AF - 45855�..
;
Cityr� of Fridley, Minn.
BUILDING
��; May 18,� 1970
PERM��
;
,
,e�.� ,�����
N. 1064
pRrn�r; — S�p�Templin B��r S. E. Templin Coas�ruction
Add�ss _•._6�1.$,� S t i n s nll��l� IQv�L�_..__.__.._..__ AddTees �SAme _..�
LOCATION OF BUILDING
No. �.Q$�3__._.._ Street S�cko� 4rive N.E. . p� ��t _,._„_._,,,
Lot � -_ Block 1 ...— Additiasi or Sub-Div�isian ._._.._ Ostman's 3rd Addition
Coiaer Lot ___._._.w_ Ins3de Lot ....._.._.x._..._.�..._.__ Setback ..._.._.�'_._.._�.._ Sideyard 15' of each side
�n�cIIe�vation ___._.�85.L-.b5 .�_ � 85[�..6.s
Wye Ton of Footi �
DESCRIPTION OF BUILDING
To be Used as:
�iellint� ^ �t 24' _ �p� 40' H�t 20' �. � 960 � � 19,344
Gaxa�e .,,,_..y._, F�t 20 � Depth 22' Height �.Q' _ Sq. Ft �.4Q.'_ Cu. F`t. �%'
Zj�pe of Coa�str�tcti� _...�_��� FF�t. Cost —�3.�.,.QSZQ_ _ To be Completed h mnnthR
SEWER LOCATION: 39 feet South of Manhole
WATER LOCATION: 48 feet Southeast of Ma,nhole on line.
Verify Basement by Survey. Provide Hardsurface Drive�aay.
In 000dderat[on oi the issuanoe to me of a permit to the b ding deecribed abowe, I agree to do
tha propored w�aa�k 3� ac�rdanc�e with the descriptioa above in oo�nplianoe with all p��o!visions o!
a�linanaes ai tbe dty of Fridley.
In caodderatian oi the payaient oi a!ee of � 44 . 00 _., p�t is i�ereby �anted to S- 7� • TP.mA 1 in
to oonatruct the building or additi� as described abo�►e. Tbis�permi� � s�ll w�ark
the exp�+� tion that theperson to whom it is �anted and his agents, employeea d
do�e in, aro�and upon said buildin8, �' �LY PRrt thereof, shall c�onform in all resperta to the ordinsnces o�
FrLd1eY, Minneaota locatio� constiuctioo, alteratia►, maiatenance, repair and moving o� �i�
wt� dty limiffi�aad� permit may be revaked at aqy ti�ne u�au violation o! suy► a! the P�daosb�o[ saTd
CLARENCE BELISLE
�
NOTIC�
1W pMwit doa �et eewr N» eonhoelk�, i�N�Na /er wlrtp, �bip, w�. s�wK �r waNr. i� w� q w
� �Y � � � Pw�it� tor f� iNw�.
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APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
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Oi�TN$S' S . NAME ::- BUILDER : �C �� L / �tI �CiLi �'�
ADD�BSS • ADD[tESS - � �
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No:. �7 6 � 3 s�.
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LOT: BLOCK:' ADDITION• �i
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C�RNER LOT: INSIDE LOT: Vi SETBA�CR:�� SIDEYARD: � fi s'��
Applicant attach to this form 1�uo Certificatee of Survey of Lot and proposed
building �ocation drawa on these Certificates.
HESCRIPTION OF BUILDING
To Be Ueed s
1 � �% :� �
Frant : Z 7` DePth' Height :
Sqi�are Feet: O Cubic Feet: ���� �f ��
� . � €� c t�� .r Froat :_ '�_Depth • �. d-- Height : % C>
w.�..�wr
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" Square Fee ;_ � y d Cubic Feet: �' +� �
1�rpe of Conatruction: - Estimatad Cost: $ i�-�"�-�
•^7�--�■--
To Be Cc�pleted: �
� The uadersigned hereby mskes application for a permit for the work herei,a
speci�ied, agieeing'to do all Work in attict accordaace with th� City o�
Fridley Ordiaaacea aad st�liags of the Department of Duildings, ;nd her�by
declarea that all the facts and repreaentatione st ted in this application
are trua aad correct.
� �
DATE: � �_ SIGNAIVAB: ----�
,
(3�e Rrvsraa Side For Additiowtl Infosmation.)
