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City of Fridley, Min.n.
BUILDING PERMIT
N° 3392
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Builder . . . '
.... . . .. ............. ..........
Address ................................. ...........
�.��j�� LO�CATIQ�1l OF � UILDING
,
No. � � �. . Street �� . . I�.�. �` Part Lot
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.... . ..... .... ..:.... ..�..........
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....
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Lot .�PZfi'. � , t7' . . . . . . . . . . . . . . Addition or Sub-Dfvision . . : . . . . . . ,�,�, . . .1. . . . . . . . . .
Corner Lot �� Inside Lot ............ Setback ........
............ .... Sideyard ...........................
DESCRIPTION OF BUILDING
be Used a�:
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. . . . . . . . . . . . . . . . . F'rom . . / .� Depth � . �. . x t . . . . . . . . � � � � l� �
� Sq. Ft. . . . . . � G�. F� . . . . . . . .
. . . . . . . . . . . . . . . . . . t . . . . . . . . Degth . . . �. . . Height . � . Q . . Sq. Fk . . . . . . . . G�. Fk . . . . . . . .
Type of Construclion . . . . . . . . . . . . . . . . . �St. Cust. ��,� � °�� . . . . ..
. . . . .�. . . . . . . . To be C�npleted . � � ; . . . . . .
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In consideration of Yhe issuance to me ot a permit fo construct the bwtldfng de�ibed above, I agree to do
the proposed work in accordance with the description above set forth and fn compliance with all proviaions of
ordinances of the dty of Fridley. �
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In consideration of the payment of a fee of $. .... p�.. permit 9s hereby granted ta6' !`."�:! .�1. ;.�'.
..... ..
... .. .. ........... ....... to construct the building or addition as descxlbed above. This permit is ted upon
the express condition that the person to whom ft is �anted and his agents, employe� and worl�en, fn all work
done in, around and upon said bwllding, or az►y part tliereof, shall c�nform in all respect� to the ordinances og
Fridley, Minnesota regarding location, construction� alteration, maintenanc�, r2pair and moving oP bu4ldings with-
in the dty limits and this permit may be revolced at any time upon viola.tion of any of the prov3sfona oF said
ordinances.
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NOTICE:
Thts permlt does not aove� ihe aonstruatlon, Inetalla#lon or altaratton for wl�ing, �
sewar o� watar. Be au�e to see the Bulldln� Inspeotor fo� separate permifs fo� these
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Caty of Fridley, Mi�nn_
BUILDING PERMIT
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N° 10014
LOCATION OF BUILDING
No. 1301 s�t Hillwind Road part oP Lot
Lot 1 _ Block Ad8i13on or Sub-Division Sheridan Acres
Coraer Lot — Inside Lot Setback — Sideyard
Sewer IIevation — _ Founda.tion IIevation
To be Used as:
RemodeJ. �t
Front
Type of Construction
DESCRIPTION OP BUILDING
Depth Height ' Sq. F't. Cv. Ft
Depth Height Sq. Ft Cu. F't.
F�t, Cost �,Q.Q9Y_ To be Completed ,'� da�r.s
In consideratlon oP the fssusnce to me of a permft to construct the buildiug described above I agree to do
the proposed work in accordance wlth the description above t Porth d 3�co plianc+e with afl provisiona of
ordinances oE the dty oE Fridley. � lr.�� �� �a G�'~ � 4�'
In conaideration of the payment oP a fee of $�[.g ,.g�—, permit fs hereby granted to
to cronstruct the building or addition as deacribed above. This permit is granted upon
the express condition that theperson to whom ft is granted and his agents, employees and worl�nnen, in all work
done in, around and u�n eaid building, or any �art thereof, shall conform fn all reapects to the orrlinances of
Fridley� Minnesota location, construchon, alteration, maiatenance, repair and. mov7ngq, of bt�fldiags
within the dty limita and permit may be revoked at e.r�y time upon violation of any of the proi►i�lona of eaid
ordinancea
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C'.T.ART+.'I�TC:F. R'fi!T'.TST.T+'.
NOTIC�
Tl� psnett dees aot aerar ths eoe�teueHoe, tnstallNioe tor wirine. plumbing, en 6�aNng, ssw�� er w�tsr. B� wro te te�
fhe en(WinB lusp�etar Por s�parah pa�s Ior f6as h�ms.
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APP'LICATION FOR BtTILDING PERIHIT
_ CITY OF � FRIDLEY, MII�INESOTA' . .. -
� OWI+�B'S NAME Ra,y Sh�ridan ,�,$UILDER D. W. Ha:rsta.a Cn�
ADDRESS_ 1301 � Hil;lwind Rd. ADDRESS 7101 Hwy 6•5 1� . L.
LOCATION OF'BUILDING . '
No. � Street� � Part of Lo�
LOT / BLQCR ADDI�ION OR SUBbIVISION . ��„_,�
����� D �� ��
. .
Corner.Lot�Inaide L �Setback f Side•Yard
SETaIER ELEVATION FOUNDATIOIQ EL�VATION , � �
Applicant attach to this form Two Certificates of Survey of Lot and propoeed,
building location drawn on these Certificates. �
DLSCRIP�.'ION OF SUII.DiNG � . •- .
To be'�u'sed as: ,�rick veneer, sidin� and roof. shingles � _� ,
Front Dept � eight
, Sq. Ft. Cu. Ft.
