AF - 46352,�
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City of Fridley, Minn.
BUILDING PERMIT
��. AIIGUST 30, 1966
Oveaer: WALTER NALEPRA �� SAME
Add�s 5373 flORIZON DRtVE N.E. A�
FRIDLEY, MCNNESOTA 55421
N°
�� ��s
8990
LOCATION OF BUILDING
No. 5373 S�t HORIZON' DRIVE N.E. p� of Lot
Lot 7 Block 6 Addition or Sub-Diviaion �RLSOIV'' S SUNIl�ZCT MANOR NORTIi ADDN.
Coraer Lot _ Inaide I.ot x Setback — Sideyard
�� II��� Foundatioa IIevation
DESCRIPTION OF BUILDING .
To be Used as:
det . Garage �t 19 �� 20 ���t 10 �. � 380 �� 3, 800
, Front Depth I�ei�ht Sq. Ft Cu. F't
Zj�pe of Constructton -� F.�t, Cost —�`la�FOQ To be Completed
Ia c�sideratlon oP the ieauan�ae to me of a perinit to conatruct the bwtlding descrlbed above I agree to do
th� proposed work 9n accardance wlth the d�scription above set in compliaac+e with a�l provlai ns of
or8iaances of the dty oP Frldley. / i p%�� -
��� �
Ia conaideratlon oP the payment of a Pee of � 4_�� . permit fa hersbY graated to WALTER A„
��E� to construct the building or addition ae described above. Thispe rmit ia granted upa�
the expre� condition that thepe�on to whom it is granted and h4s agente, employees and worlmien, 9n all work.
doae fa, around and u�n eaid building, or anypart ther+eo$ ahall conPorm ia all reapects tfl the ordinances of
FridleY� Minnesota �g lacatton, conatructlon, alteration, maint�naace, repair and moving of buildin�s
wittiin the dty ]imite�3an�tbis permit may be revoked at any time upoa violatlon oP any oP the proviaiona oP eaid
or3laancea.
c�cE � Br�,zs�. ��s �
Nonc�
ilds p�noh doa aet cewr tla eee�feuaHoe, ImhUdion for M►fe�. P��9. o+� b�+�Y. aw�r o� wat�r. 8� wn to a�
Na &tlldie9 le�or tor apuafs p�emfi� h� 16w �t.
owrnR's rTar� A��;�-����
APPLTCATION FOR BUTLDING PERI+IIT
CITY OF FRYDLEY, I�NNESbTA
a�.-����
�,nn�ss ����- ,�s �� �' ���. a�''.� aDnx�ss
LOCATION OF BULY,DING
/
NO.���,� `��� STREET ,����-�,�s�� � , %-`� � PART !JF LOT
�4
LOT BLOCR �� ADDITION OR SUBDiVISION°���,� � p ;�7�� .��- � c
GORNER LOT INSIDE LOT �f SETBACR SIDE-YARD
SEWER Ei,EVATION FOUNDATION ELEVATIOft
Applicant attach to this form Two Certificates of Survey of Lot and propoaed
building location drawn on these Certificates.
DESCRIPTIOR OF BUILDIbTG
To be used as•
7
a
°-� �--�-� Front,/�� Depth �--� Height � �
�
�
Sq. Ft. � r� � Cu. Ft. `�� �� C�
Front Degth Height
Sq. Ft. Cu. Ft. ,
Type of Conet�ructi`�ni �-�,�.e>����� Estimated Cost��� �� �''
� .
To be campleted �
The undersigaed hereby makes appl�cation for a permit for the work herein
apecified, a�reeing to do all work in strict �ccordance with the City of
Fri�Iey.Oitdinances and ruliags of the Bepartment of Bu3,ldings,.and hereby
declares that all the�facts and repreaentations atated in this application
are true and correct.
DATE_ � -� � `- � `�` � �
������ � � �,
(Schedule of Fee Costs can be found on the Reversa Side).
