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AF - 461014 � � City of Fridley, Minn. BUILDING PERMIT Da�; August 6. 1970 p��; George N. Bacou g�� Sam�? _ �� 1336 Hillcrest Drive Ad� Sa�ne , � � - �. 107'7'9 LOCATION OF BUILDING , No. 1336 g�t Hillcrest Drive � Part of Lot Lot _._..�.._.___ Block 3 Addition or Sub-Division _M�?�P T•a�p Iiil l s Corner Lot — Inside Lot � Setback �_ Sideyard Sewer IIevation � — Founda.tion IIevation DESCRIPTION OF BUILDING To be Used as: S�sZ..rag� Bld� . Front �' Depth ��_ Height Z' �t,.�].ds Sq. FL _2.$.$___ C�. Ft _n16 Front Depth FTeight Sq. F't. Cu. FL Type of Construction Frame �� �_ 450.00 _ To be Completed Sept . 1970 In consideration o4 the isausnce to me of a permft to construct the building described above I agree to do th� proposed work in accordance with the description above t forth and in compliance with a'11 provisfona of orr7inanc� oE the dty oP Fridley. � In conafderat[on oP the paqment of a fee of $5�9.0— , permit is hereby granted to to construct the building or addition as descrYbed above. Thia permit ia granted upon the express condition that the person to whom it is granted and hia agents, employees and worinnen, in all work done in, around and upon said building, or any►pert thereof, sl�all cronform in all respects to the ordinanc� of Fridley, Minnesota regarding locat3on, conatructt��on, alteration, maintenaace, repair aad. moving oP buildin�s witl�in the dty limfts and this permit may be revoked at ex�y time up� violation of aay of the Provisions of seid ordinances. ����i�e�.1 .�/.G��c.�i,�t�l�u918ina Inspector HANK. M[THICH e�� NOTICE: '�6b psemh dws eot eova� t6s �oe�rodioe, testaWNoe ter rhiee, plumbieg, eas heatieg, mv�r or wa�ar. B� sore to a� tha Bnildie8 I�aetor for mpero» pormtfa fo� t6�s Nsms. G /�`, � �4 t� � ; APLICATION FOR RESIDENTIAL, ALTERATION, OR AllllITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME : ' BUILDER : ��'�'v12._ annx�ss : /� � /v �1L���.� �. annx�ss : ��o e No : , 1.�3 � s�T LOT: �i/ BLOCK: 3 ADDITION: CORNER LOT: INSIDE LOT:� SETBACK: SIDEYARD: Applicant attach to this form 7.tao Certificates of Survey of Lot and proposed building location drawn on theae Certificatea. DESCRIPTION OF BUILDING To Be Used As: ! Front :_ / Z� Depth : Z� Height : 7/�TUI�c Square Feet: Z� Cubic Feet: �/� Front; Depth: Height• Square Feet; Cubic Feet: Z�pe of Constructioa: �✓y�, Estimated Cost: $ y�0 � To Be Completed; ��.� � %' %� . The undersigned hereby makes applicati�n for a permit for the work herein specified, agreeing to do all work in attict accordance with the City of Fridley°Ordinances and rulin�s of the Department of Buildings, and hereby declares that all the facts aad representations stated in this application are true and correct. �TE : � S IGNATURE : (See Reverae Side For Additiona.l Informa.tion.) ��� � � �` _; . � �-1 ' _ _ . d_ BUILDING PERMIT FEE SCHEDULE SECTION 2. The Iaspector of Buildings 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 repairs to any existing building or structure, upon application therefore, require the paymeat by the applicant for such permit of fees to the amount herein below set forth and in the ma.n.ner herein prwided to-wit : UNIFORM BUILDING CODE: 1�pe 1, 2& 4-$2.15 for each one thousand cubic feet, or fxaction thereof, in such cubical contents. Type 3& 5-$1.85 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for