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BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before �esuing pesmits fo� the
erection of any buildiag or structure, or for any additian to any exieting
� building or structure, or for any alteration or repairs to any existing
building or sCructure, upon application therefore, require the payment by the
applicant for such permit of fees to the amouat herein belaw set forth and ia
the msnner herein prwided to-wit:
UN1FORrI BUILDING CODE: 1�►pe 1, 2& 4-$2.15 for each one thousaad cubic
feet, or fraction thereof, in such cubical contents. 1�pe 3� 5-$1.85 for
each one thousaad cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing feea for buildix�g pa�its, tha cubical conteat�
of any building or additian, iq determined by multiplying the grouad ar�a
c�vered fsom a point eix (6) inchea below the floor line of the basernt
aac tlte cellar to the averag� hsighta of tha upp�s sasface or to th� sverag� +
�hsight of the roof aurfue of the main gabl� of a pitci�ed roof .
For repaire or alterations to an existiag atructure, the fee slull be at the
rate of �3.00 per each five hundred dollars ($500.00) or fractian thereof ia
the cost of all proposed work. .
Ia no caae ahall the fee charged for any permit as set farth in Section 2 be
less than $5.00.
VARIFICAT�ON OF FOUNDATION
IDTE: ,P�smits for sa:u tructian will be issued a miaimum of 24 houra fraa the
ttas of applicatiaa, to allaw for proper revi� of tha proposed structurt aad
of tha canstruction aite.
A Castifi�d Survay of tha lot, �ho�ing the location of ths foandatian, onc� it
La���bwn caastruct�d, vill be raquired befora proceedit� Mith ths framing.
CERTIFICATE OF OCCUPANCY
Applicatian for a �ertificate of Occupeacy Ahall ba mads ten (10) days prios
to the use or occupancy of my structuse for vhici► a building perait haa bsen
,, ��sued; aad •aid �tructure ahall not be u�ed or occup!'ad until a Certificate
of t�eciipaacy has bsan issuad.
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LAND SllRVEYOR �.` ,.
1l�QfiTt11ED UND[R LA1M� OF iTA1E 0!f MINNpOTA H1W61!►T. i-
��o sr aeonu►wc� o� emr or Knr�ro�u .� '.,
3JOC L.YNDAt,:t AYff.� SO. MI(VNEAPOLIS e. M1lW+t. '
TAYI.,fJR 4.0�70
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I h�reby Qertify that the above is a true and correct plat of a survey of:
Lot Seven (7) , Block Oiiie (1) , OSTMAN' S THIRD ADDITION,. Anoka County, �
MinAeeota.'
As s�rvaye d by me this 19th day of January 1957 A. D. _
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Signed � G . ,��� .G .��.
.�.,...._�._.r..._...��,..
Minnesota Reqistratfon N�. �5.84
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':HEAT LOSS CALCtJLATIONS UEPAR'C�tEI�T OF ItiSPEt:l�t0\
_VG'eatherslrips �I A� Guide I Construction No. _
oKS rs Reference I Out. Wa11 Int. Wall Ce�lmg Koof Floor II Kmd
e No I e No Ii 19_ I
Fl.( / v/ F.00m � L�ngth�
Winduws and oors--Crackage and Area
��.dth He�Kht Na ot Llne� I ft. Area
'.:� of paoe of ➢anr I�Rhte o( rra1'k �V: ft
Infiltration
Glass ��
Exp. wall �
I�et exp. wall
Int. wall
��ri�inp � %� �-
i loor
Total Btu.
Requir d sq. ft. E.D.R. or sq. ina. W.A. ader area
F!. ///�/ Room � Length � �dth
1� ��.—_�.
Windr,ws and Doors-Crackage and Area
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1_.__ _
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Int. wall
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Total Btu.
ticight
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iI \�:ath Hetr�t�.\u. i f I.Sneal !t —! Ar��
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sue�ecr PERMIT N0. --.__
City of Fridley — " ----
AT THE TOP OF THE TWINS g� ILDING PERMIT 22593
r
� �
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� ; y __�__ COMMUNITY DEVEIOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. �/39
[ (
l.--• A��'��,,� CITY HALL f RIdLEr 55132 NUMBER REV. DATE PAGE OF APPROVED BY
L J� 612-571-3450 910-Ft5 6/7/94 / /
JOB ADDRESS 7053 Hickory Drive NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO
DESCR. ] 1 Ostman's 3rd Addition sHeer
2 PROPERTY OWNER MAIL A�DRESS 21P PHONE
Rick Loomis 7053 Hickor Drive NE 571-
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 AfiCHITECT OR DESIGNER MAIL ADORESS ZIP PNONE IICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS Of WOHK
O NEW O ADDITION ❑ ALTERATION X REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (2nd La er) 25 S uares
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the 3rd. Provide smoke detectors
adjacent to all sleeping areas and in basement.