� Frant ' � � Dept � eight
Sq. F�. Cu. Ft.
Tqpe of Co�tstructiqn� �emodlein� � Estimated CoaC�3,000.00
To be compleCed 3� days � °
The undereigned hereby makes applicatioti for a permit for the work herein speciiied,
agreeing eo do all work in strict accordaace with the.City of Fridley Ordinances
and rulin�s of the�Department af Buildings, and tiereby dec�aree that sll:the facts
and represenCations stated in ehi.e application are Crue.and correct.
� . . `��, ��.�� � �_
DATE 9 1-7-68 SIGNATURE � ��, ���. � �--
(3ched�ule of Fee Coats can be €ound on the Reverse Side):
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_ 14� _
BtTtLDING PERMIT FEE SCHEDULI�
5BrI0N 2. The Iaspector of Buildings ehallg befdre isauing any perm�t for the
�rection of any building or structure, or for any addition to anq egisting build-
ing or stsucture, or for any alterations or repairs to anq existiag building or
structure� upon application therefore, require the payment 1iy the applicant for
s�ich permit of feea to the amouut herein below aet forth and ia Che manner herein
provided to•wit: �
2.1. For any auch permit�for the erection of any fire-proof building,
other than a garage, warehouse, factory or grain elevator, or for the erection
of any fire-proof addit.ion, for similar occupancy, to any existing building, �
shall be at the rate of $1.40 for each one thousand cubic feet, or fractiou '
thereof. in such cubical contenes.
2,2. For anq such permit for the erection of any fire-proof garage,
Warehouae, factiory or graia elevator, or for the erection of any fire-proof
addition, for similar accupancq, to any existing building eha11 be ae the rate
of $1.25 for each oae Chousand cubic feet, class3fied as "fireproof" by
Section 502 of the Minneapolis Building Cade.
HOIISBS '
2.3. For aay such permit for the erection of anq nou•fireproof building,
other than a garage, warehouse, factory or grain elevator, or any non-fireproof
additioa, for aimilar occupancy, to any existing building - permit $1.00 for each
one tho�s�nd �ub�.s f�e�a ___
GA�RAGES
2=4. For any such permit for the erection of anq non-fireproof garage,
�aarehou8e, factorq or grain elevator, or for Che erection of any non-fireproof
addition, for similar occupancy, to any ezisting building or for each such
building or addieion - ninetq cents ($0.90) for each one thousand cubic feet
or fraction thereof, in the cubical contents thereof with the.minimum of $4.00.
For`the tiurpose of camputing fees for build3ng permits, the cubica! contenta
of any building or addition to a uniform height throughout by multiplying the
ground area covered from a point aix (6) inches below the floor line of the
basement or cellar to Che average height of the upper surface or to the average
height of the raof surface of the main gable of a pitched roo£.
2`5; For repairs or alterat3ous to an existing structure, the fee shall
be at the rate of $�3.00 per each Five Hundred Dollars ($500.00) or fraction
thereof ia the cost of all propo�ed work.
2.6. In no case shail the fee charged £or aay permit as_set forth in
Section 2 be less than $4.00.
6.� � ry�
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AM
SUBJEC7 RM . .
City of Fridley � 13'723
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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; � RECE .
� • COMMUNITY DEVELOPMENT DIV. ����
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r � � PROTECTIVE INSPECTION SEC.
1 . �
( � /"�1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OP APPROVED BV
�----� • •'� s�2-5so-3aso 910-F15 8/25/76 � �
JOB ADDRESS 1301 Hi l lwi nd Road N. D.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. � Sheridan Acres SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Ray Sheridan 1301 Hillwind Road N.E.
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
SAME -
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
,°'"
5 ENGINEER MAILADDRESS ,� ZIP PHONE LICENSENO.
6 USE OF BUILDING
residential
7 CLASS OF WORK
❑ NEW �] ADDITION ❑ ALTERATION ❑ REPAIR � MOVE ❑ REMOVE
8 DESCRIBE WORK
10 x 12 Storage bui1ding �
9 CHANGEOFUSEFROM TO
STIPULATIONS
1. Must be attached to permanent type foundation.
SEPERATE PERM�TS REQUiRED FOt� �I1�RtNG�.
HEATiNG, PLUNtBiNG AND St6�5.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Frame
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT �2O 9GO
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
1 HEREBY CERTIFY 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 �(I,QO .'rJO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHOFITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �� 5O
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
8.U0
S NATUREO ONTR /QRORAUTHORIZEDAGENT IDA N PROPE Y V I ED T. IS YO � ERM 7 ^
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SIGNAT REOFOWN RIIFOWNERBUILDERI ID TEI BLOG INSP ATE
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL ALTERATION,
ADDTTION, OR REPAIR BUILDING PERMIT
owivEx � s nar� :,�� d/� Ee'c >.D �i✓ BUILDLR :�� Sh` ��2 f 1�/��tO
ADDRE S S : �3 �% ��`f /��If//✓,,a � ADDRES S : � � �l E
�10 • . S TREET •
LOT: i BLOCK: ADDITION: �%����Z)f� /�-�� •
CORI�I�'ER LOT: INSIDE LOT: � SETBACK: SIDEYARD:
Applicant attach to this form 'l�ao Certificates of Survey of Lot and proposed
building location d�awn on these Certificates.