building perndts, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average{ height of the roof aurface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any permit as set forth in Section 2 be lese than $5.00. VERIFICATION OF FOUNDATION NOTE: 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 coastruction site. A Certified Survey o# the lot, showiag the location of the foundation, once it has been constructed, will be required before proceedint� with the framing. CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupaacy shall be made ten (10) days prior to the use or occupancy of any structure for which a building pesznit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. • .� � � �. _ ,� � " ��, ��,, : o ��, o �., � ��°� �� � �� � ' �'� �� . �� aN��' 3 ��� � s�� � o � � � C p 0 �0 � a� o 4 �o�� � � ' ���0 `J �` O �• ��4� /a� ���Z � �` � � ��r0� N1 �� � 0 N ��0. � ����` . ���° c�'n V� �� ���o . � aN°•4 � � � �' -� ,� � o � � `O. :' ' � � � y``c m � � a �n O i ? �' � ' a' �'��o �� n\> N��-� . �• - a '' aa� ro � � �, o � �-� � � ,' !o �' �1 � 7 `< � • c,� � � C��� � � �a� o > o ��o� . N r, Q : �. 0. ���o O N � � � �• �' Gi ; a°.�� � � `�° ON�N � �_ N N � U�NCA � � tn' � o` �. O N. n � l�i, �y.� ..• o a _ ' l0�6� 0 � � �. .� � � � _ � S. s � n � � � : 1► O _� � � a..� .. _ � � � r .. .a � � � � � � �� � � �. � � � � .�. � � b � � � �� O � � � � �. � � O � � � � �"� - ,. � �:- � � - �„' . , �`� � OFFICE OF THE CITY MAiVAGER CITY OF FRIDLEY MEMORANDUM FROM THE C I TY f�1ANAGER T0: DATE: PUBLIC WORKS DIRECTOR NOVEMBER 15, 1974 , Memo No�� D s- i i s Respond by: � v` New Date : � --�-���- �}_ �� � �� � Jf SUBJECT: BIG PINE TREE REMOVED BY THE CITY AT WEST END OF 60TH UNDER PROJECT 1972-1. COMPLAIrTT BY GEORGE BACON TO COUNCILMAN UTTER ��Q���J'i/ �'��� /�i,c�c���� .��� °,���' George Bacon talked to Councilman_Utter and indicated he has been talkinq to Darrel Clark about the lose•of a big pine tree during street construction, and no action has been taken by the City. � Please review the item and take appropriate action. Thank you for your assistance. - NMQ/ms CC: Darrel Clark November 21, 1974 PCI was contacted and they indicated that they thought the problem had been taken care of, however, they would meet with the owner the week of November 25th to see what additional work might have to be done. RNS/jm December 6, 1974 Contact has been made with the property owner regarding the damage done to the tree. Appropriate replacement waTl be provided and work to be done in spring. RNS/jm M . . . 'n0'AS.P'*^c. / ,w. , `. � . - ' : � � �,�- _ _ ` ` d ,. `�— ��'°r'��'- __"�`�-_ S.� �Y � \ � 1 ��;��;' �� �� :�,�'. � r �� �� � � � _ m � � � - y� . � a � Ti �_�. . � � .R^p.::'. i� . . - ' C 1�---.___' '. 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QUANTITY PNOT DEPT FOR WHAT PURPOSE ORDERED - FOB- DESCRIPTION 9"°° % f ' _ White - purchasing Canary - Acknowledgement Pink - Requisitioner TELEPHONE NO. �,r �a ,r• � --, ,.. i;� m^a `'; .° '' , �r ir.� �' . a � "' Cf=-'. , �=r�ET TELEPHONE NO. TERMS UNIT qMOUNT PRICE 1 i NON-CONF. CONFIRM. TOT APPROVEO FOR PURCHASE BY: � " � ;. � Purehesing Dept Approved e 4 " � �9 vr ,�. - a e � �� / �� !o �� / /�ry/izi C�v rc'rv�� � a s • �— � ��� . 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Q o xZo, g� ro� m�l O0� b � �' c 7 N �� � � � � � �' � �A ,o�/ Wo� � .