�a`'t'� , `
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$IIILDING PERMIT FEE SCflEDUI.E
SEG'TION 2. The Inapector of B�ildinga shall, before issuing any permit for
the erection of any building or strucCure; or for�any addition Co any existin�
building or structure, or for any alCerations or repairs to any existing
building or atructure, upon application therefore, requi.re the payment by the
applicant for such permit of fees to the.amount herein below set forth and in
the manner here3n provided to-wit;
2.1. For anq such permit for the erection of any fire•proof building,
othei than a garage, warehouse, factory or grain elevator, or for the erection
of any fire-proof addition, for aimilar occupancy, tp any esiating buildin$,
sha11 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.aay fire-proof garage,
warehouse,: ��ctory or �raia elevator, or for the erection of anq fire»proof
addition, for similar,a�cupancy, to any esistiag building ehall be at�the
rate �f $1.25 for each one thoueand cubic feet, classified ss "fireproof"
by Section 502 of the Minneapolis Buildiag Cade.
80IISES
2.3. For any such permit.for.the.erection of aay noa-fireproof
building, other than a garage, warehouse, factory or grain elevator, or
any non•fireproof addition, for similar occupancy, to any esiaCing buij.ding -
permit $1.00 for each one thousand cubic feet.
GARAGES
2.4. For any such permit far the erection of say non-fireproof garage,
warehouse, factory or graia elevator, or fos the erection of any non-fire-proof
additioa,�for similar oceupancy, to any egfsting bu3lding or for each such
building or addition - ninety centa ($0.90) for each one thousand cubic feet
or fraction thereof, 3n �he�cubical contents thereof with the minimum o£ $4.00.
For the.purpoae .of computing fees for building permite, the cubical contents
of any building or addition to a uniform height throughout by multiplying the
grouad area covered from a point si.0 (6) inchee below the floor line of the
basement or cellar to the average h��ght of tha upper surface or to the average
height of the roof surface of the main gable.of a pitched�roof.
2.5. For xepaire,or alterations to an exis�ing �tructure, tkte �ee ehall
be at the rate of $3.00 per each�Five Buadred Dollaze ($500,00) or fractic�
thereof in the cost of a11 proposed work. .
2.6. . In no case shall the fee charged for any pexmit as set forth in .
Section 2 be less than $4.00. �
STORM REPAIR DANIAGE FEES:
Residential:
Commeacial;
Estimated Cost of work up to S5�!�?, ^� � SS a�?�
Estimated Coat of work ove� `': _....�:'! � Y>; ,'��0
Estimated �eC Of ian�',. �t � t;J ;r •-'' _ `,1 � ^' r;�'
Estimated at of w:�i?� ovc:r y.:yi,i;��U�1 -,�i). ,,
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N° 90�
Building Job Repo '�_ _
ADURESS �� �. � (,►-' �te-,,..�1 `J .
OWNER C - ��.�. R'� � �rr�l
BUILDEfi S'' 'L.� �'� �
DATE ,. I � PERMIT NO.
DES IPTION , �(,,�
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' INS� ECTION RECORD
DATE REPORT
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City of Fridley � 200
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
� � RECEIPT NO.
� 1 L___��_ COMMUNITY DEVELOPMENT DIV.
r i � PROTECTIVE INSPECTION SEC. �� � j_
1 . � �!J
� _ /"': � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�.---� • •,� 612-571-3450 910-F15 7/24/89
� �
JOB ADDRESS 5373 Horizon Drive N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. % 6 Carlson's Summit Manor North Addn. SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ra.lph Tniheeler 5373 Horizon Drive N.E. 572-9453
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Milton L. Johnson Co. 2513 Central Avenue N.E.� Mpls. 55418 781-9548
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside �velling
9 CHANGEOFUSEFROM TO
STIPULATIONS
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE 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 ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTEF WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND OFiDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S7pOO.O 3.SQ
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $90.00
PLAN CHECKFEE TOTALFEE
$93.50
SIGNATUAEOFCONiRACTORORAUTHORI2EDAGENT IDATEI HEN PROPERLY VA ATED THIS IS YOUFi PERMIT
' ��
� �-Y=�'s' - �
' NATUREOFOWNERiIFOWNERBUILDERI iDATE� ' BLDG INS� � qiE
� []
� L l
AL2�2 � )
Construction Addre�-.�s:
I�egal De�criptiam:
�WI12,r NdI[IL bt �+�aaQ.S:
Contract�r: �'I�1�fi
�:
r�vnv� �:
C�ARAGE ARE�i:
D�CK ARE�i:
�t
0
J
I�1 AND 1�2
m,;�ding Aermit Application
�
Effective 5/1/88
�el. # s%z - s;�-�
�. # ���-s��
Attach to this applicatian, a Certificate of S�rvey of the
lat, with th,e praposed ooa�structio�n drawn on it to scale.
