AF - 46205City of Fridley, Minn.
BUILDING PERMIT `:� �`��
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N° �4585��
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Date: .... . `.•� ,�t'J '�
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Owner: .... .. - �----- �-- - , v-- ---_ : :. Builder __ .��..���
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Address ,�-�.�-+�� - ""M.� ` '.��_ ` �' _. Address .......���-����..,i�� " -���
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.- LACATIO QF BUILDING
No. .���-�' ------. Street ... __-._ " �----- � ' -- .:.......--------_ Part oP, Lot .--------..._....-----�.�_ ......_�.._.._: _._
Lot _.._._.. � ....__...... Block ....� --.. : . ._ .... ..... .... Addition or Sub-Division --- ' ' _ . �,
' ' °'- .,�r-� ---/--- - - — i'��
Corner Lot .........................._........ Inside Lot ---.._................................ Setback ..----.......-•-----. .. � /'A �
•-•------.._........ Sideyard ....._..�,�-f�' ................._. .
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
..��-f.�._- -. __f..i..__ Front ,1...__��_.. Depth ..�:�' Height ....f..�._... Sq. Ft. �,t�.�c' Cu. F't. �'�-.�.G�
�-- - �
...._ ..............--��-� --.._.....----............- �Fr t ----._.......---..._.. Depth .............�Height ........._.....�.�tSq. Ft --��--�--��----..._.. Cu. F`k .........- --•- .....
TYPeof Construction .�( -�''�r�.r ..�' ..... Est. Cos I... .... ..... .... To be Com leted .........--•--...---- .............-......._........
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THIS PERPJ;Ii C;J; `; �!�T AUTHORiZE VIOLAT-
ION OF ANY P�;,bAl"� LA�JD COVENANTS AND
BUILDII�G RE��I"RECTIONS.
Ea consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances oP the city of Fridley.
-•�..--------_.._._�_.�..._ ..�..__....__.._.� ____._._..__
.
In consideration of the payment of a fee of $. ��.'...--.:•-----•--------, Permit is hereby granted to..-.------------------•-------...-----........._......._..
___.__._.._.._..�_.__ to construct the building or addition as described above. This �rmit is granted upon
the express condition that the �rson to whom it is gran.ted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the dty limits and this permit may be revoked at any tune upon violati �of any of the� prnvisions of said
oTdiII8IICC8. ��.� � �
.*
_._�,,.. ____ � ._ _.._ BLlildirig II18peCtOP
NOTICE:
I, This permit doea not cover fhe eonahudion, inatallafien fo� wiring, plumbing, gaa heating, sewe� or water. Be sure to see
1he Bu(Iding Inapector for seperate permits for �hese ftems.
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�PP`LIGATION FOR BUILDING PERMIT
CITY OF FRIDLEY, M�NNESOTA
Ownera Name � � � � �� i°I� � r �Q�_�= ilder d7�1 � L � -S � 0 6v� �. i�a ,
Addreas /O � 7�{0 �'Z, o �, v � �' c �� : Address �S`�a=�' p t� �!-y'� !1+"� -
wi 0 1�. ,._�_..._
LOCATION OF BUILDING
Nc. I o� Stree� F�--� yZ r z �,-✓ C� a r2 �- `� Part of Lat /3 �t ��� 1-F ��.i�
, �� fl
�t Blo� � A�dition or Sub,Div. � " �'"A
�- ����
. Corne.r Lot�_Inside Lot� t Ba.ek Side-Yard _
SEWER ELEIIATION FOUNDATION ELEVATION
Applican� at�ch to this form Certificate of Survey of Lot and proposed b�u3.lding
loca.tion.
DESCRIPTIOI� OF BUII,�TNG
To be used ass
�� t2 f� G--� Front � 5' Depth ___�.. _ Iieight s�.
� _
Sq. Ft. �°0 � Cu. Ft, � y� o .
.