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY IOAD
SEPARATE PERMITS AqE RE�UIHED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S0. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AfTER WORK IS COMMENCED. NO. DWLG. UNITS OFfSTREET PARKING
I HEREBV CEHTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALIS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORHECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
WI H WHENHER SPECIFIED HEREIN10R NOTOTHE GRANTING OF AO ERMT �1,375
$.69
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEL THE PERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR TNE PERFORMANCE OF CONSTRUCTION. �33.00 Fire SC � 1. 3H
PLAN CHECK FEE TOTAL FEE
$35.07
S�GNATUAEOFCONTRACTOAOAAUTMOR�2EDAGENT . IOATEI W Y V DATED THIS IS YO R P RMI
` �c�:�� �-�-�'
�GNATUAEOFOWNERIiFOWNERB 1 IOATEI BLOG �NSP naTE
NEW
ADDN
ALTER
[1
[1
�1
Construction Adciress:
Legal Description:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit A�lication
O S 3 �,o,
Owner Name & Address: ��r�K l�o�i
Effective 1 / 1 /94
�� �3�
Tel. # � %/ - SO so�.
Contractor: Q (,U�'l/� � MN LICENSE #
Address:
LIVING ARfiA:
GARAGE AREA:
DECK AREA:
Attach to this applicadon, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
DESCRIPTION OF IMPROVEMENT
Width Height
Width Height
OTHER ,� I=' tQD p� � f d U S� �� y�v1 �4g-�
O'� �-� !
U
Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks
Type of Constivction: '6,�2 ( �ass Estimated Cost: $ /
Approx. Completion Date:
(Cost on Back)
Tel. #
Sq. Ft.
Sq. Ft.
Sq. Ft.
�� �e wcf �,,4>',�'�2
5
Driveway Ctirb C�t Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: APPLICANT: Tel. # S�/- SD ��
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Parlc Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� _3 0�
$ �• �Q
$ • �c
$
$
$
$
$
$
�,3"0
�� �
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$800 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Eagineering
Agreement Necessary [ ] Not Necessary [ ]
.� � .
BUILDING PERMT�' FEE SCHEDULE
The Chief Building Official shail, before issuing pe�nnits for the erection of any building or structure,
or for any addition to any existing building or strucdue, or for any alteration or repair to any existing
building or structure, upon applicatioa therefore, require t�te 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 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
$15 (Minimum Fee is $15 plus surcharge)
$15 for first �500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$45 for first $2,000 plas $9 for each additional $1,000
or fraction thereof, to and including $25,000
�252 �for first $25,000 pies $6.50 far each additional $1;000
or fraction thereof, ta and including $50,000
�414.50 for first $50,000 plus $4.50 for each additional
$1,000 or frac�ion �f, to and including $100,000
5639.50 for first $i00,0(IO plus $3.50 for each additional
$1,000 or fraction thereof, to and including �$500,000
$2U39.50 for the first SS00,000 plus $3 for each additional
$1,000 or fradion thereof, to and includiag $1,000,000
$3539.50 for the first $1,000,000 plus $Z for each additional
$1,000 or fractioa �thereof -
DRIVEWAY DEPRESSION ESCROW
(Coacrete (�u�b Streds OniY)
Altemate "A": Removal and replacement of cucfi and gutter only - Driveway width plus b feet times
$13.50.
Alternate "B": Removal and replacement of curb and gubta and install a 3 foot wide .
approach with 6 inch depth - Driveway 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 structuce and of the coostruction site.
A Certificate of Survey of the tot, showing the loeation of the foundation once it has it has been
constructed will be required before proceeding with the framing.
f•�� ^�
sue�ecT N O.
c�ty of Fridley � �. � ; 9 �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
f
� � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
' j V �'����� �
r � � PROTECTIVE INSPECTION SEC.
� �
i
' � /'��1 � CITY HALL FRIDIEV SS432 NUMBEP REV DATE PAGE UF APPROVED BY
�"'""� � �'� 612-571-3450 910-F15 9/20/96
/ /
�os aooRESS 7053 Hickory Drive NE
t IEGAI LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 7 1 Ostman's 3rd Addition SHEET
2 PROPERTV OWNER MAIL ADDRESS 21P PHONE
Kevin Swanson 7053 Hickory Drive NE 574-0157
3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP pMONE LICENSE NO
6 USE OF BUILDING
7 CLASS OF WOHK
❑ NEW L�, ADDITION ❑ ALTERATION O REPAIR O MOVE O REMOVE
X
8 DESCRIBE WORK
Construct a 16' x 12' Addition and a 16' x 12' Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See stipulations on plan.
r
� WAR�IMIG �
Before digging catl for �
att ufility locations
SEPARATE PERfi�ITS REC�lilR�� FpR R a5a-oOOZ �
WtkING, HEATING, PLli�ri�iivC; fii�iD SfGNS. E4UIRED By �qW �
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTILATING OR AIR CONDITIONING.
TMIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDEO OR ABANDONED FOR A PERIOD OF 120 DAVS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE HEAD AND EXAMINED THIS APP�ICATION 1 STALLS GARAGES
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION SUHTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OFi NOT. THE GRANTING OF A PERMIT �6,660 �3.33
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �i2�F.75 Fire .5�.' �6.66
PLAN CHECK FE TOT FEE
134.74
SIGNA P OFCON�RA R AUTHOA�ZEDAGENi IDATEI pq VALI T THIS IS Y R PERMIT
, / � � VV �
1
GN TUAEOF pU WNEABU�LDER� iOATE� DCftiNS� Oti7E
�.
NEW [ ]
ADDN � [ )
AL�'ER [ J
CITY OF FRIDLEY
SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2
Build'uig Permit Application
Effective 3/1/96
��
���
ConstcvctionAddress: ?4 5,j /�������.y� �,Q/��� /i/�, �,
Legal Description: ,L t� T 7. ��l� C� � ���"' /�'t Qn S r`! �'r� Cr�i i�i0 �
Owner Name & Address: �e va ` SliJ� �. e/► . S�yrtQ Tel. # s7� - L�/ 5' %
Contractor: S e(� MN LICFNSE #
Address: �� ,�� �. � Tel. # S a-r7 Q
Attach to this application, a Certificate of Survey of the �
lot, with the proposed construcdon drawn on it to scale.
DESCRIP'I'ION OF IlVIPROVEMENT
LIVING AREA: Length ��j � Width � Height S�'D Sq. Ft. %�'! �.�-�7
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Len i(9 i idth / Z� H Ground �� Sq. Ft. ! �,X�5.8Z-
OTHER: ����nt.t G4 A'-� 7 ��C/c --
Corner Lot [] Inside Lot (] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Fstimated Cost: $�(�. � ,
Approx. Completion Date:
�, lCost on Back) .
�Y --
Dri�eway Curb C�t Width Needed: . Ft + 6 Ft. _ �� Ft x$ _$
DATE: APPLICANT: • � Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Fscrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ ,�� ` Fee Schedule on Reverse Side
$ � �O . 001 of Permit Valuation (1 / l Oth °!o )
$ �,3 3 $.50/$1,000 Valuation
$ � $900 per SAC Unit -
$ $5.00 (State Licensed Residential Contractors)
$ `—� Alt. "A" or Alt. "B" Above
$ `—' $450.00 Conservation Plan Review
$ �- Fee Detennined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ ��7 Fs �
. .
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SuB�ECi
City of Fridley
AT TNE TOP Of THE TWINS g � I L D I N G P E R M I T
r
� .
� �
� ; y ����� COMMUNITY OEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1 . .
l•--.�� "' �'� CITY MALI FRIOIE� SS�32 NUMBER AEv
L 763-571-3450 910- F 15
JOB ADDRESS 7053 Hickory Drive NE
1 LEGAL �07 NO. BLOCK TRACT OR AODITION
oescR. 7 1 Ostman's 3rd Additior
2 PROPERTY OWNER MAII ADORESS
Kevir. & Mary Swanson 7053 Hickory Drive NE
3 CON7RACTOR MAIL AODRESS
Same
4 ARCNITECT OR DESIGNER MAIL AODRESS
5 ENGINEER MAII A
8 USE OF BUILDING
Residential
7 ClASS OF WORK
❑ NEW � ADDITION
8 DESCRIBE WORK
Convert existing deck into livir
Construct a 268 sf entryway behi
9 CHANGE Of USE FqOM
STIPULATIONS
See notations on plan.
SEPARATE PERMiT�
REQUIRED fOR:
PLUMBING� ANDnS16�IS
OATE I PAGE OF
8/27/02 � �
ZIP
3301�
�
RECEIPT NO.
v '� �
APPpQVEO OY
SEE ATTACMED
S►IEET
PMONE
763-574-0157
PMONE LICENSE NO
PHONE LICENSE NO.
PHONE LICENSE NO
O ALTERATION O REPAIR O MOVE O REMOVE
space (16' x 12'); Construct a 16' x 16� Deck;
garage
TO
���
6� fo�� , ��NG
a!I �d��8i�� cap for
4�j��� rions
���U�RED
By ��1�
SEPARA7E PERMITS ARE REOUIqEO FOR EIECTRICAL, PIUMB�NG, HEATING. ���` v• Vv•�.
