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AF - 46097City of Fridley, �Minn. BUILDING PERMIT N° 5941 Date: _� > � Owner: Builder . Address ____ Address — .� �' T��BUILDING No. .�.�r�s��.�-- Street ____ ..�.�L_,� P of Lot Lot ��,..�.!'" Block ��—..�_ ddition or Sub-Division ,��' .�' �... '" Corner Lot __ Inside Lot � Setback � Sideyard —.L� # � ' � Sewer IIevation Foundation IIevation DESCRIPTION OF BUILDING T e Us : +� � � Front Depth �� Height � Sq. Ft :!� Cu. Ft •e��r r� � A Depth Height �� Sq. F� �y�... F_� Cu. Ft ..,,�.i��+d� of truction Fst '_`To be Completed � � . .r 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 wlth the description above set forth and in compliance with all provisions of ordinances of the dLy of Fridley. ll� � 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 worluuen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of k'ridley, Minnesota regarding location, construction, aiteration, maintenance� repair and moving oP buildinga �� city ]imits and this permit may be revoked a t �� u� v�y'alati� of any of the provisiona of said � Buflding Inspector Nonc�: This pannh doss not eovsr �he eanatrueHon, in�tallaHon fo� wiring. plumbing, gas headeg, sswer or wmr. Bs sun fo sea fhs Buildia8 lospeeror ior apuate permifs for fhas itsm�. ,�+.. � �y: _ �c+ l_ L ✓ .� \ °< I � � � a�4 r„� ..i,-a �=;'�' i o,� �� -�.�, �� x� ��`� � `�� s�� m �+- �oo� .� o � o�� e o ° �� ° � s o �. �o�+' � 7�p4 �� ' O � ` l � �` � N �o �� N� �O N N �� ti o �� U� � � � e � � ��o , � Q tV �' Q " � � � � � �� s� �, � ajco�, O � ' �• p � �' � \� ��.� �1 . � � � o�(n�� •'�°� � ° �-�� . � Z �a � � � a��`� ^ c� � �"o o : °- 0. �� O N � a�� o ON�N - N, ? ��N�l � �(n p,o �. O N. n � � �� ° � .�M T . � �' � S � � r `i �ak��o .D � � �, }`�,o� �o� �;��, �r p w � {�, ko1 � P • .�a w : � l ��°��d ° ��Q226�'•PJa�A�� `� �j1 / ,�� ; ��o � o�� ►�, o,� y �-�o ,�ok �k�o;��`�,o�k � `�� ,t � �'��k��° 6�. o k' �,, ' �o�, � o � • . �l� �o �,o� � � , � 01 P' 01 �',�o.►� �a� �,�k ti k z a k��? j,��,'• �� a�yo � ti � �°� a�'•� ` � �` �� 0 ��v � a�� p�ow � , � � � � N � /�, �`� ��. N / a��1 aa Ja��k .��ti ti�k�1 � �� titi �� IQl. 36 � y -- N �� , �S 7 :o ��. r. � �•. o.. : /�ti �v . n t0 � � . 11 � • i, � . �� S. 1 0 / � ti O y � w.�, a? ,rr'0-� �� pr � O �N� � � �• � �� N _ N r � �r Z O O � � � � � 0 C � � -` APPLICATION FOR BUXLDIRtG PERMtT CITY OF FRIDLEY, MiNNESaTA Owner' s Name r�l. ,D � R R � / / �'�'/ � / / e,oj Builder�� ,� �/ ,a �, .S � � a� � � lo� Address /27��s o�eR /��f� � �O�Sarea�Address �� o� ,D�.�,o�-� Au� �a S�re�9 � LOCATiON OF BUILDING No. �� Street�/>J/c �� s� ,� a�,� � Part of Lot �- Lot B1vck�,Addition or Suhdivisioa �/ c o aa e��/� p,�,i �//.� Corner Lot �___. Znside Lot tl Setback 6%� Side-Yard di �� EWBR ELEVATION FOtJDIDATION PZEVATION Applicant attach to Chis form 7:v'wo Certi£icates of Survey of Lot and proposed building location drawn on fihea� Certificates. DESCRIPTION OF BIIlZDING To be used as: o �s,t �ioo�4 --� 2�� D� P�/ , ��t � Fronti � 5�` Dep h�� Height 2 s t� R��B�s'�° Sq. Ft. / � / � Cu. Ft, / �'�� o � -�� a R a�� Front �� Depth 2 3 Height g� � � , Sq. Ft. ..��Z Cu. Ft. �.� �� Type of Conatruction ,�� ,� �„� Eatima.ted Goat �� a� To be Completed � � a � 9 G�. The undereigned hereby makes application for a permit for the work herein specified,.agreeing to do all work in strict accordance with the CiGy o£ Fridley Ordinances and ruliags of the Department of Buildiu�s, and hereby � declarea that a1.1 the facts and representations stated in this application �re Crue and correct. n � H �/ .1► � � � � / ...