AF - 46213Date
Owner
Address
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BUII.DING PERMIT
N°
Village of Fridley, Minn. '
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Builder ..��� �'"�r.: �' .n��.�°:4� ..�1.�?'�.�.........
Address . � �: . � �, , , f �; ��°�L� �
LO�CATION OF BUILDING
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No. . .�1. � �� . . . . . Street . . . . . . . . . . . ���'�65��� . . . . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . .
%/' °� �`�/ ,� . �j ��
Lot . . . . . .'l.l. . . . .. . Block �,,,7. .. .. . . . . . . . Addition or Sub-Division . 7� "'.°���?'2°.°, ;'�;�?�`!`? ;��i; , ,�I,�,e��='1�;'`
�° � �
Corner Lot ......... . Inside Lot . �....... Setback .�. .... Sideyard . ��.��a .��.r'.....
To be Used� as:
` . ���'. . . . .
Type of Construction
DESCRIPTION OF BUILDING
` / /� �
Front .�� . . Depth :"?. .�.�. . . Height � �E���
v
Front . . . . . . . . Depth . . . . . . . . Height . . . . . .. .. Sq. Ft. . . . . . . . . Cu. F't,
�'� . . . . Est Cost . .l. ��: . �i. . .��. . � . . . . . . To be Completed . . . ����?: . . .,. �f �
Sq. F't. .��� Cu. Ft, ........
e ,
c����. � �v �
In consideration di 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 of the village of Fridley.
.... ..... . ........... .. ..�y.. ..^..
.... .. ... ...
Tn consideration oi Uae payment of a fee of $ �.r� �.��ermit is hereby granted to ��� :� . . :'.•. : . . . �:�. : � :��
• • • • • • • • . • . . . . . . . . . . . . . to construct the butild'uig or ad dition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and worlunen, in all work
done m, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota. regarding loc�,l3on, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. �
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NOTICE:
Inspector
Thls pe�mtt doea not cover the construotlon, installation or alteration for wiring, plumbing, gas heating�
sewer or wa4er. Be sure to see the Butiding Inspe�tor for separata permits for thase items.
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City of Fridley, Min.n..
BUILDIl�TG PE1�.l�IT
N° 5�.01, �
nate: _ � `- �
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Ovvner: �� `�-' � F � � -�,� Builder � ��'� �
Address l �— � Address ��'-�`�%� �� ! _____�
�, �' LOCATIOiV,-�4� �BU DIRlC
°A
No. � � Street � _ ,_�� ._.� Part .oi Lot ,t_—_ �
f �Lot _ Block ��._��ddition or Suk�-Di ' on .%, ����;� � ' ` �f1.� `'..:
Coraer Lot � Ins�ide Lot '�back �' � Sideyard ___�..__._._.......�_._._.,�
Sewer IIevation ��__.._ _. F` dal3on Elevation _
DESCRIPTION OF BUILDING
To��e Us y ��`'s,"
.�� �� Front _�'� Depth .��� Height ..�__ Sq. Ft. �����" Gti, Ft, �����
�. Front Depth � Height ��Sq. Ft .— Cu. Ft
Type of Construction ��`et",� F�t, Cost ������ __ To be Completed ...—
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the descriptton above aet forth and in compliance with all provisions of
ordinances oP the dty oY Fridley. !
�
In consideration of the payment of a fee of $�.,,:��""—, permit 3s hereby granted to
to construct the buildiag or addition as descrlbed above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and worlunen, in all work
done in, around and upon said buildfng, or any part thereof, shall coffiorm in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of bwlldinga
��� city limits and this permit may be revoked at any time upon� lation o� � of the provieions of said
Building Inspector
NOTICE:
'fhPa permit does no� cove� the conatweHon, tnstallaHoe fo� wiring, plumbtng, gae heaNng, sewer or water. Be sure to see
t6s Bnildieg laspedor fo� separate permits for these hems.
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lddrese
No.
Lo
. APPLICATION FOR BIIILDIIJG PERNIIT
LQCATIOAT F pIIILDING
, _ � �� d �9
Corner Lot �Snside
�. �
� Par�t of Lot
� Addition or Subdivision .�' '` �1 �a2! �
Lot �sck Side-Yarcl � � s
ELEVATION
�pplica.nt attach to this form Certificate of Surveg of Lot and propoaed building
location.