VENT��ATING OR AIR CONOITIONING
THtS PERMIT BECOMES NUII ANO VOID IF WORK OR CONSTRUCTION ZONING
AUTHOR12ED IS NOT COMMENCED WITHIN 80 DAVS. Oii IF CONSTRUC710N
OR WORK IS SUSPENDED OR ABANOONEO fOii A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCEO, NO DWLG. UNITS
1 HEREBV CERTIfV THAT I NAVE READ AND EXAMINEO TMIS APPLICATION 1
AND KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS Of �AWS VA�UA710N
ANO OROINANCES GOVERNING TMIS TVPE OF WORK W�LL BE COMPLIE� @9 SOO
WITM WHETHEF SPECIFIEO MEREIN OR NOT. THE GRANTING Of A PERMIT •P f
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL TME pEqMIT fEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON-
STRUCTION OR THE PERfORMANCE Oj/CONSTRUCTION �LH1.2.S
s�cN•
��2EO�GENi iD�iEi
— ���z
Q� iD�iEi
F
OCCUPANCY GROUP IOCCUPANCVLOAD
SO.FT CU FT
OFFSTHEET PARKING
STA�LS GARAGES
suArnx
$4.75
SAC CNARGE
Fire SC $9.50
TA� FEE
$195.50
Y VAL
RMIT
r�i r
(VEW ( J CITY OF FRIDLEY Effective 1/1R002
ADON (] 6431 University Ave NE. Fridley. MN 55432 (763) 572.'i604 Bidg insp
�►LTER ( J SINGLE FAMILY AND DUPLEXES R-1 AND R Z
BUILDING PERMIT APPLICATION
Construction Address: �� �� � �6G�p � ��, � E"
Legal Description: _ L C� T % , ,� �O C /� � , �.S �'"N? Q /I �� 7r %/' U � AQ� ��`i0�
Owner Name 8� Address: l�P c/i ✓► � 1'� Q rti1 SC</'�� S�Y( Tel. #?�3 ~ 3 �Y �� l S �
Contractor. Jti° L, l= MN LICENSE #
Address: .�✓4/�'t �� Tel. #
LMNG AREA:
GARAGE AREA:
OECK AREA:
on�eR:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length �� I Width _ jo�- / Height � Sq. Ft
Length Width Height Sq. Ft
Length �� Width �� H round Sq. Ft
��
CS t P
��,�us
Canstruction T pe: 8r� �4 Estimated Cost: $ `'i � S�`� '� a��. S
Y mn �Y
Driveway Curb Cut Width Needed: Ft + 6 F= Ft $ _$
oA�: �l�y/� '
� APPUCANT: Tel. #?�3 �- S7 �-4 i.S 7
Call (763) 572-3604 for Pertnit Fees if mailing in ap cation or Fax to T63-571-1287 if using credit card and we will
call you fo� card number.
Permit Fee
Fire Surcharge
State Ss�rcharge
SAC (:harge
License Surcharge
Driveway Escrow
Erosion Controi
Park Fee
Sewer Main Charge
$ ��%��
$ —
$
$ l�
$ � ��
$
$
$.
$
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Ait. "A" or Ait. "B" Above
$450.00 Conservation Plan Review
Fee Determined by �Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ u�•� STIPULATIONS:
BUII.DING PERNIIT FEE SCHFDULE
The Chief Building Officiat 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 manner herein provided co-wit: °
TOTAL VALUE
� 1 to $500
��01 to $2,000
S'_,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
FEES
$23.50
�23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
�69.2� for first $2,000 ptus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or firaction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
._ $1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
�$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1, 000 or fraction thereof
DRIVEWAY DEPRESSION ESCRO�V
(Concrete Curb Streets Only) �`'
Removal and replacement of curb and gutter only - Driveway width plus 6 feet �imes $17.00.