�ront Depth Hei�ht._,. -
Sq. Ft. Cu. Ft,
Tgpe of Construction W� �, p- Tstimated Cost / 6 3�. �o
To be completed. � � �� �
�`he undexeigned hereby makes application for a permit for the work. herein specif3ed,
a�reeing to clo a11 work in str3ct accordance with the City Ordinances and ruling of
the Departmeat of Bui7.d3.nga, and hereby declares that all the facts and representa-
tions at�.ted. 3.n this appl.ication are true and correct. �
DATE �' /O SIGN.ATURE `���� �'v�L�° �G . �'j, � � r.�2r�v
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o ts can be found on the Reverse Side.) ��
(A Schedule of Fee c s
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BtT1LDING PERMIT FEE SCi�DULE
Section 2. The Inspector of Buildings shell, before 3ssu3ng ang perm3t
for the erection of �.ny building or strv.cture, or for ar�r addition 'to
any existing building or structure, or for any elterat3ons or re�irs �
to any existing building or structure, upon application therefor� require
the payment by the applicant for such perm3.t of fees to the amount here3n
below set forth and in the manner herein proeided to-wit:
2.1. For any such permit for the erection of any fire-proof bu3ldix�� other
than a garage, warehouse, factory or grain elevatar, or for the erection of
any fireproof addition, for similar occupancy, to any existing hui�.ding
sha11 be at the rate of �]..1�0 for each one thousand cubic feet� or fraetion
thereof, 3n such cubica]. contents.
2.2. For any such permit for the erection of any fireproof garage, ware-
house, factory or grain elevator, or for the erection of eny f3reproof
addition for similar occupancy, i-,o a,ny exiating building ahall � at the
ra.te of �1.25 for each one thousand cubic feet, classiiYed as "fireproof"
b�r Section 502 of the Minneapolis Bu3lding Code.
HO.�
2.3. For ar�y such permit for the erection of an� non-fireproof bu3lding
other than a garage, warehouse� factory or grain elevator, or eny non-
fireproof addition, for similar occupanc�yr� to any exiat3ng build�ng.
Permit �7..00 for each one thousand cubic feet.
GES
2.4. For any sU.ch permit for �he erection of any non-fireproof gara�e,
werehouse, factory or grain elevator, or for the erection of R.ny non-
fireproof addition, for e3milax occupanc�� to any existing bu3lding vr
for each su�b, bu31d3ng or addition. Ninety Cents for each one thousand
cubic feet or fraction thereof, in the cubical contents thereof taith a
minimum of �4.00. �
For the purpose of computi.ng fees for building permits the cubical eontenta
of any build3ng or addition to a uniform height throughout by ffiult3pl�.ng
the gronnd area covered from a point s3x (6) inches be].ow the f`].00r line af
the basement or cellar to the average height of the upper surface or to the
average height of the roof surface of the main gable of a pi�iched roof.
2.5. For repairs or alterations to an ex3.sting structure, the fee shall be
at the rate of $3.00 for each Five Hundred Dollars ($5fl0.Q0), or t�act3on
thereof i.n the eost of all proposed work.
2.6. In no case sha11 the fee charged for any permit as set forth 3.n
Section 2 be less than �4.�.
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Date:
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Caty of Fridley, Minn_
BUILDING PERMIT
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Address Address
,, LO�ATIO OF ,, I DING
No. , st�et � — ,,�art Lot
,
Lot __ Block � Addition or Sub-Di an . �
Corner Lot __ � Is�de Lot ___. � Setback e Sideyard �,..� �
Sewer IIevation — Fo � tion IIevation
N° � '7302
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DESCRIPTION OF BUILDING
Pi�ont � Depth ..�� Height �� Sq. F't. Q���� C�. F'L ��
Depth I�eight � Sq. Ft Cu. Ft
Type Of COnBtsuCtfOII �..� F�t,_ I,^.OS� �R��� "�_ TO be COmplBted
In consideratlon oP the issuance to me of a permit to construct the building described above I agree to do
th� proposed work in accordance with the descript3on above set fort� in comp ce with a'11 provIaions of
ordinanc�s of the dty of FrYdley.
fl 2.�
Ia conaideral3on of the payment of a f� of $�_�� � permit is hereby gra.nted to
to conatruct the buflding or addition as described above. This t is granted upon
the express candition that the peraon to whom ft is granted and his agents, employees an workmen, in all work
done fn, around and u�n satd building, or any part thereof, shall conform fn all reapects to the ord.inauc� of
Fridley, Minnesota g location, construct�fon, alteration, ma3ntenance, repair and moving of buflclings
within the dty lirnitsean�this per�nit may be revoked at any jj�e upon violation of an,y of the proviaiona of said
ordinancea O 1� „ �Il ���
BUi1�IIS I�8�2CtOY
NOflC�
n '1hb perm(t doa no� emrer ths eoadroaHoe, 6ntallnion ter �rMn9. P��+�9. 6n haNne, »w�� m w�Mr. B� am to �
!ha &rfidine i�� fee pp�rafr p�rmtis Ior fhas hw.