� n�m� a� u�aava��rr
�h wic�tn xeic�t sq. r't.
��h Width Height Sq. Ft.
7prr��h Width Hgt/Gr�ound Sq. Ft.
Corner Iot [] Inside Iat [] Ft. Yd Setback Side Yazd SetbacJcs
�YPe of Constn�ction: Fstimated Cost: $ � . �� . �/
Approx. C7oanpletian Date:
Proposed Driveway Width If New f)penirrg Is Desired; Ft. $ S
� Wi + 6' See Baak Page
LIATE: _% � �l �� APPLICAN'r: 'I�e1. # 9A/ —� ��
Permit Fee $ 9�. 0 0
st.ate sut�ct�ge $_ � - ��
SAC Ct�arge � $
Driveway ��x,Q„i $
Park Fee $
Sewer MdiTi Q]arge $
. v
��� :
$ �� -�
CI�1'Y IIBE �II,Y
Fee Schedule an Rever�.,e Side
$.5o/$i,000 vatuation
$575 per SAC Unit
Alt. nA° or Alt. nB�� AbOVe
Fee Det�22miTled by �i ru�ri rrf
�
� N�Y L l xat xece.ssary L]
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0
0
:_�1� �����_ ��;•Y�y �:�" :��:���_��
Zhe Chief Buildirrg Official snall, before i�Q,; *� pe�mits for the erection of 2�ny
building or stru�c4ue, or for ariy additiaa�► to ar�y existis�g building or structure, or
for any alteration or rep�air to ariy existir�g buildiryg or structure, upon application
�ernfore, rec�,; *+p the payment by t2�ee applicant for such ��; t of fees t�o the amount
h�erein belvw set foYth arid in the manner herein prwided to�ait:
�►rAL, V�1I�JE
$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
� �.
$15 (Minina� Fee is $15 plus surcharge)
$15 for fitst $500 plus $2 for each additional $100 or
fract3aai thereof, to arYi includi.ng $2, 000
$45 for fitst $2,000 plus $9 for each additional $1,000
or fractian th+ereof, to and includirig $25, 000
$252 for fizst $25,000 plus $6.50 for each additional $1,000
or fraction ti�ereof, to and includirig $50, 000
$414.50 for first $50,000 plus $4.50 for each additional
$l, 000 or frackion thereof, to and incltbding $100, 000
$639.50 for fiYSt $100,000 plus $3.50 for each additional
Sl, o00 or fraction thereof, to ar�a incluairig SSOO, o00
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1, 000 ox' frdckion thel�eof, to a� includirig $1, 000, 000
$1, 000, 001 arid up $3539. 50 for the fitst $1, 000, 000 plus $2 for each add.itional
$1,000 or fraction thereof
�tIVF�li D�PZ�ESSI�T ESC[�D�W
(Caonc7+ete Curb Streets On1Y)
Alternate ��A�� ; Ramaval and replao�nent of curb and gutter only - Driveway width plus
6 feet times $13.50.
Alternate ��g�� ; Removal arid replace�oent of curb ancl gutter and in.stall a 3 foot wide
approach with 6 inch dep�tii - Drive�ray width plus 6 feet times $15.75.
' �• ■' v� •: ��° �����i�-_� �J�
Penoits for �uct.ion will be issued a n�*+�+�m+ of 24 hours froan the time of
applicaticn to allaw for p�roper review of the pr+crposed stnicture ar�d of the
oonstruckian site.
A C�ertificate of S�vey of tt�e lot, showing the location of the foiu�dation orioe it has
it has beei� oo�nstYUCted will be re�quired before prooeeding with the fram.ing.
,� -.�. . _ �,
_
_
CITYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287
November 21, 1990
Mr. Ralph Wheeler
5373 Horizon Drive
Fridley, NIId 55432
SUBJECT: Curb Replacement
Dear Mr. Wheeler:
PW90-307
The curb replacement in front of your house has now been completed.
We would like to apologize for the length of time it took to
complete the repairs. Our concrete contractor was tied up on
several out of town projects which delayed his return to our
replacement list.
The black dirt has been placed on your boulevard and the disturbed
area will be re-sodded in the spring.
Again, we apologize for the delay in the completion of this work
and will be endeavoring to correct our procedures so this type of
incident is not repeated.