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 framing. New Houses Onlv
�
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. ��r� ��s��ro Engineers � SurQeyors. � � �•» c•+• ��_ . ;,�';.^. �
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: _ . I�qf{M,�f �lt ifildin�s� it aMr� th���ee►� and all •isibl� �eereatl�Mnts� ii anr� irom or on soid' I�nd. TAis i��+r is ..=��
n�d� eiJp'i� cewwestie� voifb a n�erf�g� leen.new. Ming plec�d on fM prop�rty end ne liobilitr it essvn��d '-�i;�:-'
_ z�ssNt ti 11w MIrM e� ivek n��rtgoy� or �n�. eth�r iet�e�st ae7vind br ►Iw nasen sF aueh mertyey�. It ir • �� �F
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' SU6URSAN ENGINEERtNG, INC. .=�
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new
16'x 16'
deck
256 sq ft
- 268 sq ft new _
sd i�'�''X'�
o.�v �i�,� o w
existi�g garage 44� sq ft
new home sq ft 1696
, •
adding 192 sq. ft. of living area
great room/living room
existing home sq ft 1224
�
kitchen
;
master bedroom
�
CR.DSS
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c�ty of Fridley
AT TNE TOP OF TME TWINS
i �
� �
� ; y ����� COMMUNITY OEVEIOPMENT OIV.
r � � PR07EC71VE INSPECTION SEC.
� . �
� � �'•'1 � CITY NALL FRIDLE� 55�J2
�""'� � ��� 763-571-3450
SuB�ECT
BU ILDING PERMIT '
NUMBfp pEV OATE VAGE Oi
s�aF�s 10/16/02 � �
108 ADORESS 7053 Hickory Drive NE
t LEGA� �OT NO. BIOCK TRACT OR ADOITION
oesca. 7 1 Ostman's 3rd Addition
2 PfiOPERTY OWNEH MAIL A�ORESS
Kevin & Mary Swanson 7053 Hicko�y Drive NE
3 CON7FACTOR MAIL AOOFiESS
Same
!
5 ENGINEER
Eq MAIL AODRESS
MAIL AODRESS
ZIP
21P
33180
RECEIPT NO.
�7d'S
AIPqOVEO SY
SEE ATTACNED
SNEET
763-574-0157
PHONE LICENSE NO
E LICENSE NO.
PMONE LICENSE NO
6 USE Of BUILDING
Residential
7 CIASS Of WORK
C� NEW O ADDITION O ALTERATION O REPAIR O MOVE O REMOVE
8 OESCRIBE WORK
Construct a 32' x 30' �nd Accessory Buildin,�
9 CHANGE OF USE FROM
TO
STIPULATIONS Special Use SP 4�02-09 was approved with the fol�owing st�pu�ations:
1. Staff shaZl conduct regular inspections of this si�e. If at any time a traii
simuiating a driveway is present, a hard surface draveway will need to be expeiied
within 90 days. 2. The petitioner sha3i obta�n aIl necessary buiid�r�g perm�ts pr�or
to construct�on. 3. The structure sha�I not be used for a home occupation or �iving
area. 4. A�1 vehicles shall be stored on a hard surface as approved by the Cit�.
5. Total square footage of ail accessory structures must not exceed 1400 sq ft.
6. Accessory buildings shal� be arch�tectura�ly compatible with the same sidir.g and
color scheme.
�������
SEPARATE PERNii�� �efore di99in� call for
REQUIRED FOR: ��� ��tv �ocations
WIRIHGj HEATING� 4l�2
�q ._,��
rrae oc coN
SEPARA7E PERMITS ARE FiEOUIRED FOR ELECTRICAL, P�UMBING. HEATING.
VENTILATING Op AIR CONOITIONING.
THIS PERMIT BECOMES NUII ANO VOIO If WORK OR CONSTRUCTION 20NING SO. fT
AUTHORIZEO IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOEO OR ABANDONED FOR A PER100 Of 120 pAYS AT
ANV TIME AFTER WORK IS COMMENCEO. NO DWIG. UNITS
I MEREBV CERTIfV TNAT I HAVE REAO AND EXAMINEO TNIS APP�ICATION 1 STA�LS
AND KNOW TME SAME TO BE TRUE AN� COFiRECT. ALL PROVISIONS OF LAWS VALUATION
AND OROINANCES GOVERNING TMIS TVPE Of WOqK WILI BE COMP�IED �21 OOO
WIThi WME7MER SPECIi1ED MEREIN Op NOT. THE GRAN7ING Of A PERMIT �
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEI TME pERM17fEE
PROVISIONS OF ANY OTHER STATE OR LOCA� I.AW REGUTATING coN- �335 . Z.S
STRUCTION OR THE PERf�ORMANCE OF CONSTRUCTION
jhW�O� N'AA TOpOAAUTMOA�ZEO�GENT DAiE�
, �,�_ ,Qrr4 d.�
lOAO
FT
FSTiiEET PARKING
IGARAGES
$10.50
AC CMARGE
Fire SC $21.00
OiAL FEE
$366.75
THIS IS YOUR P� MIT
N�uv [ J
ADON [ J
' n�rER Il
CITY OF FRIDLEY Effective 1/1/2002
6431 University Ave NE, Fridley, MN 55432 (763) 572�3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R 2
BUILDING PERMIT APPLICATION
Cohstruction Address: �0 � 3
Legal Description:
Owner Name 8 Address:
Contractor.
t,v i �!