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APPLiCATTON FOR BUILDING PL°1�IIIT
CITY OF FRIDLEY, MINNES�TA
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OWNER'S NAME BUILDER
AIIDRESS � U I(.�1�� 1 ZdN L<1? ADDRESS
LOCATION UF BUILDING
No. � Street Zl ' a�� � r � i fi. �art of Lot
Lot Block AdditioA or Subdivisio ae� i��
Corner Lot ✓� Inside Lot $etback Side Yard � O.� �-�'`'�-
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed biild-
ing location drawa on these Certificatea.
DESCRIPTION bF BUILDIPTG
To e used as:
Fron[ � � �.:p�.h °'� �"— Height / �
Sq. Ft. �j�� � Cu. Ft. �1 �- (� �
FronC `��Depth 4� � Height.
Sq. Ft . Gu . Ft .
;. .
Type of Construction Estimated Cost ��
To be Completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridley Ordiaances and
rulings of the Department of Buildings, and hereby declares that all the facta and
representationa stated in this application are true and correct.
DATE`! �' D V � ,�Q y S
�(Schedule of Fee Gosts can be found oa the Reverae Side).
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BUII.DSNG PER�T FEE S(�tEDULE
Section 2. The Inspectar of Buildin�s sha11, before iesuiaQ any per�it for
_ the erection of any buildiag os structure, or for any addition to any ea�i.Et-
ing building or atructure, or for any alterations os repa:t=a to any exist:in�
�� building or structure, upoa application therefor, require the pa3�eent by the
applicant for such permit of fees to the amount herein below set forth and
ia the manner herein provided to-wit;
2_l., For any such petanit far the erection o.f anq tire-p�oof 6ui�.di�.g, oeher
than a garage+ warehouse, factory► or gr�i�t elevaCor, or £or the ereetion of
aay fire-psoof additioa. for similar occupancy, to any egfating buil@iu�
shall be at Che rate of $1.40 for each o.ne thousaad cubic feet, or fractiaa
thereof, in such cubical contenta.
2.2. For anq euch-p�rmit for the �erecCion of any f3re-proof �arage, raarebouse,_
factory or grain elevator, or for the erection of any fire-proof edditiosz,
for similar.accupan�cy, to.any existiag buildimg shall be at t&e rgte of $1.25
for each one theusand cubic feet� clasaified ae /1fireproof" bq Sectiou 5C2 of
ths Minneapolie Building Code.
SOUSES .
2.3. For �eny such permit for the �rection of' aby 'non-fireproof buildir..� otl�e�
than a garage, warehouse, factory or grain elevator, or any noa-fireg.ccY�
addition, for similar occupancy, to einy existing build3ng - permit $�..QO for
each one thousand cubic feet.
GARAGES
2.4. For eay such'permit for the erec�:�i�� �� �;:; ��n-fi�.?��c*o� gara�e,
_,... warehous�e, factorq or grain elevator, �z• 'c�;: �.�3r �T,�Frs:�ieu �:� �ny nou-s�Lr�r�oof
add�ixioa, for -simi.lar occupancy, to :-,y:: .���:is ..�r;, i;:<�. :4:��0 os for each aLCh �
� �,..._ �.bu�i„1.diag or addition - ninety ce�a�.� �;;��;;,a;'i a�� er:=a:a oae ebo�asand cubi� feet
or fraction thereof, ifl the CLti�iCG,9. ��:��� _.r.;;:� tlie��c�i with a minimum of $4.U0.,�
For the�.purpose of cam�putiag fees f4c ��'r.utng perm3*s, the cubfcal conteats
. of e.ny_ building or �dditioa to a unifc�.a-k±�'�izC throLghout by multiplyin� the �
$rouad area covered fram a point six (6), 3aches be?,w the floos liae of..�he
baaement o� cellaz to the average height of t��e r�g>;�er aurface or to the �
average height of Che roof surface of the maia �;a�le of a pitched roof.