� � °e °' k � z �� � a' � � � � ta �c r � o m o° �n o m�y n � � {ar' �, � � � � � � 0 �. r a� � z tD ny �- � ao .W W W a ~ rro � `� " o O � �i o � � ��'�� � a' � �' a+ H ap., �G ay a� A'O p N N��ro � 000� � °o-°OOr .. moWo � w � o° r4,� o o� � +n v� +n O 00 O��I�PN 0 00 0000 O O O O O O O in i/1 �(A fA Vi N iA iA 0 C � � C � � � � H 0 � � y I o I y H � d O � H O N � � � � C9 � 0[ H 1 � � , ,� � �� � � ro ro ro � �c r � n k-�•� a m a a�m�mx�n r b� T� A� A� D�� � 9 nmMa� � �rt�o� 9 H oo�on� ?? � � a o rr �° ro � °' M � 'c�x a°�� b* ao 0 0 o ° o � 0 O � � O � H 4 � iP �f V J� N 00000 O O O O O tAtnN�i/! a�ro ��� � "' � � rn mrwf, p. � a. na rt m w r, ro o n w � M� �. � � a C� o`y°aE'r p K O �. ��a � W � O O � � a�"xro '�C � G � N � F�'- W � fi � � � � O a w � p �M �' n.„ n an ��aro �m�a�`� a�<m f~D W E �: r �.. M C 0~i � G � (�D 7 :± � N ID (J O. � rt $ 0 o��� I-+ (D Iw-� O tD �O n~m m I� � N � * �a t�umh� � wwa a K m m �(gQ m � Ri P� (D fA � F��R W rtcro t�+ N ' a m � ¢ � ���� � � 0� A `� �mE �ro � � sr ao �o � O O O � ��pJ�1N y 0600 tt� O O O O i/! iA {/! i? � �r � H �p � � �W ,W N� M W 1 M M V�itrM o� � w r W .� � . W N � < � W � C � z � M a r � � N � � w N O � a �' m m 1' � A � � 0 � a -�--1 a r � m c^/� • • x � �l � v �o r � a -� 0 z 'fl � .� O � m � 3� j'�S7 .:7 n Z C"� -I O N� Z ri m � � o x z � � N � .� . � -� c� �' °o ti � d�' m m �'-�. � c� .. m � N -� O Z � m � � � m a � 0 2 a Z d c'� � 0 -n =n � _ Ci � _ t From ths d�sk vt NASIM QURESHI CITY MANAGER'S OFFICE DATE: September 24, 1986 SUBJECT: Call From Don Savelkoul, Attorney Fridley State Bank regarding George Bacon Property MEMORANDUM �R- a2 TO Jock Robertson 0 Y ACT10N UPDATE 9/26/86 Mr. Savelkoul called and stated that �is client George Bacon, 1335 Hillcrest Drive, has been contacted by Mr. Y.och from Concentral Jevelopment Corporation regarding buying part of his property for development for vacant property south and west of George Bacon's property. Mr. Savelkoul's inquire was regarding Mr. Koch's credentials and ability to do what he was proposing. Please review this matter and if you have a proposal plan, discuss it with me. Thank you for your assistance. NMQ/la T0: Nasim Qureshi F�QM: Jock Robertson �,TID: Oct�ober 2, 1986 Ni3rk Burch has worked with Mr. Cook (not Koch) on other projects and says he is reputable. We do not have ariy other information at this time on tY� proposed project behirrl Mr. Bacon at 1336 (not 1335) Hillcrest Drive. See attaciied map. JR/ts Attacl�rnnt sua�ecr PERMIT NO. City of Fridley 2000 5 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � RECEIPT NO. � `L � COMMUNITY DEVELOPMENT DIV. �� A�� f � � PROTECTIVE INSPECTION SEC. y ' i ' � /'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. bATE PAGE OF APPROVED BY �..__11.• •�� 612-571-3450 910-F15 7/17/89 / / J08 ADDRESS 1336 Hillcrest Drive N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 21 3 Moore Lake Hills SHEET 2 PROPERTYOWNER MAILADORESS ZIP PHONE George Bacon 1336 Hillcrest Drive N.E. 3 CONTqACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Richar.d Ha$tings Roofing 6331 Riverview Terrace N,E. 574--9�66 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION �l REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof DHtellix�g (32 Squares) 9 CHANf3E OF USE FROM TO STIPULATIONS On '�� Iln�� Tnfp /,�l �^�1 n�('. S:,;t� �';�de �u�tl�i£� :1�3;r ,, �� ����!ar�^�g�t