DESCRIPTION OF BUILDING
To �e Used As:
/B, , �`
YGi��e' �K� fqi�agFront : /� � Depth : �� Heigh�c :
� Square Feet: %ZO Cubic Feet: �� �
Front: Depth; Height:
Square Feet; Cubic Feet:
Type of Constru.ction: ��%'7� Estimated Cost: $'�O ��
�° �� /��
To Be Completed: �GT- � �
The undersigned hereby ma.kes applicati�n for a permit for the work herein
specified, agreeing to do all work in stxict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
. R
�° / �1..�°�
DATE : �,�.✓" ���� S IGNAT[TRE ' t¢
(See Reverse Side For Additional Information.)
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BUILDING PL'RMIT FF;� SC�iFillUL�:
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SECTTON 2. The Inspector of Buildings shall, before issuing permits for the
erection of any building or structure, or fox any addi.tion to any existing
building or structure, or for any alteration or repairs to any existin�
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;
NEW CONSTRiJC�ION: Sa,ng],e Family Iiomes and Garages: $�.00/1000 cubic feet
PLAN CIiECK: 25 percent of building permi� fee.
ADDITIONAL INFORI�IATION
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the gxound area
covered from a point six (6) inches below the floor line of the basement
ox the cellar to the average heights of the upper surface or to the average�
height of the roof surface of the ma,in gable of a pitched roof.
Fox xepairs or alterations to an existing structure, the fee shall be at the
rate �f $3.00 pex each five hundred dollars ($500.00) or fraction thereof in
the cost of all progosed woxk.
Tn no case sha11 the fee charged for any pe�:mit as set forth in Section 2 be
less thaii $7.50.
VERIFICATION OF POUNDATION
NOTE: Permits for construction will be issued a minimum of 24 hours from the
fiizme of application, to allow for proper review of the pxoposed structure and
o= the construction site.
A Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceeding with the framing.
CERTIFICATE OF OCCUPANC�'
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of a�ny structure for which a building permit has been
issued; and said structure shall not be used or occupiad until a Certificate
of Occupancy has been issued.
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�� - � ��� �p—� g `9 � _(��g. �� �' Minnesota Well and Boring
wELL OR BORING LOCA N M►MNESOTA OEPARTMENT OF HEALTH Sealing No. H � � �
Camly Name WELL AND BORING SEALING RECORD M���esoca u��q�e No.
Minnesota Statutes. Chapter f031 or W-senes No.
ILeeve Wank d rtpl knoYml
Townsh Name Township No Range No. Secdon No. FracUOn (sm. • Ig.) Dale Sealed Approximate Date Well
���� �� �, � � �r � � �' � � � � � Q� or Bonng Conslructed � � 5Q � o�a
Nwrrencal Street Address or Fire Number and City of Well or Bormg Lacation
;;�,,,;3Q-�, ��a���� ��9� Oepih Before Seating 1�� N. Original Depih � it.
Shanr exad locatan ot we0 rn bonng Sketch map of well or boring Siatic Water Level �Accurete
m sedion grid wilh'X'. � location. showing propeAy Ilnes.
roads. and buildings. ❑ Approximate
N
� � i � ���
-� - � - - � - -� • ------�• �Single Aquifer ❑ Muifiaquifer fl. Delow above land suAace
w
ET
T
N-- i r�ro� --►{ �{7 i 1( Wd � t�d:.! i'+��
PROPERTY OWNER'S NAME
�4��� �����
Madmg Address d diflerenl Ihan propeAy address mdicated above.
�. � �� � i� � i �d"j`�i r�'1',� ��a`�' �''�
�7°9.°1.i.l�Rii�i.-.R.y � J�bl��
m
CASING TYPE
(�teel ❑ Plastic ❑ Tile ❑ Other
� ��� ���
Screen from 10 fl. Open Hole from
OBSTRUCTIOIWDEBRIS/FlLl
❑ Obsiruction ❑ Debns ❑ Fill
Type of debns/obsiruction
Obs[ruchoNDebns/Fi�l removed? ❑ Yes ❑ No
PUNIP
❑ Not Present ❑ Other
ro
CASING
GEOLOGICAL MATERIAL COLOR �RDNESS OF �0� TO '
FORMATION Diameter Depth Sei in oversize hole? Annular space indially grouted?
If nat known. mdicale estimated forma6on log from rrearby well or boring. �°i
�F#� ���� � � _� � �n. from � to �' � B h. ❑ Yes �No ❑ Yes ❑ No ❑ Unknown
� a�/�i�
��� �� ,� � �� in. (rom to fl. ❑ Yes ❑ No ❑ Y� ❑ No ❑ Unknoxm
���Y ��F ��,� �� � � in. (rom to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unkrrown
METNOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE:
C�°�� ���� a, i. � �. ��'i No Annular Space Exisis
��� ���� ��� �� ❑ Mnular space grouted with tremie pipe
❑ Casmg Perforation/Removal
�3������ ��.� � � � � �
in. from lo fl. ❑ Pertorated ❑ Remwed
in. from to ft. ❑ Per(orated ❑ Removed
Type o( perforator
❑ Other
GROUTING MATERIAL
Groutingmaterial ���J�� from �`�Td ��—tt. Ya�ds ���9�
from to tt. yards ba9s
RENARKS, SOURCE OF DATA, DIFFlCULTIES IN SEALING
�7��s�� �" �� e ����.�°.s ���i � from to fl. yards bags
�:���' ��a� �'<����,e
from to H. yards ba9s
UNSEALED YYELLS AND BORINGS
Other unsealed well or boring on property? ❑ Yes �No
��� ��� LICENSED OR REGISTERE gCONTRACTOR CERTIFlCATION
This we0 or boring was sealed in aceordance with Minrresota Rules, Chapter 4725. The information contained in Ihis repoA is
true to the best of m knowled e.