To be,3a.sed as :
DESCR�PTION OF BIIII�DING
Front � Depth Height � �
3q. F't. �56 /'� Cu. Ft. �1' �
Froat_,_ Depth Height .
Sq • �''b. Cu. Ft.
Type of Construction �is�i��__� Estimated Cost_ A���
To be Gompleted
The undersigned hereby makes appl3cation for a permit for the work here3n specified,
agreeing to do all work in atrict accorda.nce with the City ardinanaes and rul.3ng of
the Department of Build9.nga, and hereby declares that a11 the facts a.nd representations
stated in thi� appl3cation are true and correct.
DAT�_ � °�'° l� '� � tC SIGNgTURE `°
(A Schedule oi Fee Costs can be Yound on the Reverse Side.)
�"1 ,�"`1
.,, � - _
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HIIILDING PERMTT FEE SCI�DIII�
Section 2. 'ihe Tnspector of Buildings ahall, before issuing any perm3t for the
erection of any building or structure, or for any add3t3on to a.qq,exi.sting build-
3ng or stsucture, or for a.ny alterations or repa3rs to any existing building or
structure, upon apglication therefor, r�uise the payment bg the applicsnt for
such permit of fees ta the amount here3.n below set forth and in the manner herein
provided to-wit:
2.1. For ang such pe.rmit 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 addition, for s3mi7_ar occupanc�, to any existing building shall be at the
rate of �1.40 for each one thousand cubic feet, or fraction thereof, in such
cubical contents.
2.2. For any such permit for the erection of any fireproof garage, warehouse,
factory or grain elevator, or for the erection of any fireproof addition, for
sim3ler occupancy, to an�r existing building shall be at the rate of �7..25 for
each one thousand cubic feet, classified as '�fireproof'� by Section 502 0£ the
Ntinneapolis Building Code. '
HOUSES
2.3. For any such permit for the erection of any non-fireprooP building other
than a garage, warehouae, factory or grain elevator, or ex�y nor�-fireproof
additioa, for simi].ar occupanc:y� t,o any exist3.ng building. Permit $]..00 for
ea.ch one thousand cubic feet.
GARAGES
2.L�. For any such perm3t for the erection of any norr�-fireproof garage, we�.r'ehouse,
factory or grain elevator, or for the erection of any non-fireproof addition, for
si.m�.].ar occuparicy, to any existing building or for each auch building or addit3on.
Ninety Cents for each one thousand cubic fest or fract3on thereof, in the cubical
con�ents the.reof with a minimum of $4.00.
For the purpose of computing feea for building permits the cubical contents of any
building or addition t.o a uniform height throughout by mu7.tipl�ring the grovnd area
covered from a point six (6) inches below the floor line of 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 pitched roof.
2.5. For repairs or alterations to an existi�ag structure, the fee ahall be at the
rate of $3.00 for each,Five Hundred Dollars (�5�.00), or i�action thereof in the
cost of all propoaed work.
2.6. In no case ahall the Fee charged for a,ny permit as set forth in Section 2 be
less than �4•00•
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SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M i T
i �
� �
� `L ____�_ COMMUNI7Y DEVELOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC.
, � ;
� �"'1 � CITY HALL FRIDLEY 55432 NuMBER aEV DATE
!'""�� � ,�' 612-571-3450 910-F15
6/18/79
JOB ADDRESS 124 Horizon Circle N. E.
1 LEGA� LOT NO. BLOCK TRACT OR ADDITION
DESCR. ]_], 3 Carlson's S�nmit Manor North
2 PROPERTYOWNER MAILADDRESS 21P
Charles P. Jansen 124 Horizon Circle N.E.
3 CONTRACTOR MAIL ADDRESS ZIP
Same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP
5 ENGINEER MAILADDRESS ZIP
8 USE OF BUILDING
R�sidenti.al
7 CLASS OF WORK
B DESCRIBE WORK
9 CHANGE OF USE FROM
❑ NEW
�e� ., �n�
PAGE OF
� �
� 15268�
IP .