2.5. For repairs.or alteratione to an exietin� structure, the fee ahall be
at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction
thereof in the cost o£ all prpgosed work.
2.6 . In no caee ahall the fee. ;charged for . any permi� ezs set forth 3n
,Section 2 be lesa. thaa $4.00. '
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City of Fridley, Minn_
BUILDING PERMIT
n8te: _ avne 17, 1965
owaer: William G�f'X'C
A� 1t)0 Horizan Circle
Builder
Address
sa�ce
.�
11T° '7925
LOCATION OF BUILDING
Na �'� Street �O�'2o21 C3PC1� Part of Lot
Lot 9 Bl�k 3 Addition or Sub-Divisian Carlson� s^aummi� Ma,nor No
Coraer Lot Inaide Lot Setback Sideyard
3e�ver IIevatian
Foundation Elevation
To be vsed as:
DESCRIPTION OF BUILDING
Front �. Depth Height
Front Depth ITeight
Type of construction �, � 8t�.�
Sq. Fk Cu. FL
Sq. Fk C:ti. Ft
To be Completed
Repair storr� danqage
In consideration of the 3ssuance to me of a permit to construct the bwtlding described above I a�ree to do
the ProPosed work 3n accoraance witii the d�scrlption above set�fo,�th�and ia compliance with afi proviaions oP
ardinaac.ea of the dty oP Fr3aIley. n. //�I C%s a
In camsiderai3� oP the PaY�t of a fee of � �'� , Permit fa her�bY granted to �i113.8m Gef1.
to construct the building or addition as described above. Thiap�r� t is granted upon
the expresa c�ndition that the pezsfln to whom it is gi�ated and his agents, employees anc� worlmien, ia all work
done fn, around and ugon said building, or any part thereo� slaall conform in all respects to the orrlinaace� of
wit�bin the d�i�i�m,its and ��, construction, alteration, ma3ntenance, repair aad moving of bufldings
ordinanc�es. � ���,� P�t may be revoked at any time upan violation of aay of the P�visiona of said
611en deII88II g„�� ��
NOTICEa
i6b permk den eaf eovu ths consfrueHoe, �on Io� rrMe9, P���9. 6+� ��6. sar�� er wNer. B� wre to as
� �dine �r [or +�Pv+h �rm� fo► 46u� h�m�.
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APPL�CATIOR FOR $UILDING PERP�T
CITY OF FRIDLEY, MINNESOTA •
9
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OWNER's NAME ��;�� � l�i`� � � BiiILDER ' �" �"� �
ADDRESS ,��L� %��JE�VL��������� ADL`RESS �C���- �—'�" �/����� �l�l�" Q
LOCATION OF BUILDING
-�� S[reet part of LoC
(�`�
L�T R� ADDITION OR SUBDIVtSIOI� � t d ���
%2� •
Coraer Lot`_Inside LOT Setbeck Side�Yard
SI�WER ELEVATION � FOUNDATiON ELEVA�ION_
�.._.�.
Applicant attaah to this fox�n Two CerCificates of Survey of Lot and proposed
bu3,lding locatioa drawn on these Certifi�catea.
To be used as:
DESCRIPTION OF BVViLDING
Front Dept3� = eight
Sq. Ft. Cu. Ft.
Front Depth� geight
-----�—
� Sq. Ft. Cu. Ft.
?ype oi Coxtetruction E�timated Gos��G��� � �
To be cc�mpleted
�'he undessigned hereby makes application for a permit for the work herein specified,
agreeing to do all work ia strict accordance with the City of Fridley Ordinances
and rulings of the Department of Bu3ldiags, and herebq declarea that all the facts
and repres�atations stated in this application are true and correct.