�..e � (Schedule of Fee Coets can be fouad on the Reverse 3ide). � �, . � � �� , � a BUILDING PERMIT FLE SCHEDULE Section 2. The Tnsgectos of Buildinga ahali, before isauin ehe�erecCion of �ny buildiag or structure, or for an ad iag building or structure, or for an $ � g��' pe�t for building or si��ture u Y lteratioas or re airs�to�anany e��e� appl��t for such �� p°n BPplication therefor, require Che a�' �i8t�ng in the manner here�n p�vid aftoe�iC';the P Yment by the amount herein balow 8et £orth aad 2•�. E'ar aay such t�att 8 Permit for the erection of any fire- gara�es Warehouse, factory ar proof bui],din 8�y fire-proof addition, for sim�,],8r� occupaac �' ather grain elevator, or for the erectioa of shall be at the ratevoi $Z.y.O for each one thous nd$ ub thereof, iA such cubical conten�s. y��et3ag bui].diag ic feet, or fractioa 2•�• For aay such permit for the ere¢i��dn . faetory or grain elevator °f $n for simil�ar occupaac ' O1 £Or the erectiott o� gare '�rO°g Sarage, warehouee, for each one rhousand�cubi�n eeti8�� build3n 8� y fire-proof additioa, � 11 be at the raCe of $1.25 the Mitnne$ olis Buildia s cl�saified ae a� p S Code. f3reproot" b �Q�_ . y Section 502 og 2•3• Eor any such than a g$rg e pe�t for the''erection of'an additioa �'�ar�house, fecEo Y noa-£3reproof buiidiag othet each one�thous dicubiccfeetncv�t�r�ya�aisting�bu3ldiaan_ y noa-firepr�f � Permit $1.00 �Qr 6�g ?`4• For any such pex�m�t warehouse, facter for the erectio� o� 8n addition Y or grain elevator 3' aon-fireprQOf gar�ge� . , for aimilar a�cup�� or for the ereceion of aa building or.add3tion Y' �o $n3� existin 3' tton-fire�r� or fract3on thereof _ a�aety cents � bu$lding or for each auch �$0.90) for each oae �housand cubic feet , ia the cubizai contenta �thereof with a mi,ni�av� of . For the purpose of computin - �4•�• of e.ny building or additiongtoea8uniformiheight t . g�rouad area covered fr� II � pe��8� the cubical contents �- basement or cellar to the aVerate$�� hrau�hout by raultiplying the i6) 9.aches below the floor iimme of the average height of the roof surf ce of�gh��mBiAe�u pper murface or to the For re a3rs �a��s of a pitched roof, 2•5. p or alteraEione to aa �xiatin s� $t �he rate of $3.00 per each � �cture, �he fee shall be thereof fn the cost F�v`� ��dr� Dollars of alZ proposed work. i$5 00.�0) or frsction 2°6• In no c�se eha11 the �Eee charged for aa Section 2 be less th�n $4.00. Y Per'mit as � � set forth ia � ��v � �� _ _ . ± L - y � G � � � � � p � : N � : � . m : m . y : o . a . � 0 ' � . � • sn � � G ! � � �� W � � p � � � � � � N ' O ' O � . O . . W : : � : : � x � � � � � O O O � � � H Q � � C � Cro" � bd z � � z � z � m y �, m � � 8 � �. 8 � M y � hi � x � � fD � �4 �� d y : O � � � � � y � ¢ O : � �- : � N . �- W�, O . �� 0° . a g ' °q . oa o : . . . � td : : : : : � : : : : � �e �e �a oa ia �a tn � ca t.� ca r r+ ►+ C�it p C�i� O O O � tsa t�s tH t» en � � H � � � 0 � x � v ► � � A � r � m �/'� �I m C r m . � w N .• � � a. a. �' � Storles x�8 w�ren � m ctosers '�f �i URINALS RT � � ` MTH � �� a �� p � � I SiNKS � � � WASH � TRAYS DRINK � �d V � � FOUNT. sHwRS. � �ooa DRAINS �� BASINS AUTO H/�$}��{ GAS MPL GAS RAIVGE GAS OPENINGS a • z a �, �n a m A m � � A I �' ° � � � �. �. � � � � � � � � � ° � � �� . � R' °� � � oa �, C � bd C� '� � � or�, � Q' � �o � � � � � � ¢ � oc��o5'�• � � � � ��o � ro � � � �'i � �,�� °� � � .