�'' �� ��������'s� �E ��a�' � ��� � �l �.��.�
According to �RN S�ate Re�utafi�ns
�L-��!�� ���' � I H
Authnnz�
a�3}SM l�1L�.�
Name o/ Person Se�
Name
e Signature
�������� �����
Wefl or Bo�mg
Ucense or Hegistranon rvo
���� ��
Date
sue�ecl pE.F{Ip(� -Ng__
City of Fridley �'� %� �
AT THE TOP OF THE TWINS ����..!
� BU ILDING PERMIT
� � RECE�PT NO.
� ; L ______ COMMUNITY DEVELOPMENT DIV. �
r � � PROTECTIVE INSPECTION SEC ��.�
� � /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV DATE PAGE Of APPROVED Bv
�"'"� � ��' 612-571-3450 9t0-F15
11/27%95 � �
J08 ADDRESS 1301 Hillwind Road NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1 Sheridan Acres SHEE7
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
I bal Ahmed 1301 Hillwind Road NE 572-8071
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAIL AODRESS Z�P PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASSOFWORK � NEW � ADDITION f� ALTERATION O REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WOfiK
Construct 20' x 20' Gara e• 20` x 6'6" Livin Area• 20' x 10' Livin Area;
Convert �c�g part of existing garage to living area
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Provide a hard surface driveway.
.t
1 ������� �.
Before di�gir�� cali for
ail utility locations
454-0002
SEPARATE PERMITS REQUIRE� 4�OR RE(�UiRED �Y LAUU?
V1iw c8���u, V�EATIRR�, �LUE��If�lG ��v� �iG�S,
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTFiICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AU7HORIZED IS NOT COMMENCED WITHIN 60 DAYS, Oii IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PEHIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GAHAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF IAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WOHK WIIL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN Ofi NOT. THE GRANTING OF A PERMIT �20�000 �lO.00
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUC710N OR THE PERFORMANCE OF CONSTRUCTION. �L87. LS Fire SC �LO.00
PLAN CHECK FEE TOTAL FEE
$317.25
S�GNATUAE OF CON'AACTOA OR AUTM0�712ED AGENT IDATEI WHEN PqOP� RLY VALIDATED THIS IS VOUR PERMIT
� ��s, c�' / ���d���
SiGNATUAE OF OWNEA iiF OWNEA BUILDEA� �OATEi - DG �NS� �iFTE
� � �
NEW
ADDN
ALTER
C'1
��
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective 8/ 1 /95
1 ��
�/ �
ConstrucdonAddress: ���� ��•f�r�.�� �� ��r, C�� �.1�� 3 Z _
Legal Description: � % � lLe,.... �.� �r.v� .
Owner Name & Address: _����� Tel. #-� la � 7� �'67/
Contractor: ��v �j�� _ MN LICENSE #
Address:
LIVI1�iG AREA:
GARAGE AREA:
DECg AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it t,o scale.
DESCRIPTION OF IMPROV��I�ENT
I � � ���� /x/� /
Length � Width � Height
Length � Width _� � ' - Height
L.ength V�dth HgtlGround
��� �
Tel. #
Sq. F�
Sq. Ft.
Sq. Ft.
^ - - - - • � i . - �
Corner Lot [] Inside Lot (�J Ft. Yd Setback Side Yard Setbacks
Type of Constiuction: ���� ���.�� Estimated Cost $ er
Approx. Completioa Date:
(Cost on Back)
Driveway Curb Gtiut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � G � APPLICANT: '' Tel. # ��02 �� �•
. ���
�ITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Maia Charge
TOTAL
STIPULATIONS:
$ 02�% a.S � Fee Schedule on Revers� Side
$ p2Q. 00 .0p1 of Penmitt Valu�trion (1/1Qth%)
$ /Q . Ol� $.50/$1,OOQ Valuation
$ $850 per SAC Unit
$ $5.00 (State LicenSed Residential Conira.ctors)
$ Al� "A" or Alt. "B" A�ve
$ $450.00 Coaseivation Plan Review
$ Fee Det,e�mined by Engiaeering
$ _ Agreement Necessary [ ] Not Necessary [ )
$ �/%�S
7 -�Lv ; i � �
�
� � �
�UILDING 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 struc�ure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such �rmit of fees to the amaunt
herein below set forth and in the manner herein provided to-wit: �
TOTAL VALUE
$1 to $5(?0
$501 to $2,000
$2,�1 to $25,000
$25,�1 to $50,000
$50,001 to $100,Q00
$100,001 to $500,000
$500,�1 to $1,a10,000
$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
fraction thereof, to and including $2,000
$62.25 for first $2,OOp.pins $12.50 for each additional $1,000
or fiaction thereof, to aad including $25,000
$349.75 for first $25,000 plus $9.00 for each additionat $1,000
ar fra.ction therEOf, to and including $50,000 .