roOfS, mapp� tQ$eth�r. be inst Iled. to � f 15 I�, felt, �p frQm exterio�r �a11 fine, or ihe ��� Qf D� hes approved �u,r,���,�y,��t mem6ra�e SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WOHK IS COMMENCED. • NO. DWLG. UNITS OFFSTREET PAHKING I HEREBY CERTIFV THAT I HAVE READ 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 $1 � 6OQ. $. SO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TNE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 3'].00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $ PLAN CHECK FEE TOTAL FEE y�3%a 80 SIGNATUREOFCON7RACTORORAUTMOHIZEOAGENT �onTEi �/�IHb�V PROPERLY VA IDATED THIS IS YOUR PEFMIT / SiGNATUREOFOWNERiIFOWNEFBUILDER� IDATEI BL�G iNSP rypT� � [ J Effective 5/1/88 � L ] R-1 AND i�2 �� [ J Buildir�g Permit Application c:onstructian �. �: _ / 3L� �6 �r�C L C �� s°t D � Isgal Descrip�tioaz: Owner Naiae & s �: _ � � � R � � � A c � �Y Tel . - # Contzactor: � i c_ l, �,� � �{� s f'r',v 6 S' Tel. #�S 7 y-9 �66 s.aa � � � � � _ �� 1 �V.���a���,/ %'�, Attach to this application, a Cettificate of S�vey of the lot, with the pro�o�ed ow�struction drawn on it to scale. D�IPiI�i O�F II�VEt�Tl' I.NII�iG AREA: TpTM� h Width Height Sq. Ft. Q�iR�GE AREA: I,eT�gth W'ldttl HE1gYlt Sq. F't. DECK ARETi: Ierx3t-h Width Hgt/Groiu�d Sq. Ft. O�: Corner Iat [] Inside L�t [] Ft. Yd Setback Side Yard SetbacJcs ZYpe of Consttuction: _(Z��aof �I'°'�A��FF Estimated Cost: $ ldao Approx. c�npletion Date: �lS/�� 3� S-� . Prop�d Driveway Width If New Openinq Is Desiredz Ft. $ $ Width + 6' See Baalc Page np,�: 7 c? a� ��c�r: ' / :� z'ei. #_ s� y- ���.G P�erm.it Fee $ �� �% L1 � State S�r.hax,ge $ � c� SAC C�arge $ . Drive�ray EsGra„i $ Park Fee $ Sewet Main Charge $ • Y• ����5 : � � �� �� b CITY 08E �Y Fee Sdiedute on Reverse Side $.50/$l,00o valuation $575 per SAC Unit Alt. "A" or Alt. "B" Ai�ove Fee D�ete�.miried bY Erigineerir�cl Agreement Neoessaxy [ ] Not NPCe.ssary [ ] a • 4 . _ � �:_�1� � �,. ��+;•��y :�:�- : �.:i:��:�� The Chief Buildirg Official s�all, before issuing peraiits for the erection of any buildir�q or stn�ure, or for arYy additian to any existiryg build9r�q or structure, or for ariy alteration or repair to ar�y existir�g building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amau�t herein below set forth arri in the mar�es herein pravided to�-wit: ZO�rAL VAIIJE $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 M��a±-? Sl5 (Minina� �ee is $15 plus s�chaYge) $15 for fixst $500 plus $2 for each additional $100 or fract3aa'i thereof, to and includi� $2, 000 $45 foY'first $2,000 plus $9 for each additional $1,000 or fractian ti�ereof, to ar�d including $25, 000 $252 for first $25,000 plus $6.50 for each additional $1,000 or fractia� thereof, to and iricluding $50, 000 $414.50 for first $50,000 plus $4.50 for each additional $1, 000 oz' fractio�l thereof, to and includirig $100, 000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction thex�eof, to and including $500,000 $500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction thereof, t� arid including $1,000,000 $1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional $1,000 or frackion thereof ffitIVL�It �P�88I�1 ffiC[i�W (�ete C1irb Streets On1Y) Alternate ��A�� ; R+emoval ar�d replaoement of curb ar�d gutter only - Driveway width plus 6 feet times $13.50. Alternate "B" : R�naval and repla�snent of c�cb and gutter ar�d install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. ��::�• .