building or structure, upon applicatio n
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: � -
Total Valuation
$1.00 to $500.00
Fees
$10.00 (Minimum Fee is $15.00)
�501.00 to $2,000.00 $10.00 for the first �500 plus $1.50 for each
additional $100 or fraction thereof, to and including
$2,000.
'$2,001.00 to �25,000.00 $32•50 for the first $2,000 plus $6.00 for each
additional �1,000 or fraction thereof, to and
including $25,000.
$25,001.00 to $50,000.00 $170.50 for the first �25�000 plus $4.50 for each
additional $1�000 or fraction thereof, to and
including �50,000.
$50,001.00 to $100,000.00 $283.00 for the first $50,000 plus �3.00 for each
additional �1,000 or fraction thereof� to and
including �100�000.
�100,001.00 and up
�u33•00 for the first �100,000 plus $2.50 for eaoh
additional �1,000 or fraction thereof.
DRIVEMTAY DEPRESSION ESCRW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway Width plus
6 f��L times $13•50
Alternate "B": Removal and replacement of eurb and gutter and install a 3 foot wide
approach With 6 inch depth - Driveway Width plus 6 feet times $15.75
VERIFICATION OF FOIINDATION
Permits for construction raill be issued a miaimum of 24 hours from the time of
application to allow for proper reviex of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the loeation of the foundation once it
has been constructed wi11 be required before proceeding with the framing.
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F..,• .'�:( ��,�.
LAND SURVEYOR
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�r•��"aunN.�":: Mqri���.o REGISTERED UNDER LAWS OF STATE OF MINNESOTA
I.�CFN�+FU BV OAC)INANCFS (J< <�TV O� MINNFAVOl�S
3300 LYNDALE AVE. 50 MINNEAPOLIS 8 MINN
TAYLOR 4-0370
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I hereby certify that the above is a true and correct plat ot a survey of:
Lot 7, nlock 3, OSTMAN'S THIRD ADDITION, Anoka County, Minnesota.
As surveyed by me this 19th day of January 1957 A. D.
_.f'� � .�r�;��?�c<.�:��t.�
Minnesota Registration No. 2584
00'Ot� - 00'0(�'�' A�o �I�o�s 30 �so� pa�earF�sg
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NOIltI�I�Ia3A ��d1S GN11 A3�lWIH�
�_ �`� — C� � /'�
r�
City of Fridley
6431 University Ave NE � � � `�
Fridley MN 55432
(763) 572-3604 or Faac (763) 502-4977
Water and Sewer Permit Application
❑ New Connection
�Existing
Date: //�� d� �i �2��
Job Address: U ��� �
Name of Applicant (Plumber):
Name of Property Owner:
Existing Structure Permit #
Permit Type: Sewer Fee:
Water Fee:
Meter Fee:
Repair Fee:
Relocation:
State Surcharge:
SAC Charge:
Special Assessment Fee:
�.
� �
Total: $ /�
Applicant
,
Inspector approval:
Water Meter Re air —\ ee1 nd & H�
Water Connections Per '
Sewer Connections Permit
Inspection Fee for Water/Sewer Line
Special Assessments
Cost of Water Meter
SAC Chazge
State Surcharge
Water Tap
�[Jtility Line Repair/Relocation
❑Water and Sewer Connection
$iasmou�
$50
$40
See Engmeermg
See Utility Billing
$1675
$ .50
See Eneineerine