$574.75 for first $50,000 plus �.25 for each add.itional
$1,000 or fraction the,reof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fradion thereof, to aad including $500,000
$2887.25 for the first $500,000 pins $4.25 for each additional
$1,000 or fraction thereof, to and including $1,�,000
$5012.25 for the first $1,000,� plus $2.75 for each additioaa.l
$1,000 or fiaction thereof �
DRIVEViIAY DEPRESSION ESCROW
(con� c� s�� o�y)
Alteraate "A" : Removal and replaceme� of canb and gutter only - Driveway width plus 6 feet tim� $13.50.
Alte,�n�ate "B" : Removal and replaceme�t of c:urb and gut�er and install a 3 foot wide
apprQach with 6 inch d�ttt - Driveway width pius 6 feet tim� $15.75.
VE1tIFICATION OF FOUNDATION
Pe�n�ts frn' cons�uction wi11 l� issued a minimum of 24 hwirs from the time of a�pplication to allow for proper
review of the proposed structure and of the consiruction site,
A Ce�tific�te of Survey of the lot, showing the location of the faundation once it has it has been constiucted
will be required t�fore proceeding with the fiaming.
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CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the exisdng chimney or stack:
1. Has been carefully examined Yes () No ()
2. Is free from rust or deterioration Yes () No ()
3. Has no foreign objects lodged within _ Yes () No ()
4. Is securely supported � ' Yes ()� No ()
5. Meets all cucrent Code requirements for size '-
and total BTU's conri� Yes () No ()
fi Has total heating BTL7's of
� All other BTU's � . � . - -
TOTAL BTU's
7. Has a liaer been provided for water heater Yes () No ()
8. Has cambustion air been provided for water heater Yes () No ()
Remarks:
Y 11 :: Y �► :,- �� �,.�-
. HEATING CO:
Signed By:
Date:
;,�, NF'�'—t=� 1—, ��G t`1i=ihd '1 � : �� I T:� :
Q4/Oir96 i�:�o �
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City of Fridley
AT TME TOP OF TNE TWINS
r
� �• COMMUNITY OEVELOPMENT DIV.
� j V'� '��
r � � PROTECTIVE INSPECTION SEC.
� . �
l-__.� ��"' �.� CITY NAII FRIOLE� 53132
ti 612-571-3460
JOB ADDRESS 1301 Hillwind Road NE
t LEGAL �OT NO. BLOCK TRAC'
sue�ecr �
�U ILDING PERMIT
NUMB@P REV DATE PAGE Of
s�aF�s i/28/00 / /
oesca. 1 Sheridan Acres
2 PROPERTY OWNER MAIL AODfiFS$
Iqbal Ahmed 1301 Hillwind Road NE
3 CONTRACTOR MAIL ADORESS
Same
d ARCNITECT OR DESIGNER MAIL AODRESS
ZIP
3064�
RE�� T NO.
�
�VPROVEO BY
SEE ATTACMED
StiEET
INE
572-8071
INE LICENSE NO
LICENSE NO
S ENGINEER MAIL ADDRESS Z�P PHONE LICENSE NO
8 USE Of BUIIDING
Residential
7 CLASS OF WOpK
❑ NEW O ADOITION �] ALTERATION ❑ REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Interior alterations to kitchen & bath
9 CHANOE OF USE FROM
STIPULATIONS
See notations on plan.
�ALL �OR �1�1�L INSP'ECTIO�
�VITHI� 101�A�� �� WOAK
����LL-�'I`I�II�
���'�' �'� ��M�OWNEI�
TO
�EREQ�TE PER��S
UIRED fOR.
�LUM�ING AHly�D S�G
. isius.
TYPE OF CONST.
SEPARATE PERMITS ARE RE�UIREO FOR ELECTiiICAL, PLUMBING. NEATIN(3.