�Z�c�
��+
i��
?N�`rd ��l d:
Te�. # �63- 57y �/5� �
Address: ��.P Tel. #
LNING AREA:
GARAGE AREA:
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 3 Z� Width 30 , Height ��� Sq. Fk �
OECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER: �
X�. �� -� � •
�
Construction Type: t� v D d ��I,v►�L Estimated Cost: $ ,��
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x =$
DATE: %4�/G�d L APPLICANT: r Tel. # 5�'�
Caii (763) 572-3604 for Pertnit Fees if mailing in plication or Fax to 763-571-1287 if using credit card and we will
cali you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Esc,�ow
Erosion Control
Pa�lc Fee
Sewer Main Charge
CITY USE ONLY -
$..�.5�. �� Fee Schedule on Reverse Side
$ �/. DD .001 of Permit Valuation (1/10th%)
$ /a . SO $.50/$1,000 Valuation
$ $1200 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 $ STIPULATIONS:
BUILDING PERMIT FEE SCHEDULE
4
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 manner herein provided to-wit:
TOTA�L 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
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up _ $5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRE.SSION ESCROW
(Concrete Curb Streets Only) •
Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00.
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.
YERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the �xisting foundation will be required before
proceeding with the framing. New Houses Onlv
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Rum River Lumber
10141 Woodcrest Drive
Coon Rapids, MN 55433
UNITED STATES OF AMERICA
(763}862-7300
S 001
O QUOTE4
� QUOTE LEVEL 4
p QUOTE LEVEL 4
T
O
PAGE 1
INVOICE DATE 8/27/2002
INVOICE NO 26825
« QUOTE »
S JOB ONE
H KEVIN SWANSON
I
P
T
O
SLS1 SLS2 � DUE DATE DISC DUE DATE ORDER NO ORDER DATE SHIP DATE
_ _.. _ _..- -__ __--.. _..--- ------__. ----
8/27/2002 8/2T/2002 00042600 8J27/2002
_ _ ...... ... _. ._... _. _ __ _ _ _
_ _
_ _
TERMS DESCRIPTION CUSTOMER PO NUMBER SHIP VIA
_ __ ......... __ _...__
_. _
Net 30
_...__ _...... _ _ ........ _. ... _ __ __ . _ _ _
ITEM ID TX CL UNIT ORDERED SHIPPED UNIT PRICE
61SIL 0 EA 3.00 .00 7.24
6 O.C. SILL SEALER 50
1T26RL 0 LF 110.00 .00 .G5
2X6 ACQ STD .40 R/L TREATED
1 F26RL 0 LF 250.00 .00 .43
2x6 SPF RANDOM LENGTH
1 F268PC 0 EA 140.00 .00 3.47
2X6-92 5/8 STUD
8M1178 0 LF 34.00 .00 3.21
11 7/8 MICRO LAM 1.9E
1F2108 0 EA 1.00 .00 6.15
2x10-8 SPRUCE/HEMLOCK
2C4834 0 EA 4.00 .00 20.65
4X8 3/4 CDX PLYWOOD
26348 0 EA 36.00 .00 8.45
4x8 25/32 BUILTRITE SHEATHING
N8T 0 1 1.00 .00 1,593.92
Trusses
1 F2414 0 EA 128.00 .00 3.91
2x414 SPF
2C4812 0 EA 40.00 .00 15.99
4X81/2 CDX PLYWOOD
7JS56S 0 BX 1.00 .00 20.73
1/2 STEEL H CLIP
1F2610 0 EA 4.00 .00 4.60
2x6-10 SPF
Thank you for your order.