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APPROVED BY
SEE ATTACHED
SH EET
PHONE
566-3453
PHONE LICENSE NO.
PHONE LICENSE NO.
PHONE LICENSE NO.
ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
e
STI PU LATION S
Insta.11 a ha.rd surface driveway.
TO
SEPERATE PE�RMITS REQt�11R�p FOR VrrlRf�;,
HEATtNG'� PC.U�ABtNG AND SIGNS
SEPARATE PEFiMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, '"`v� Vv�•V �.
VENTILATING OR AIR CONDITIONING. OpC� }.''I'�e
THIS PEFiM1T BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION �.
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3i348
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �`�.G.00
PLAN CHECK FEE
�B1m RE OF COj AC
NATUREOF OWNEAI�F
AUTMOR12EDAGENT IDATEI
�',/ �
BUILDER� IDATEI
����
Bef� ��TMg �N toc�i ntiti�es
1�tEPHONE • ELECTRIC - GAS Etc.
REQt�IRED BY LA'W
OCCUPANCY GROUP OCCUPANCY LOAD
S�. FT. CU. fT.
400 4000
OFFSTREET PARKING
STALLS GARAGES
SURTAX
$l. 67
SAC CHARGE
N PROPERLY
TAL FEE
$17.67
fHIS IS YOUR PERMIT
CITY OF FRIDLEY
APPLICATIQN FOR RESIDENTIAL.BUILDI�G PERMITS
(New, Alterations, Additions, or Repairs)
� � � �
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BUI LDER : �ir�,�
ADDRESS:
TEL N0:
Construction Location
STFt�T NO: � STREET: � r
LOT: � � BLOQC: �
Corner Lot: Inside Lot:
0
ADDITION:��`'L J cal�I t�GC/�f�/T /'<�/i'l��' /l/�
Setback: Sideyards:
Applicant a�tach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOtJ OF CONSTRUCTION
� l f � !
. Front: p� �C.� Depth: di, � Height: � v
Squ.�e. Feeta � Cubic Feet: '�� �
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction : ("�1 ��� ��.�1�,_�
Zb Be Cbmpleted: / � �- � � .o '� �
Estiraated Cost: $ � � � � ��
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ ' ry
. SEE REVERSE SIDE OF SHEET
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work i.n strict accordance with the City of Fridley Ordinances and
rulings of the Departmerft of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE: � ` / ��i — � f ` SIGN�iTURE :
Stipulations : �'��
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BUILDIi�G PERI�IIT FEt SCiiEDULE
SECTZON 2. The Inspector of }3uildings shall, before issuing pernlits for the erecL-ion
oi' any building or st.ructure, or for any addition to any existinq building or structure,
or for any a3.teration or repairs to �any existing building or structure, upon apYlication
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 CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic ieet.
PLAN CHECK: 25 percent of building permit fee. ,
DRIVEWAY D�PFtESSION: (Concrete C�zrb Streets Only)
• Alternate A: Removal and replacement of concrete curb and
gu�ter only; Driveway width plus 6 feet x�1�.75
. Alternate B: Removal and replacement of concrete curb and
, gutter and install a 3 foot wide approach with
• - 6 i.nch depth; Driveway width plus 6 feet x$17.85
:1/ _�\: ► �' ' �1
For the purpose of computing fees for building permits, 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 sur�ace
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 thereaf in 'the cost
of al1 proposed work.
In•no case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
VERIFICATIO� OF FOUNDATION
NOTE: Permits for cons truction will be issued a mi.nimimn of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before procee�di.ng with the framing.
� : � • '�1
Applica�.ion for a Certificate of Occupancy shall be made ten (10) days prfor to the
use or occupancy of any structure for which a building perniit has been issued; and
sa3.d structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
. � , .
.. . , a VLI\ � L �i T .
1
erOY�TRU� � �� C. E. C 0 U� T E R 'v ' ���rr�wa
�ustMw , r�wr wtva►s
� �p� LAND SUiiY�YOR " ���isMO�■
�ww�Nrc MRMIN6 RE613TER�D UNDER I.AMis OF f7'ATB OR MiNNEfOTA ' �uoic��•
LiC[N�QD 07 ORDINANCi O► �i{Tf 6/ MINN[�/OY�
i 3'00 LYNDALE AVE. SO. MINNEAPOLIS 8. MINN.