VENTILATING OR AIR CONOITIONING
TMIS PERMIT BECOMES NULL ANO VOIO IF WORK Oq CONSTRUCTION ZONING
AUTHOpIZED IS NOT COMMENCED Y�!ITMIN 80 OAYS. OR If CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOO Of 120 OAYS AT
ANY TIME AF7ER WORK IS COMMENCED NO DWLG. UNITS
I MEREBY CERTIFV TMAT I HAVE READ ANO EXAMINED THIS APPLICATION 1
ANO KNOW TNE SAME TO BE TRUE AND CORFECT. A6L PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING TMIS TVPE OF WORK WILL BE COMP�IED �lO�OOO
WITM WHETMER SPECIFIEO MEREIN OF NOT. TME GRANTING OF A CERMIT
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OF CANCEL THE pEqMITfEE
PROVISIONS OF Y OTHER STATE OR IOCAL lAW REGULATING CON- �151.2,5
STRUCTION OR RFORMA OF CONSTRUCTION
� �LAN CNECK fEE
b Si G FCON'AACTOAOp U M0�1iIE IDATEi EN P i
t '
S�GNOTUAE O� OWNEAaf OWNEA BWLOEN� �DATE� N�? _
I�
�
STA�LS
OCCUPANCVLOAD
FT
OFFSTREET PARKING
GARAGES
SUiiTAX
$5.00
SAC CNARGE
Fire SC $10.00
TOTA� FE
$19�25
/1 V V
N� Il
ADDN []
ALTER [ ]
Construction Address:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
/36 /
�
Effective 1/1/2000
612-572-3604 Bidg Insp
���, ��
�
Legal Description:
Owner Name & Address: �� �L /�'1�f�. C:�� Tel. #�/Z S 7 Z�oi I
Contractor: MN LICENSE #
Address: Tel. #
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
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 Width Height Sq. Ft
Length Width HgUGround Sq. Ft
Construction Type: ���`�- � ^ Estimated Cost: $ �
�
Driveway Curb Cut Wdth Needed: Ft. + 6 Ft = x$ _$ �[/. [��
DATE: l�" v'� APPLICANT: Tel. #
CITY USE ONLY - Call (612) 572-3604 for Permit Fees if malling in application
Permit Fee $��- Fee Schedule on Reverse Side
Fire Surcharge $ �� •c�b ,001 of Permit Valuation (1/10th%)
State Surcharge $ � �. !X� $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
$ �� $1100 per SAC Unit
$ � $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary []
TOTAL
STIPULATIONS:
W � � �
�
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addirion to any existing building or structure, or for any alteration or repair to any existing building or siructure,
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
$1 to $500
$501 to $2,000
$2,�1 to $25,000
$25,Q01 to $50,000
$50,001 to $100,000
$1�,001 to $500,0(}0
$500,001 to $1,000,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $SQO plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,(�0 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,OW
$391.25 for first $25,OQ0 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,0(�
$643.75 for first $50,000 plus $7.Q0 for each additional
$1,000 or fraction thereof, to and including $100,IX?0
$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,OOO,Q00
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Altemate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
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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'suoi�ru�sqo `uoi�e�oua�ap '�sru wo� aa�} si pue pauiwexa uaaq sey 6w�uan
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NOI1ti�I�Rl3/l 211t/ NOI1Sf18WO� aNt/ 2101�3NN0� 1N3A 1N3A NOWWO�
sue�eCr PERMI
City of Fridley 31271
AT TFIE TOP OF TME TWINS g � I L D I N G P E R M I T
r
� � RECEIPT NO.
� � COMMUNITY DEVELOPMENT DIY. , /�� �
� �
� j �i -
r � � � PROTECTIVE INSPECTION SEC. ��
� . .
( � �"'1 � CITY HALL FRIOLE� SS13P NUNBBA REV DATE PAGE OF ACPROVED 81I
�----� • •,' 612-571-34b0 9t0-Ft5 8/1/�� � �
JOB ADDRESS 1301 Hillwind Rd NE
t LEGAL L.OT NO. BLOCK TRACT OR AODITION SEE ATTACNED
DESCR. 1 Sheridan Acres SHEET
2 PROPERTY OWNER MAIL AODRESS 21P PHONE
I. Ahmed 1301 Hillwind Rd Fridley, MN 55432
3 CONTRACTOR MAII ADORESS ZIP PHONE LICENSE NO
Owner
4 ARCNITECT OR DESIGNER MAIL ADOFiESS 21P PNONE LICENSE NO.
5 ENGINEER MAII AODFESS 21P PHONE LICENSE NO
B USE OF BUIIDING
Residential
7 CLASS OF WORK
O NEW C� ADDITION ❑ ALTERATION O REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
7' x 6' porch - gable roof
9 CHANGE OF USE FROM TO
STIPULATIONS
For stipulations, see attached plans.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCr LOAD
SEPARATE PERMITS ARE REQUIREO FOR ELECTRICAL. PLUMBING, HEATING.
VENTILATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL AND VOIO IF WORK Ofi CONSTRUCTION 20NING SO. fT CU FT
AUTMORIZED IS NOT COMMENCED V�!ITHIN 60 �AYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONEO fOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED NO OWLG. UNITS OfFSTREET PARKING
I MEPEBY CEiiTIFY THAT I HAVE REAO AND EXAMINEO THIS APPLICA710N �. STA�LS GARAGES
AND KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS Of LAW$ yp�UATION SUpTAX
AND OFDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMP�IED
WITH WHETMER SPECIf1ED HEREIN OR NOT. TME GFiANTING OF A PEFiMIT y�1�2O0.00 y�.6O
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL TNE pEqMl7 FEE SAC CNARGE
PqOVISIONS OF A OTNER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR , E fORMANCE OF CONSTRUCTION �4�Ie9O I.T SC a�le?.O
�' PLAN CHECK E TOT , FEE
�' $49. 70
S�GFi8�4UABOi � � pACTOAOp4UTNOA�� GENT ID�TEi ME PiiO VALIO E THIS IS R P�iMIL �
� - jd L�L/
^ - :Is
S�GN4TUAEO�OWNEQ� O �DAiE� - B�' �N ���TE
NE1N [ Effecfive 1/1/2000
ADDN �, ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALT��t [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 `
BUILDING PERMIT APPLICATION
_ /� ,, r� �`� �
C nstruction Address: � 3� Y �cSl.� /�-�.- ']` �
Legal Description:
Owner Name & Address:
Contractor.
Tel. #
MN LICENSE #
Address: Tel. #
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
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 Width Height Sq. Ft
Length Width HgUGround Sq. Ft
1 -f" (�a„��c H,In,(� G�f.l. LPMv�- °� �Y+-�--1�,�'
p d'
Construction Type: r.� s►S�"�°� Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
�/'
DATE: APPLICANT: ✓ Tel. # �!L .��y ���
-�
_��� _..