� „ '° ` �;, r � , � ��.� � ❑ .� 0 � � � �� e � �. `� �� ! � � � b � �� 41 p p� � � � w o � � R, � p � �'�,o � N �`°�� p a fD � o�� y � �� yO •O9 � � ►" fD �. � ��. C � iT� � A �ro a� Rx & h°n p � M �� W �� i � � � � �- � �� -`' � � � � � a � � �� O OM \ bs � ! � � ro �' � o � � � � � �. � �° � a U � �� City of Fridley, inn BUILDING PERMIT Date: March 7, 1969 �er: Walter Johnson B�� Chuck; s Const. Co. Ad�e�a 1334 Hillcres t Drive Ad�� 3800 Hayes St. N. E. ��d�o N° 10129 No. 1334 Lot 22 _._. Corner Lot �_ Sewer IIevation LOCATION OP BUILDING Street �llcrest part of Lot . Block 3 Addition or Sub-Divfaion Moore Lake Hills Addn. Inside Lot Setback — Sideyard Foimdation IIeval3on DESCRIPTION OF BUILDING To be Used as: Cabinet & Top �ont _.._ Depth Height Sq. Ft. Cu. F't Front Depth fTeight Sq. F't. G�. F't. Type of Constructfon Frame ��_ 150.00_ To be Completed In conaideral3on of the issuaace to me of a perrnfi to c the building described above I agr�e to do the proposed work ffi accordance with the description above�� and in compli�nce with afl provis%ns of ordinances oP the dty of FrYdley. 67 (� �!i /f' e°1 In coasideration of the gayment of a fee oP $ 5. 00 � p�t is hereby granted to Chuck � s Const . Co . to consLruct the buflding or adc]itton as described abave. This permi� is gtanted u�n the express condition that the peison to whom it ia granted and h3a agent�, employees and worlmien, ffi all work done fn, around aad u�n said building, or any part thereo� shall conform in all reapecta tfl the ordinanc� oP FridleY� M3nnesota regarding location, conatrucl3on, alteration, maintenance� repair and maving oE bufldinga witl�in 'the dtY 7fmi'ts an�i thia permit may be revoked at any tiane upon violation of any oE the provisions oP said ordinances. �� Official .� Buildin8' � Hank Muhich NOflCE: 'I6h psnnN d� eo1 eovsr fhs eoes�rocHoe, festaWfion ior wirieg, plum6ine, ea haNee, pwu er �r�fsr. 8� an fo a� �6a Bulldio8 tesp�etor ior aparaf� porm6s for t6as h�ms. _" „ ., _ � 9PPLICATION FOR BUILDING PIl3MIT �� ITY OF FRIDLEY MINNESOTg � � ; � � �` � � /' � • a� � � � � � r� � � ,�' � � ; � � �• .� , - _��+� : �.. �/ : � _ �r�� _ -- -' _ - , '��' i / � - / LOCgTION OF BIIILDING Noo r �;3� smx�r � e�,e� , � LOT �� BLOCK � AUDITION OR SUBDIVISION �. .�� CORNER LOT INSIDE I,OT SE°I'BACK SIDEYARU .�.,--�.._» SEf�fF� ELEVATION TOP OF FOOTING � Applicant attach to this fo�:m Two Certificate� of Survey of Lot and proposed buia.ding location drawn on theae Certificates. To Be IIaed 9.s : DESCRZPTION OF BiTII,DING Front Depth Height Square feet Cubic Feet Front Depth Height � Square feet Cubic Feet Type of Construction �'�•�.F`C.-`�—�� Estimated Coat �.�� To Be Completed �� % The underai�nn.ed hereby makea application for a permit for the wark herein specified, agxeeing to do all work in atrict accordance with �the City of Fridley Ordinances and rulin.ga of the Department of Buildinga, and hereby� declares tha,t all the facts and repreaentationa stated in this application are true and correcte DATE e�� SiGNA!l'iTRE (Schedule oi Fee Costs can be fouiid on the Reverse Sideo) �� • , .. �.. :�, _ f:, � � � . = M. - - BUI7�DING PERMIT�FEE SCHEDULE SECTION 2. The Inspector of Buildings ahall, before iesui:ng permite