TAXABLE NONTAXABLE
FREIGHT SALES TAX
MISC
PREPAYMENT NET DUE
SHIP NO
EXTENSION
21.72
71.85
108.10
485.58
109.17
6.15
82.62
304.37
1,593.92
500.48
639.58
20.73
18.40
TOTAL
Rum River Lumber
10141 Woodcrest Drive
Coon Rapids, MN 55433
UNITED STATES OF AMERICA
(763}862-7300
s ��
O QUOTE4
� QUOTE LEVEL 4
p QUOTE LEVEL 4
T
O
PAGE 2
INVOICE DATE 8/27/2002
INVOICE NO 26825
« QUOTE »
S JOB ONE
H KEVIN SWANSON
I
P
T
O
SLS1 SLS2 • DUE DATE DISC DUE DATE ORDER NO ORDER DATE
8/27/2002 8/27/2002 00042600 8/27/2002
_ __._.__ _.... _... __ _ __._. . _ _ _ _ _ __ _
TERMS DESCRIPTION CUSTOMER PO NUMBER SHIP VIA
_...._. __ .... . . . . . .... . _. _.... . __ . .... __ _ _ __ _ _ _ _ _
Net 30
_...... _.._ _. _.. __ _ __ __ _
ITEM ID TX CL UNIT ORDERED SHIPPED
1F2618 0 EA 2.00 .00
2x6-18 SPF
1 F2616 0 EA 2.00 .00
2x6-16 SPF
5AIW32 0 EA 2.00 .00
TOUGH GUARD ICENVATER
5AFELT 0 EA 4.00 .00
15# PREMIUM FELT
5ARV6 0 EA 5.00 .00
#865PLACTIC ROOF LVR BLCK
5AXT25 0 BL 40.00 .00
XT25'DO NOT INVOICE'
1C1612C 0 EA 6.00 .00
1x6x12 #3 8 BTR CEDAR R. SAW
1 C1614C 0 EA 6.00 .00
1x6x14 #3 8� BTR CEDAR R. SAW
1C123 0 LF 154.00 .00
1x2 #3 CEDAR R. SAW
2A1838TP 0 EA 5.00 .00
12x96 3/8 TEX PLYWOOD
2A2838TP 0 EA 9.00 .00
24�Q6 3/8 TEX PLYWOOD
7MC1646R 0 EA 10.00 .00
16 X 4 BROWN SOFFIT VENTS
6H12T 0 EA 108.00 .00
12x16 TEXTURED PRIMED
Thank you for your order.
TAXABLE
NONTAXABLE FREIGHT SALES TAX
PREPAYMENT
SHIP DATE
UNIT PRICE
9.82
7.31
24.07
17.18
7.77
11.80
9.91
11.56
.24
6.42
12.85
1.52
11.68
MISC
NET DUE
SHIP NO
EXTENSION
19.63
14.63
48.13
68.71
38.87
472.14
59.45
69.39
36.84
32.11
115.67
15.18
1,261.87
TOTAL
.
� • ,
__ ' Rum River Lumber
10141 Woodcrest Drive
Coon Rapids, MN 55433
UNITED STATES OF AMERICA
(763}862-7300
S oo�
O QUOTE4
� QUOTE LEVEL 4
p QUOTE LEVEL 4
T
O
PAGE 1
INVOICE DATE 8/27/2002
INVOICE NO 26826
« QUOTE »
S JOB ONE
H KEVIN SWANSON OPPT. ATTIC
I
P
T
O
3LS7 SLS2 DUE DATE DISC DUE DATE ORDER NO ORDER DATE SHIP DATE SHIP NO
8/27/2002 8/27/2002 00042627 8/27/2002 ---
_._......._...--- _---.._...____.._..-------._._..........------------.._ _..... .____......_._.._ _-------___............_.._ ..............__......_...........----......_._....-----_...._ .._______.._..__......_.__................ _...........__ _ _ -----
TERMS_DESCRIPTION CUSTOMER PO NUMBER SHIP VIA
--. _ . . ..........._..........._....-------
Net 30
_._....-------------.._...._._........_...---_._....----... ................--------...______--._.._................._._.__......_.............._.......------ __...---..........._._._........----._._.._.__....__._._.._..__....._._._..
ITEM ID TX CL UNIT ORDERED SHIPPED UNIT PRICE EXTENSION
BTTR 0 EA 3.00 .00 36.89 110.67
11 7/8 X 17- 6 TIMBERSTRAND
201181242 0 EA 15.00 .00 4.41 66.15
1-1/8X12-42 P.B.TREAD
1P18122 0 EA 5.00 .00 9.65 48.25
1x8x12 #2 PINE
204834TG 0 EA 12.00 .00 13.00 156.00
4x8 3/4 T&G ORIENTED BD. OSB
7C50664 0 EA 6.00 .00 4.12 24.72
FRANKLIN SUB.FLOOR ADH/QT
1 F2410 0 EA 20.00 .00 3.37 67.40
2x410 SPF
N8T 0 1 1.00 .00 1,382.30 1,382.30
DIFF. IN ROOF TRUSSES
Thank you for your order.
TAXABLE
1,855.49
NONTAXABLE
.00
PREPAYMENT
l> �" D f� /4- �o �� �!n J 5.�
FREIGHT
.00
.
O P > > ��
.00
SALES TAX
120.61
MISC
.00
NET DUE
TOTAL
1,855.49
1,976.10