� �� .: .�� .��, �� � .� P�Cl1.tS for C�i1G'�lOI1 W111 be 3SS11g�1 ��ninirnm+ of 24 hO11Y5 fY'C84 �]+L' t],II12 of agplication t�o allcw for prc�per review of t�e proposed structure ar�d of the vo�st.l.vctiari site. A Certificate of Sutvey of tt�e lvt, shc�wirg the location of the fourr3ation onoe it has it has beeiz vonstruc.�ed will be required befor+e prooeading with the framirig. �, _, �. �, � � � � �. � n � 0 m Q 3 � O N fp � � � A o � 3 � sy O n.. o m� 7 '� (� A � fl. � � N � N � o � a � W Q i s O �. � � � r � O nc � m D � � c c-» � v nn � � n � m � � O Z 0 z � m Z � -o rn n -i � z m m � .p N o° _ � � � O � Q. � � z 0 c � s 1 � v m � � � � � .�-« (D � � � � � � � v� cn � � a. w � � m z 0 � 0 D r m (lT , � _ m � z � c) O � -D � Z � �'' S O � m aS�m _�� a z�< Zn �m �m �� � � m � c A s m � � � 1 � N � �, 3 � o o � c � � a °, c � � a m pi � A � O < O � 1 D �O o � Q1 N � � � o �, �� � pi D A � m � O � C N O � r � -�1 O L � D c� � * D n 0 � a � O 7 � � 1 n N � N � � N v � � Ll ¢1 N � � � cn � � � � N -+ -�. 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O � 3 N, � y N > > "0 � � rt � -a > > . �i � � � ..: �' o� o � m �' �, � � � o N G, N � r. �p � -p 2 � � m m n� � 1 C di (� �� r�y', o. �' -�'s -" 0 � r► � o �. � s m °1 � fD ~' � `� o � a"3' � N � N 7 � r C W Z � � /t. � ��� _ _ CIIYOF FR[DLEY FRIDLEy MLJNICIP�, CENTER • 6431 UNNERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 October 3, 2001 PWO1-059 Qwest Angel X Meulners, Claim Office 1801 California, Suite 2210 Denver Co 80202 Subject: Notice of Claim (0119372) 1336 Hillcrest Drive Dear Ms. Meulneers: I have reviewed your "Notice of Claim" (0119372). I interviewed the City's construction inspector regarding this matter at 1336 Hillcrest Drive. It is my understanding that the service wire was buried too shallow in the City's right-of-way. Although the line was marked and potholed, the wire was damaged during the removal of the 6-inch concrete driveway in the front yard adjacent to the curb as the wire was only 2-3 inches under the concrete driveway. Prior to beginning construction we were notified by Qwest that the wires were clear. Qwest was invited to attend our preconstruction meeting but did not attend. Thus the claim is not valid as the service wire was too shallow under the driveway. If you have any questions, please contact me at 763-572-3551. Sincerely, Layne Otteson Assistant Public Works Director LO:cz cc: M. Everette/City of Fridley :,: _�''' �s• ridt t�� l��i�t .,.;;:�': .�'�° � � �w 1801 California, Suite 2210 Dem+er, Colorado 80202 09/27/2001 NOTICE OF CLAIM Honorable Mayor of CTTY OF FRIDLEY 7000 Lf1�IVERSITY AVE NE FRIDLEY , MN 55432 RE: Our Damage Claim: 0119465 Thic Notice is tendered to alert yon that QWEST sustained damage to communication faciliti�. Thank you in advance for yonr prompt attention and concern 1. NAME AND ADDRESS OF C.I.AIIVIANT. The name and addreSS of the claimant is QWEST, Claims Office, 1801 California, Suite 2210, Denver, Colorado 80202. 2. STATEMENf OF BASIS OF CLAIlVL On or about 08/29/2001, in the vicinity of 1340 ur�.i .