for the erection of any building or etructure, or for any addi,tion to any �xisti.n� structure or building, or.for any alteration or repa,irs to an�r egisting buildi_ng or structure, upon application there�ore, require the pa.yment by the applicant for such permit of fees to the amQunt herein below set forth and in the manner herein provided to-wit: IIniform Building Code: Type 1, 2, & 4-$1075 for each one thousa�d cubic feet, or fraction thereof, in such cubical c.nn.tents. Type 3& 5- $1.50 for each one thoueand cubic feeto For the pu�pose of computing �eea for building permite, the cubical Contenta of any'buildix�g- or� addition to a uniform hei$ht" throu.�hout by multiplying the ground area covered from a point six (6) in�hes below the floor line of the basement or the cellax to the average hei�ht of the upper surface or to the average height of the roof eur�ace of thQ ma,in gable of a pitched roof. For repaizs or alterationa to an exiating structure, the fee ehall be at the xate of $3.00 per each five hundred dollara ($500.00� or fraction thereof in the cost of all propoaed work. In no case shall the fee char�ed for any permit as set forth in Section 2 be lesa than $5.00. NSSSD Coxinection Chargea based on location - 9sea 1 or 2. , -. �� /"� ...., _ s ,� �,.., - SuBJECT City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M i T i� � � i • COMMUNITY DEVELOPMENT OIV. ' j \i -��-� r � � PROTEC7IVE INSPECTION SEC. � � � i_--_� ��"' �.� CITY HALL FRIDLEY 55432 NUMBER AEv i 612-571-3450 910-F15 10B ADDRESS 1334 Hillcrest Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. 22 3 Moore Lake Hills 2 PROPERTY OWNER MAIL ADORESS Hazel Johnson 1334 Hillcrest Drive NE 3 CONTRACTOR MAILADDRESS D& D Home Improvement Inc 7401 Central Ave 1VE, d ARCHITECT OR DESIGNER MAIL A�DRESS DATE I PAGE OF 10/26/95 � � ?�� ftZElYI NV. � �PROVED BY SEE ATTACHED SHEET ZIP PHONE 571-6437 21P PMONE LICENSE NO MN 55432 784-7543 484( ZIP PMONE UCENSE NO. 5 ENGINEER MAILADDRESS ZIP pHONE LICENSENO 6 USE OF BUILDING Residential 7 CLASS OF WORK �C NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE 8 DESCRIBE WOFlK Remove exist 9 CHANGE OF USE FROM STIPULATIONS deck; Construct a 16' x 10' Deck See notations on plan. TO ��i' 'a'�� 9��`v� Before tliggin� ca1! for all utility locations 454-0002 REQUfRED BY LAVI� TYPEOFCONST. OCCUPANCY GHOUP SEPARATE PERMITS ARE REOUIHED FOfi ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTFiUCTION ZONING SO. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OH ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,371 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- @ STRUCTION OR THE PEFFORMANCE OF C NSTRUCTION. �p�FS. %S � PLAN CHECK fEE License SC $5.00 SIGNATUAE OF CON'RACTOA OA AUTNORIZE� AGENT IDATEI HEN PfiOPERIY V D) � � /�/ 1 V� SiGNATURE OF OWNEA iiF OWNER BUILDEAi iDATEi —�' ai nr, i sv UPANCVLOAD CU. FT. OFFSTREET PARKING IGAFAGES $.69 SAC CHARGE Fire SC $1.37 TOTALFEE $52.81 � N� [] ADDN [ ] AL1'ER [ ) CITY OF FRIDLEY SIN(iLE FAMII.Y AND DUPLEXES R-1 AND R-2 Building Permit Application c�a,��on Aaa�: � � � `� /�a� I I �v��s -� .� �^ . Effective 5/26/93 r.ega� nescripaon: --- Owner Name 8t Address: %� z��, l �� h � � � � Tel. # �� °- ��,/,� � Co�tractor: D 8 D Home Imnrovement. Inc _ MN LICENSE �l 4840 Addre�s: 7401 Central Avenue N.E., Fridley, MN 55432 Tel. /f 7g4-7543 Attac6 to this application, a Certiftcate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRI"PTION OF IMPROVEMENT LIVING AREA: Length (iARAGE AREA: Length DECK AREA: Leng�th � " � 01 IliSll. w�act� Width V�lidth . � n � � � , _ Heig6t Height x�c�a �. � J� �d l/ / f.