_ �� � `� � �
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HA� SIGNAT[TRE ������'�`�'� -a'
(Schedule of Fee Coats can be found on the Reverse Side),
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SUI�DI�iG PFRrBT , F"�� . SC�.E "
SE`G�'ION 2. The Inspector of Buildings shall. before isauiag any �rmit for the
erection of any building or aCructure, os for any addition to anq existing build-
ing or atructure, or for any alterationa or repairs to any exietiag building or
structure, ugon application therefore, require the paymeat by the applfcant for
auch pesv�it of fees to the amount herein below set forth and in the.maauet hereia_..
pravided to-wit: ,
2.1. For any such permit for the erection of any fire-�proof buildin�,
other than a garage, warehouse, f�ctory or grain elevator, or for the erection
of any fire•proof addition, for similar occupancy, to any exiating building,
ahall be at the rate of $1.40 for each one thousaad cubic feet, or fraction
thereof, in such cubtcal couCents.
2.2. For any such permit for the erection of any fire-proof garage,
warehouse, factozy os grain elevator, or for. the erection of any f3re-proof
addition, for ain3ilar occupancy, to any esiating buildiag shall be at the rate
of $1.25 for, sach one Ehousand cubic feet, claesified as "fireprovf" by
Section 502 of the Minneapolis Building Code.
SOIISES . . . . . ..
2_3. For any such permit for the erection of any noa•fireproof buildin�,
other thaa a garage, warehouee, factory or grain elevator, or any non-fireproof
addition, for eimilar occupancy, to anq existing buildiag - permit $1.00 for each
one thousand cubic feet.
GARAGES -
�_
2` 4. For any auch perm�tt for Ehe erection of any non-fireproof garage,
warehouse, factory or grain elevator, or £or the erection of anq non-fireproo#
addition, for si.m�ilar occupancy, to any eaisting building or for each such
building or addiCion - ninety cents ($0.90) for each ane thausand cubic feet
or fraction thereof, ia the cubical coneeats t&ereof with the minimum of $4.00.
For the purpose of camputing fees for building permits, the cubical contents
of any building or addition to a uniform iseight throughout bq multiplyin� Che
ground area cavered from a po3nt eix (6) iriches below the floor line of the
basement or cellar to the average he3ght of the upper surface or to the average
beight of the roof su,rface of the main gable of a pitched zoof.
2_.9. For.repaire or alterations to an exieting atr�scture, the fee shall
be at the raCe of.$3,00 per each Five Hundr�d Dollars ($500.00) or fractioa
thereof in the coet of all propoaed work.
2 6; In no case ahall the fee charged for,any germit ae aet forth in
Sectioa 2 be les� than $4.00. "�
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I, _�� _ C3` ,1"�„��, hereby give permission to Ralph A
PRINT NAME �
Groenke at 112 Horizon Circle, Fridley, MN 55421 to have his cement
drive way and retaining vall come within 6 inches of the lot line.
iw °°��°���
1 � �:•. BARBARA E. BRYANT
�i�.!! �'� NOTARV PUBLIC — M�NM�SdTA
;��,,��, ANOKA COUNTY
�y Commieeion ExpirES F1ar, t, 1Rg7 ;'
=°++,P�Pd+�`Ai'�hPP •,
Witness �A'�`�
_ ._ ,,�.���� --
Da d
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ignatur f Own r of
Property located at
100 Horizon Circle,
Fridley, MN 55421
�
------- ---------------
Ralph . Groenke
SUBJECT �T ,
City of Fridley � 0 18893
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
� � REC NO.
� `v ___�� COMMUNITY DEVELOPMENT DIV. � _B� ��
f � � PROTECTIVE INSPECTION SEC. jf
1 i �
1 /"'1 � CITY HALL FRIDLEV SS4$2 NUMBER REV. DATE PAGE OF APPROVED BY
�"""�"� ��� 612-571-3450 810-Ft5 4/20/87 / /
JOB ADDRESS ]_OO $i)r1ZOri Circle N.E e
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
SEE ATTACHED
DESCR. 9 3 �Carlson�s Sunnmi.t Manor North SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Dick Freeherg ]:00 Iiorizon Ci�cle N,E. 571-�1422
3 CONTRACTOR MAIL ADDFESS ZIP PHONE LICENSE NO.
Manion's Ma,ster Roofing 3841 H�yes Stxeet N.E.. 781-7228
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO.