[ :uFST, in the city of FRIDLEY, and the State of Minnesota; one or more of your employees or agents acting within the scope of their emplayment damaged a BURIED SERVICE WIRE owned by the claiman� Your employ� or agents caused said damage during SIGSWAY STREET EXCVATION. STATEMENT OF NATLJRE AND EXTENT OF INNRY. As a result of the above descn'bed damage, the claimant has ���a�ne� financial damage as a result of having to employ its men and machinery to repair the damage. 4. AMOUNT OF DAMAGE. The amount of monetary damage is $ 9530. Should you have azry questions or disagree with our assessment of damage.s, please contact the undersigned. ANGEL X MEULNERS QWEST Claims Office 1801 California, Suite 2210 Demer, Colorado 80202 866 864 2255 Ext 3794 City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 � Mecha-nical Perrr��t# ����° ���5 Residential Application City of Fridley See Back Side For Required Information- Date q-!H -� Site Address: � 3�� /-� �`/�c r�.sr A/L The ap licant is: (cirlce one) Ov�mer ntra or Property Owner: Ld �. ar+. ��f � s°4-� Address: 13 3� �+.11 c i�s�f-- D v� City: F r'A(� State: �� Zip: �4"Y3z Phone: iCo3-��y-a°��' Cell: Fax: Contractor Information CompanyName: (a��,c �an S��c Contact Persor�: �-� Address: d� i L-1 2 t A�;y�ti�•y�.( ¢- Sr n� w City: C o�� 2g�, ,�s State: �+� Zip: ���5�3 2- Phone: 7�3 -� SS'-Ce'�f�8 CeIL• f��a-ZS�-�Sq 7 Fax: Email: MN Bond# & Exp Date Type of Work (circle one): New eplacement AlteratioNRemodel Detailed Description of work: R�move� ►2 e� � �� �� 9c��' Li� '� %�-t �Ir�- �- /-'r� N e�,.� y Equipment Installed: MFG: w.s odel: Size/BTU: !.� f' f vJJ ? MFG: Model: Size/BTU: MFG: Model: Size/BTU: Please check all that apply: _Fireplace (gas) $15.00 New Gas Grill-$10.00 A/C $25.00 _Fireplace (wood) $35.00 _Gas Unit HTR $10.00 Airto Air exchanger $15.00 Fumace $35.00 _Pool Heater $35.00 Boiler $35.00 Gas Dryer $10.00 Ventilator $15.00 Chimney Liner $10.00 Gas Piping $10.00 Duct Work $10.00 �Gas Range/Oven $10.00 Permit Fee $ Minimum fee $15 or 5% of cost of improvement Surcharge � 0.50 whichever is greater + surcharge Total Due $ Make check ayable to C' of Fridley This is an application for a permit- not valid until processed I hereby apply for a mechanical permit and I acknowledge that the informa�on abova is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with tha Minnesota Construction Codes; that I understand this is not a permlt but only an application for a permit and work is not to start without a permi� that the work will be in ac.cordance with the approved plan in case of all work whfch requires review and approval of plans. � Signature of Approval I ns Date: �� y� Date: (� C �� Please Note: Separate permits are required for Building, Plumbing, and Electrical work Revised 6/14/2005 REQUIRED iNFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HQMESIADD{TIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOF� NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel lMC Chapter 7 with MN Amendmen.ts b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a, IMC Chapter 5 with MN .Amendments 3. Venting a. Gas appliances IFGC Cha.pter 5 with MN Amendments b. Fuel other tha.n gas 1MC Chapter 8 with MN Amendm.ents REQU(RED FOR IdEW HOMES 4. Heat loss & cooling load. per room a. Required on new construction IMC i 346.0312 5. Ventilation a. Per N1N En.ergy Code 7670 or 7672 6. Duct Design Per IMC 134-6.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanicak Code Guidelines software may be used for combustion and make up air calculations ����-��33� City of Fridley 6431 University Ave NE Fridley MN 55432 (763) 572-3604 or Fax (763) 502-4977 Water and Sewer Permit Application ❑ New Connection �'Existing „ ��Date• .