__��Ll Scl- Ft. Sq. Ft. Sq. Ft. � % � � � ., `�� Corner Lot [] Inside Lot � Ft. Yd Setba�ck Side Yard Setbacks Type of Constivction: �� "�i�� ,� - Estimated Cost: � /` �'� b`� /,T �� Approx. Completion Date: ,/� - � � � �� '� � /, Z 1 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x� _$ DATE: � °� �� APPLICANT: �� Tel. fl ��"�" �� Petntit Fee Fire Surcharge State Surcharge SAC Charge Lice�se Swcharge DfIVCWdy ESCfOW Erosion Control Patk Fee Sewer Main Charge TOTAL � v � �, �� /, 3% � � G �i S $ �� $ $ S � a � dr d �� .�i .7:l�T�i Fee Sch�iule on Reverse Side .001 of Peimit Valuation (illOth%) $.50/$1,000 Valuation $750 per SAC Unit SS.00 (State Licensed Residential Contractors) �t. ~i�� i 111t. �Dw Al7l7vei Conservation Plan Review $450.00 Fee Determined by Engineering . Agreement Necessary [ ] Not Nece,csarS► [ ] ST(PULATIONS: � , �� ti '� �� o ° v � t° � � �� , � �� . �� . �,� � � - y �'P � � �n �' -- �� o� �°5 .��, � : ` 9 3��. a w �, k°1 ��P' �� J w a�� , o •t� � tik � � �, ': � ��o � �l ��oa ��,Q��y �� d'o o m �d� ok �k�qW�t�lod� °� .,. o � � ' s �y. � X� � • �� 0� � ok a � � o, � oti � • . 1 �o k �;o� � , o � � � o`I P' }o� �a�3 a � �,�►�� b k'ti�•f�ti�i�, t�t��ak o 0� .. � � � 4 ��D� p�J�� p �'1 �� »' � � `� -� � � �10 `� o'� � �o °, �' � , a� a�°� o�.pO ' �� { 'L .. .�� ` ? p �1 ,� �`��C � X� � •.. � �D � � . . . 2�c�o ,. - 2 S � � � � � r,. N "'- y�ti„ 3 � � n� �o. < . 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City of Fridley ;, AT TH��_��54 6 U I L D I N G P E R M I T qE�81 14 ,. � �V ��_�� COMMUNITY OEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC ��6 � 1 ; � � � �"'1 � CITY NALL FRIDLEY 33�32 NUMBER pEV DATB P�GE OF AVpqOVEO B� �"""'�" �'� 612-571-3460 s�aF�S 10/6/98 � � JOB ADORESS 1334 Hillcrest Drive NE t LEGAL LOT NO. BlOCK TRACT OR AODITION SEE ATTACNEO oescR. 22 3 Moore Lake Hills SHEET 2 PiiOPEflTY OWNER MAIL ADDRES$ • 21P PHONE Hazel Johnson 5 1-6437 J CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO B& B Roofin Service 6760 s n 4 ARCNITECT OR DESIGNER MAIL ADORESS 21P PMONE LICENSE NO 5 ENGINEER MAIL AODRE$S 21P PMONE LICENSE NO 8 USE OF BUILDING Residential 7 CIASS OF WORK � ❑ NEW ❑ ADDITION O ALTERATION }� REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WOfiK Reroof house 16 S Tear-off 9 CHANGE Of USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PE1iMITS ARE REOUIRED FOR ELECTRICA�, PLUMBING, HEATING, TVP� OF CONST. OCCUPANCY GROUP OCCUPANCY �OAO VENTI�ATING OF AIR CONDITION�NG TMIS PEFMIT BECOMES NUIL AND VOIO IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHOR12ED IS NOT COMMENCEO V�1ITMIN 80 OAYS. OR IF CONSTqUCTION OR WORK IS SUSPENOED OR ABANDONED fOR A PERIOD OF 120 pAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWIG. UNITS OFFSTpEET PARKING I MEREBV CERTIFV THAT I HAVE READ ANO EXAMIN�O THIS APPLICA710N STA�LS GARAGES ANO KNOW TNE SAME TO BE TF1UE AND CORRECT. A�� PROVISIONS OF LAW$ yp�UATION SUiiTAX AND ORDINANCES GOVERNING TMIS TVPE Of WORK WILI BE COMPLIEO WITH TMER SPECIFIEO NEREIN OR NOT. THE GRANtING OF A pERM1T j .