8 USE OF BUILDIN(3
Res.iden�.i:al
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 OESCRIBE WORK
Reroof House & Garage C3CZ squares)_
8 CHANOE QF USE FROM TO
S�TIPULATIONS
R�o� ca.n.be th.e 2nd la,�er but not th� 3rd� Install xidged galvanized
valleys..
SEPARATE PERMITS AqE RE�UIRED POR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
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 ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEFEBY CERTIFV THAT 1 HAVE READ AND EXAMINED THIS APPLICATION �. STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SUHTAX
AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT yfi2�3ZO �`].a16
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CNARGE
PROVISIONS F ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION THE PERFORMANCE OF CONSTRUCTION tii`3S, SO
� PLAN CHECKfEE TOTALFEE
� �r�0 �� / y�3�a frl�
a--�L
StGNATURE OF CONTRACTO OR AUTHOR12ED AGENT iDATE� �--yyHEN PROPERL V LIDATED THIS IS YOUF ERMIT
r
SiGNATURE OF OWNER iIF OWNER BUILDER� �DATEi BLDG iNSP � '/
�aTE
xEw [ ]
ADDN. [ ]
AI,TER. I ]
Construction Address:
Legal Description:_
Owner Name & Address:
Contractor: ►' " `�-
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
�
City of Fridley .
�R-1 AND R-2
Building Permit Application
� �
�P 3 ` ,
,
. � ..
/�i� p-�a,e.� • �. �`c .
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROYEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
Effeetive �4/1/86
.
Tel . � •S-7 � - ( � � L
Tel. # %�(^72 2�
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [] Inside ot [] t. Yd. Setback Side Yard Setbaek
Type of Construction: Estimated Cost: $��� 2�
Approx. Completion Date: �� � '�
�
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: �� Z� � �� APPLICANT: ��� /���,�.�'7i� Tel. � ��'' � L�'
Permit Fee
Plan Cheek
State Surcharge
SAC Charge
Park Fee
SeWer Main Charge
F����
STIPULATIONS:
CITY IISE ONLY
g ,�•,°. s�
�
$ � /�
$
$
$
$ ��7'-��
Fee Sehedule on Reverse Side
25� of Building Permit Fee
�•50/$1,000 Valuation
$ 525 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Neeessary [ ]
�
BUILDING PERMIT FEE SCHEDIILE
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 applicatio n
therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
Total Valuation
Fees
�1.00 to $500.00 $10.00 (Minimum Fee is $15.00)
$501.00 to $2�000.00 $10.00 for the first $500 plus $1.50 for each
additional $100 or fraction thereof, to and including
$2,000.
$2,001.00 to $25,000.00 $32•50 for the first $2,000 plus $6.00 for each
additional $1,000 or fraetion thereof, to and
ineluding $25,000.
$25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for eaeh
additional $1�000 or fraction thereof, to and
including $50,000.
�50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for eaeh
additional �1�000 or fraction thereof� to and
including �100,000.
$100,001.00 and up $433.00 for the first $100,000 plus $2.50 for each
additional $1,000 or fraction thereof.
DRIYEiIAY DEPRESSION ESCRO�i
(Conerete Curb Streets Only)
Alternate "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 times $15.75
VERIFICATION OF FOUNDATION
Permits for construction taill 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 s3te.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been c:onstructed �rill be required before proceeding With the framing.
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SUBJECT IT�NQ.
City of Fridley 2 6 3 3 3
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � RECEIPT NO.
� ; � _ COMMUNITY DEVELOPMENT DIV.