�
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
;
$ 7e �Q Fee Schedule on Reverse Side
$ � � oZ� .001 of Permit Valuation (1/10th%)
$ � � $.50/$1,000 Valuation
$ $1100 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 [ ]
$ �-I � �71�
...
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or fdr 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 mazmer herein provid� to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,�0
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,Q00,000
$1,Q00,001 and up
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,�
$391.25 for first $25,Q00 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
$1,0� or fraction thereof, to and including $SOO,OQO
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,0�
$5,608.75 for the first $1,000,�30 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
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 times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificaxe of Survey of the lot, showing the location of the foundation once it has it has been coa��acte� �vill
be required before proceeding with the framing. New Houses Onlv
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��.�i�YE:S�.�+►�TD STACK V�RIFICATION
The undersigned hereby veri�es that che existing chimney or stack:
1. Has be�n ca�efi�9ly axamtneci °�es (� i1To ()
2. Is free from rust or deteriotation
3. ��s no foreiga� obj�cts lodged witl�in
4. Ys securely supnsyrte�
S. 1VSeecs a�ti ctatrerat Code r�quirem�nts for sue
�$nd B��al �iT43's ca�nn�cted
6 i�ias tocal he�ting �TU's of 1 ,.��� +
At! othe� �TiJ's
'T�i'ATe 8�ti'�
7. �-Ias a liner been prodadeci for water heate¢�
S• hlas eombustion air be�n provided �or w�ter heater
R�rnarks:
List _ E TIONS Beire Doe��:
x���r�� co:
�igned �y:
1�at�:
—�
Yes (�j No t )
Yes ( � No ( )
Yes (�j No ( )
X�s(�No()
Yes()No()
Yes ( ) 1�To ( )
..=:s,,:.
�
_
CITYOF
F'ItIDL�,Y
FRIDLEY MUMCIPAL CENTER • 6431 UTTIVERSTTY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
February 1, 2002
Mr. Ahmed Iqbal
1301 Hillwind Rd NE
Fridley, MN 55432
Re: Final Inspection at 1301 Hillwind Rd NE
Contractor: Daves's Appliance Heating & Air
Dear Mr. Iqbal:
A mechanical permit was issued on August 25, 2000 to install a furance at your
address. According to the 1991 Uniform Mechanical Code a final inspection shall be
conducted on the work authorized by this permit. As of this date, no inspection has
been called for.
The permit fee that was paid covers the inspection to make sure the work was
completed according to the Codes. We �vill keep your permit open for another 30
days and if we do not hear from you within this time to set up the inspection, we will
mark the permit "no inspection called for" and no further action will be taken.
To set up the inspection or to have any questions answered, please contact the
Building Inspection Division at (763) 572-3604.
Sincerely,
�— .
�z�/�� /
: � �� � �- �
� �� �
,
sue�eCT P .
c�ty of Fridley 3 2 6 6 0 �
AT TME TOP OF THE TWINS g u � L D I N� P E R M I T
r
; � RECEIPT NO.
� `v __��_ COMMUNITY DEVELORMENT DIY.
r � � PROTECTIVE INSPECTION SEC. ��S �
�
� _ �
� �"'1 � CITY NALI FRIOLE� SS1�2 NuuBflA aEV D�r� VAGE o� �6vaovEO Br
�----�' �•� 612-571-345Q 910-F/5 6/5/02 / /
108 ADDRESS 1301 HILLWIND RD NE
1 LEGAL LOT NO. 9LOCK TRACT OR ADOITION SEE ATTACMED
DESCR. 1 Sheridan Acres SNEET
2 PFOPERTY OWNEii MAIL AOOR�S$ 21P PHONE
Iqbal Ahmed 1301 Hillwind Rd NE 763-572-8071
3 CONTqAGTOR MAII ADDRESS 21P PHONE LICENSE NO
Windows America 7928 C University Ave NE, Fridley, MN 55432 763-786-8115
4 ARCNITECT OR DESIGNER MAtL AODRESS 21P PHONE UCENSE NO,
20248265
5 ENGINEER IMAIL AODRE$3 ZIP PMONE IICENSE NO
B USE OF BUILOING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION � REPAIR p MOVE -❑ REMOVE
8 DESCRIBE WOfiK
Replace 13 windows within existing openings
9 CHAN(iE Of USE FROM TO
STIPULATIONS �
Provide smoke detec�ors in all sieep�.ng ro�ms and on a'll levels of �he dwelling
per Section 310.9.1.2 of the 1997 Uniform Bu�lding Code.