LOCUST 0870 �
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I� �iwrnrg�out's �Iltt'tititat�t �
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,�_ I hereby certify tFaat the �bove is a true and aorrect plat of a eurvey of:
Lot �leven (llj. B�ock Three (?), C_4RL50N' S'[�IIT MANOA NQRTH ADDI'I'ION� Anoka �aunty.
F11 t� 90 tn.
: , ' �,� � -
As surveyed by me th�� L�th day oP Aprih ��jSB �.D, 7� . .
� ��. . " ' �4 si�,ea �
� � A:�anegot� egidtration No. �581�
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� AR`� � t7 E. C AR �SON � . �-,
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r-�' ' ' � � SuBJEGT � � � �
City of Fridle�
AT TNE TOP OF TME TWINS g�J I L D I N G P E R M
;,
� �
' ' COMMUNITY DEVEIOPM�NT DIV.
� VV ��'�•'�
f � � PAOTECTIVE INSPECTION SEC.
i = �
� �"'� � CITY NALI FRIOLEY SS132 NUMB8f1
�"""� � �'' 612-571-3450
s�o•F, s
JOB ADORESS 124 Horizon Circle �
t IEGAL �OT NO. 860CK TRACT Oii ADOITION
DESCR. il 3 CArlson's Su�
2 PROPERTY OWNEH MAIL AODR�S$
Jansen
3 CONTRACTOR MAIL ADORESS
Superior Constr. Services 8665 Jefferson
a ARCHITECT OR DESIGNEfi MAIL ADORESS
S ENGINEER MAIL AODfiE$S
8 USE OF BUILDING
Residential
7 CIASS OF WORK
REV OAT@ VAGE Oi
10/2/98 � �
Ma.nor North Add'n
ZIP PMONE
ZIP PHONE
28081
RECE_____�
�
APPROVED 811
SEE ATTACNED
SHEET
LICENSE NO
723�_
LICENSE NO.
LICENSE NO
O NEW O ADDITION ❑ ALTERATION � REPAIR p MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage (33 Sq) Tear-off
9 CHANOE OF USE FROM
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE FiEOU�RED FOR ELECTRICAL. PLUMBING, HEATtN(i, TrPI
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION pON
AUTHORI2ED IS NOT COMMENCEO WITHIN 80 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANQONEO FOFi A PERI00 OF 120 DAYS A7 '
ANY TIME AFTER WORK IS COMMENCED. ' NO.
1 MEREBY CERTIFY THAT I MAVE READ AND EXAMINEO TNIS APP�ICATION
AND KNOW THE SAME TO BE TFIUE AND CORRECT. AlL PROVISIpNS OF �AW$ �A��
AN� ORDINANCES GOVERNING THIS TVPE OF WQRK WILL �E CfJMQUED
WITM WMETMER SPECIfIEO HEREIN OR NOT. TME GRANTING OF A PERMIT 2
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR C,AMCEL 7ME pEq�
PROVISIONS OF ANY TNEF STATE OR LOCAL lAW R ULATING N-
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ConstructionAddress:
Legal Description:
Owner Name & Address:
Contract�
Address:
CITY OF FRIDLEY
SINGLE FA1�III.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
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Effective 1/1/98
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Tel. # �
LIVING 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
Length Width Height
Length Width Hgt/Ground
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Tel. #� y�L/���! 3�
Sq. Ft.
Sq. Ft.
Sq. Ft.
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Construction Type: ��/�� �� �}- j� �-, r� Estimated C st: $ �CJ� O
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DA�'E: e a g� APPLICANT:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
MI'1.:M•�_
Tel. # y� �/ c�/3 �-�
CITY USE ONLY
$ �`1. �� Fee Schedule on Reverse Side
$ � m� � .001 of Permit Valuation (1/ lOth%)
$ , I $.50/$1,000 Valuation
• $ $1000 per SAC Unit
$ �j�, (,� $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 [ J
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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 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 $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,OQ0 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 $SOO,OQO 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,d 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.