r � � PFiOTECTIVE INSPECTION SEC. ' ����
1 .1 � ��
`-.-- j ��'�',•� CITY HALL FRIDLEY $$4$2 NUMBER REV OATE PAGE OF APVROVED 8Y
t �� 612-5�t-3450 910-F15 6/24/98 / /
10B ADDRESS 100 Horizon Circle NE
1 LEGAL LOT NO. BLOCK TRACT OF ADDITION SEE ATTACMED
DESCR. 9 3 Carlson's Summit Ma.nor North SHEET
2 PROPERTY OWNER MAIL AODRES$ 21P PHONE
Dale Larson 100 Horizon Circle NE 572-1940
3 CONTqACTOF MAIL ADDRESS ZIP PHONE LICENSE NO.
• Same
a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADORESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑_ REPAIR O MOVE ❑ REMOVE
%
8 DESCRIBE WORK
Reroof House & Gara e(28 S) Tear-off
9 CHANOE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBIN(i, HEATINO, TYPE OF CONST. OCCUPANCY dROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTtiUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAVS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOO 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 STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2�335 �I.IG
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEliM1T FEE SAC CHARGE
PROVISIONS OF ANV OTHER STATE OR LOCAL LAW HEGULATING CON- @
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION y�7�F. %S Fire SC �L.33
PLAN CHECKFEE TOTAL
.24
SI R F C NTRACTOF OR AUTMOHIZED AGENT IDATEi EN OP ALIDAT IS IS V�}JR PF�iM
G/ G / r
NER�IFOWNERBUIL�ERI IDATEI Bl �NSD f�6TE
� � .1
NEW
ADDN
��
� � Effective 1/1/98��j� `�
[ ] l� �
CITY OF FRIDLEY �
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-�IT�f OF FR I D LEY
BUILDING PERMIT APPLICATION 6431 UNIVERSITY �,�I�E. �.E.
FRIDLEY, i�N 55432-4384
ConstructionAddress: / a � � � �'� E��� �-'�
Legal Description:
Owner Name & Address: ,D�-�.� �i=11'� �'�° �`�� t`��'��� �Tel. # � � 2- � �� Y�
Contractor: MN LICENSE #
Address: . Tel. #
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTI�R:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIP'rION OF IlVIPROVEMENT
Length Width Height
Length Width Height
Length Width � Hgt/ round
/ .�� � (� �� � � ^�.�
`� � J �s �
Sq. Ft.
Sq. Ft.
5q. Ft.
Construction Type: //� � U � Estimated Cost: $ .��%� �� � � �� "'
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: '0 - �% �� APPLICANT: Tel. # S� � ��' ✓�'l/ �
Permit Fee
Fire Surcharge
5tate 5urcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
ToTai,
STIPULATIONS:
$ / �-
$ -�
$_-1. •�
$
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 / l Oth %)
$.50/$1,000 Valuation
$1000 per SAC Unit
$ $5.00 (5tate Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
� ° , ���
� J � �
- �;� �� ��� BUII,DING PERMIT FEE SCHEDULE
��.�' ,��� �"�.��
The Chief Building ��ci�shall, before issuing permits for the erection of any building or structure, or for
��" any addition to any �cistvhgl 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 pemut of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$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 $2,000 plus $12.50 for each additional $1,000
or �fraction thereof, to and including $25,000
$349.75 for first $25,Q00 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 ESCROW
(Concrete Curb Streets Only)
Alternate "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 times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed 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.
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THE BELOW MUST BE FILLED IN WHEN REpLqC�NG FUEL BURNING APPLIANCES OR THE
APPLICATION WILL 8E RE-RJRNED
• �� �� � ► I ► I ► • ► ► ��■o�:�_�►via�i���ii_1�F.`f�(�1►�I�11:a�/�:7T
� r•►
Wh@(1 renlar_ine an pric+in� f ��� �e undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes (�- No ()
The venting system is plastidPVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes (� No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturers specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances,
The ex��r��g �oR,h„�tien atr is sized and installed to meet the current codes
and manufacturers specifica6ons.
When �2qulf2d t0 inctall a npw cemb ietien ��r�,it will be sized and installed
to meet the current codes and manufacturers specifications.
When inctallinA a nP��v ��inQ�ctpm, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
specifications. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances.
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes.
Yes(�-No( )
Yes (-�- No ( )
Yes (�j No ( )
Yes �) No ( )
Yes.�(,J No ( )
�.• .� •- .�. - •uu.� -. .�. -� .��-.,. � .iu. .�
Appliance #1 Type BTU Input Fan Assisted or Nat
Applianc� #2 Type �TIJ Inp�t. F2� Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter inches
9
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Fieight ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
►�\i : � •► �- ..-
HEATING CO:
Signed By: Date :