��r�ni� Insp�ction �ards
INill B� Mailed
To Homeowner To Pos�
` TYP� OF CONST. OCCUPANCY GROUP OCCUPANCY IOAD
SEPARATE PERMI7S ARE FiEQUIREO FOR EIECTRICAL. PLUMBING, FIEATING,
VENTILATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT CU FT
AUTHORIZED IS NOT COMMENCED WITNIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOEO OR ABANqONEO FOR A PERIOD OF 120 DAYS AT '
ANV TIME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS OFFSTqEET PARKING
I MEREBY CERTIFY THAT I HAVE REAO ANO EXANAINED THI$ APPI.ICAiION 1 STA��S GARAGES
AND KNOW TME SAME TO BE TFlUE AND CORR�CT. A�L PROVISIONS OF LAW$ yq�UATION SUiiTAX
AND ORDINANCES GOVERNING THIS TYPE OF WpRK WILL �E CpMPUEO
WITM WME7MER SPECIFIED HEREIN OR NOT. TNE GRANTING OF A PERMIT �$fOOO ��F.00
DOES NOT PRESUME TO GIVE AUTHOqITY TO VIOIATE OR GAMCEL 7ME pEqMIT FEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- �153.25 Fire SC �B.00
STRUCTION OR THE PERfORMANCE Of CONSTRUCTION
PLAN CMECK FEE TOTAL FEE
:�ice $5.0 $170.25
S�GN4TUNEOFCON'AACTOpOpAUTMOp�ZEDAGENT IDATE� ME PRO VALIO D THIS IS r up aE �T
- � � � r�
S�GNaTUAE O� OWNEpo� OWNEA BU�lOEA� �O�TE� �OG �MS� ` r��tt
N� II
ADDN [ J
ALTER [ ]
Construction Addres:
Legai Description:
�����n��
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 PERMITAPPLICATION
Owner Name & Address: !'Y1 E? Tel. # 7lp �-S°%� - 8L57%
Contractor. e� MN UCENSE # oz0�98a(p5
Address:� 9a� �C' /�li2i �1 �aY <fv /�-U e 1� F�r � d�,u; 1�7�C 55Sl3� Tel. # 1� 3-7�10 -�115
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certficate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft �
Length Width Height Sq. Ft
Length Width Hgt/Graund Sq. Ft
Construction Type:1..� 1''Ce�Yo �;t vi���l w-i ndo� Estimated Cost: $ g� (�/�/)
reP to�c e �r.�1�5
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DATE: �� APPLICANT: � ��� ��r� Tel. # `%�e3 —% g� - ��IJ�"
Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
�#�te S+�rcl�a��e
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
� �
$ r�3ssiaJ
$ �',��� �
�_-� �-� �
$
� 6, oD
$
$
$
$
$
� y���. �S�
3� d2
� 5
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
�.��$ i,a�.°'� °ti%t'i:L'a`ldo°3H: _. -- - - -
$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 [ ]
STIPULATIONS:
�
BiJII.DING PERMIT F�E SCI�DULE
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
$1 to $5�
$501 to $2,000
�2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $SOO,OQO
$500,001 to $1,000,000
$1,(�0,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each addidonal $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,0� plus $14.00 for each additional $1,000
---_�_ or fraction ther��f_,�t.� a�� in�t„4���.� ��4�-
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fracdon thereof, to and including $50,000
$643.75 for first $�,000 plus $7.00 for each additional
$1,000 or fraction ereof, to and including $1Q0,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fracdon thereof, to and including $S�,Q00
$3,233.75 for the first $SOO,OUO plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 fur each additional
$1,Q00 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
'�.^>:,��`�tp �'� 5��� �:;i�l
s
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
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 times $23.25.
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
�
Building
Inspections
763-5�z �3��04
SITE ADDRESS _
THIS APPLICAN'f IS:
PROPERTY OWNER/
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATTON
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
E-MAIL ADDRESS
❑CONTRACTOR
NAIv�:
STATE LICENSE
EXP DATE
Permit No.:
Received. By:J
Date Rec'd:�
.TE ZIP
ADDRESS: CITY STATE ZIP
PI�ONE _ FAX
PROPERTY TYPE
O
PERMIT TYPE 0
0
�
TYPE OF WORK: �
❑
TWO FAMILYMEW
DESCRIBE 9JORK BEING DONE:
SIZE OF IMPROVEMENT
NUMBER OF SQUARES _
GARAGES
PROPOSED S1ZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
W WDOWS
IId EXISTAIG OPENWGS OYes ONo
OR FOR NEW OPENATGS-DESCRIBE SIZE OF
OPENIlVG CHANGES &
TYPE OF WW�W TO BE WSTALLED
F-INISH 1 ❑ ROOF
E�# ❑ SIDIlVG
��
� HOUSE & GARAGE
O ATTACHED GARAGE
0 DETACf�D GARAGE
❑Soffrt
❑ Trim
❑ Fascia
L.�ATION OF WINDOWS
NUMBER OF
❑ DRAIN TILE
`�OTHER �,�-� �
HEIGHT
BASEMENT REMODELING SUBNIIT•
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members w be used
F�
FOR NEW CONSTRUCTION INCLUDWG DECKS,
ADDITIONS. & PORCHES SUBNIIT:
1. Site Plan/Survey showing the existing sVuctures
and proposed project
2. Two sets of constrnction plans
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
_ TOTAL JOB VALUATION $__ ���� �y� OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Chazge
Curb Cut Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
Total Due _
$ � c� c�
$ ot _C`� C�
$
$
$
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valua.tion
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 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 pa_yable to: Citv of Fridlev 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; that I understand this is not a
permit but only an application for t and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work whicl�r�' es reyae�w�nd approval of plans. � _
SIGNATURE OF APPLICANT
Page 2- Building Residential Application
.
,
, �
BUII..DING PERNIIT FEE SCHEDULE v
The Chief Building Official sha11, before issuing pemuts 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: • - . �• �
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 Certificaxe of Survey of the lot, showing the location of the existing founda.tion will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
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