�,�� Job Address: Name of App Name of Prop Existing Structure Permit # �Utility Line Repair/Relocation ❑Water and Sewer Connection Permit Type: Sewer Fee: ater Fee: ee: Repair Fee: Relocation: State Surcharge: SAC Charge: Special Assessment Fee: Total: $ �� pC) Applicant Inspector approval: _Water Meter Repair — Weekend & H Water Connections Perinit Sewer Connections Permit Inspection Fee for Water/Sewer Line �ecial Assessments Cost of Water Meter SAC Ch e Sta.te Surcharge Water Tan $40 _ See Engineering See Utility Billing $1675 $ .50 See EneineerinF Building [nspections 763-572-3604 763-502-4977 F�X DA7'E t U 51 '(] � SITE ADDRESS 1,�„ THIS APPLICANI'1S- BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE I-I-0S Pernut No.. Received By: Date � YOUR E-MAIL ADDRESS �'�a�l k 2+'1 (.� �� �% �(nG�l� i,(�'j;,k. . ❑ OWNER �CONTRACTOR PROPERTY OWNER/ NqME: j,r,t !� .�f-, e�`�,,.�,e� . TENAN'Y' ApDltESS: �t �z , CtTY PHONE: �76�' � �S� — Zv C� - CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE PROPERTY PERMTT TYPE TYPE OF WORK: DESCRIBE WORK BEIAiG SIZE OF IMPROVEMENT ROOFING , J� NUMBER OF SQUARES `L GARAGES PROPOSED SiZE: PROPOSED HEIGHT: SIDING O Vinyl ❑ Aluminum ❑ Other 'ATE ZiP ADDRESS: �G3% e%��° �v+'. �`� CITY Ci�(uc�.btx' %��(� STA�ZIP �,� 'i�( PHONE 7�,3 -iC16--L2 rS3� FAX STATE LICENSE #�60� �-%S% EXP DATE Oe� % O/ �I SMGLE FAMILYMEW CONSTRUCTlON SIZE ❑ TWO FAMILYMEW CONSTRUCTION STORIES O BAS�MENT FINISH �ROOF � DRAIN TILE ❑ DECK ❑ SmING � O OTHER ❑ SWIMnRA1G POOL O AiEW HOME CON3TRUC7'ION ❑ ADDTI'IOAf �I MAWTENANCFJREPAIR ❑ REMODELING WINDOWS IA1 EXISTING OPENINGS OYes �No OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES 8c TYPE OF WINDOW TO BE INSTALLED ❑ HOUSE ONLY �Pi HOUSE�AG"E ❑ ATTACHED GARAGE � DETACHED GARAGE �Soffit ❑ Trim � Fascia LOCATION OF WINDOWS NUMBER OF BASEMENT REMODELMG SUBNAT• 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUSMIT: I. Site Plan/Survey showing the existing struchues and proposed project 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB VALUATION $ ����`�j�G THE 1997 UBC FEE SCHE OCCUPANCY TYPE Pertnit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Chazge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ $ c $ ,� $ `�L� U $ $ $ $ $ . 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) $1825 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 Fridley Attach THIS IS AN APPLICATiON FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; t�jat I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with th approvfj� �plan in the cese of all work which requires review and approval of lans. SIGNATURE OF APPLICANT G��� � ,.�� PRINT NAME �dt DATE 1 Q'�'°i(j� �' APPROVED BY �� DATE page 2- Building Residential Application BUII�DING 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�3� existing bt;i� or .s]zucture, upon applica.tion therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein grovided to-wit: VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to a11ow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the loca.tion of the existing foundation will be required before proceeding with the framing. New I'iouses Onlv City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 ' 763-572-3604 Faz: 763-502-4977