( DOE N PRESUME TO GIVE AU7MORITY TO VIOLATE OR CAMCEI TME pEqM17 FEE SAC CHApGE P VISI NS OF ANY OTHE TATE OR LO AL LAW REGULATING CON• RUC ON OR THE PERF ANCE F ST CTION Fire SC 1.3 /� � � Q� PLAN CMECK FEE TOTAL FEE i (/ S�GN4TUA F CON'FACTQA OA oUTMOA�2E0 oGENi IOATE� WMEN PROPERI A�IOA7ED THIS IS YpUR PERMIT _ � r (J�' - � S�GNATUAEO�OWNEpi��OWNEpBWIDEA� iD�tE� �0 �NS� - qpit ._ , NEW [ ] �DN L l ALTER [ ] ConstructionAddress: 4 Legal Description: _ CTTY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION `� ��c ��..� i l) � Fyt % I,f�L Effective 1/1/98 �I�-� �� c� Owner Name & Address: �/f% � �'� �O f7�� s��°! Tel. # .�' %l — � "�7 Contractor: �� Y��j`!Ls MN LICENSE # �G �/�— Address: �0�� 2�,��/�7JYl � % Tel. # ��-�a'�� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: Length I.ength DECK AREA: Ixngth OTHER: II2 �'�,G� � � / DESCRIP'TION OF IMPROVEMENT Width Width Width Height Height Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. V ' Construction Type��j ,�� / ��/L -�/=/= Estimated Cost: $ f � % � (Fee Schedule on Back) ]?riveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE:�G—Iv— jc� APPLICANT: Tel. #,57� U�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ � S� Fee Schedule on Reverse Side $ %,3% .001 of Permit Valuation (1/lOth%) $ � 9 $.50/$1,000 Valuation $ $1000 per SAC Unit ° $ , C�D $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.(� Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary ( ] Not Necessary [ ] $ ��- � / BLTILDING PERMIT FEE SCHEDULE 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: TOTAL VALUE $ i 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 $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fractiori thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1, 000 or fraction thereof DRIVEWAY DEPRESSION ESCRdW (Concrete Curb Streets Only) Altemate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet tunes $15.75 . VERIFICATION OF FOUNDATION Pemuts 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. CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 PERMIT NO.: 2004-02222 DATE ISSUED: 12/Ol/2004 � (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 1334 HILLCREST DR NE j� 6�� pjN : 243024120043 LEGAL DESC : UNAVAILABLE : LOT BLOCK � PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 0.00 # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE � # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 1 # GAS DRYERS 0 # GAS RANGES � # OF NEW FIXTURES 0 VALUE (FOR MINIMUM CALC) 400 # WATER TRMT APPLIANCES 0 APPLICANT PLBG PERMIT MINIMUM FEE 0.00 PLBG FIXTURES (NEW OPENINGS) 0.00 NORBLOM PLUMBING CO pLBG FIXTURES (EXIST OPENINGS) 0.00 2905 GARFIELD AVE S 0.00 MINNEAPOLIS, MN 55408-2173 WATER TREATMENT APPLIANCE (612) 827-4033 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 35.00 GAS RANGE FEE 0.00 OWNER GAS DRYER FEE 0.00 PLBG REPAIR/ALTERATIONS 0.00 JOHNSON HAZEL V STATE SURCHARGE, PLBG FLAT 0.50 1334 HILLCREST DR NE TOTAL 35.50 FRIDLEY, MN 55432 ` PAID WITH CHECK # 29583 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 work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or Fancel the provisions of y other state or local law regulating construction or the pe ormance of construction. Applicant Date Bldglnsp � y� cFnnu nTF PF.RMITS REOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � a N � W � � W C9 Z � LL Q � 0 a Z C J � � a 0 � v J a a a 0 O ti ~ N U �- a � z � W � �Z �J � � Q � �+- �� N Z ��', 0�� m �. 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