Sincerely,
� - U�-� '1-�-�-�
Jon Thompson
Construction Inspector
JT/kn
1.�_
/�
,.
March 31,1995
TO WNOM IT MAY CONCERN:
This is �o ioform you tl�a[ we, Step6en Steeda [Husbandl �nd 6race W. �egda [VII'�fel, tl�e
owuers �nd residents ot 5385 Rori�on DrNe N E, Frldley MN in Moka County, agr�e to the
reqnest of Bonaid G. S'trelow [Hasbandl and E�en 6. Strelow [Illfifel, the owners and
r�sidents of 5373 Hori�on DNue N� pridley MN in Anoka Coonty, that tdey be aliowed to
construct a driveway apron an t6e aorrh side of their properql.
We anderstand and agree W�t satd dri�ueway aproa wiil be approximately tweh►e [12l
Inc6es soatl� of ine soatl� propeKy lide of 5385 8ori�on Drfi►e N E[w6icb Is tw�lu� [12l
inc6es soath ol t6e nort6 propert]I line of 531� 8ori=on Driue N EJ
�:i- � � .
�
Stepden Szegda aas6andl
5385 Hori�oo Drnre N E
I�idiey MN 55421
�
/ ��
GreCe W. Siegde [111r�fe]
5385 Horizon Driue N E
k�diey MN 55421
�
_
C�IYOF
F'RiDLEY
FRIDLEY MUr1ICIPAL CENTER • 6431 UNNERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287
December 30, 1998
Ronald Strelow
5373 Horizon Dr. NE
Fridley, NIDT 55421
Re: Construction Without Obtaining a Building Permit
(Fascia/Trim at 5373 Horizon Dr. NE)
Dear Mr. Strelow:
According to Section 106.1 of the 1994 Uniform Building Code as
adopted by the City of Fridley, no building or structure regulated
by this Code shall be erected, constructed, enlarged, altered,
repaired, moved, improved, removed, converted, or demolished unless
a separate permit for each building or structure has first been
obtained from the Building Official.
You have been notified of your need to obtain a building permit and
have failed to comply as of today's date. Aa a result, a special
investigation fee will now be added to the permit, equal to the
permit fee. The City of Fridley will give you 30 days in which to
comply before turning this matter over to the City Attorney for his
legal consideration.
Please contact me at 572-3603 if you have any queations on this
matter.
Sincerely,
�!/ e
BARRY IESCH
Building Inspector
BR/bk
sue�etr PERMII-d+lO:--�
City of Fridley �f
�
AT THE TOP OF TME TWINS g � I L D 1 N G P E R M I T 2 8 8 6 5
; � RECEIPT NQ
COMMUNITY DEVEIOPMENT OIV. °0°°�°� �
� � �. •-----� �� �J
� � � PROTECTIVE INSPECTION SEC. �
� _ �
� /�"1 � CITY HALL FRIDLEV SS�3Z NUMBEh REV DAT6 PAGE OR APPROVED BY
�"""� � ��� 612-571-3450 910-F15 1/25/99 � �
108 ADDRESS 5373 Horizon Drive NE
t LEGAL LOT NO. BLOCK TRACT OR AODITION SEE ATTACNED
oescR. 7 6 Carlson's Summit Manor North Addition SHEET
2 PROPERTY OWNER MAIL ADOii�S$ 21P PNONE
R Strelow 5373 I3orizon Drive NE
3 CONTRACTOR MAIL ADORESS 21P PMONE LICENSE NO
Viking Home Improvement Co 4832 2 1/2 St NE, M ls., MN 55421 572-1820 4772
a ARCNITECT OR DESIGNER MAIL ADOqESS i1P PMONE LICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PNONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATIpN C� REPAIR ❑ MOVE O REMOVE
B DESCRIBE WOfiK
Reroof House & Garage (21 Sq) Tear-off; Fascia; Casing wraps
9 CHANOE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYP� OF CONST. OCCUPANCV GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PIUMBING, MEATINfi,
VENTIIATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL ANO VOIO IF WORK OF CONSTfiUCTION 20NING SO. fT CU FT.
AUTHOi;12E0 IS NOT COMMENCED V�(ITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOii A PERIOD OF 120 OAYS AT
ANV TIME AF7ER WOpK IS COMMENCED NO DWLG. UNITS OFFSTREET PARKING
I HEREBY CEiiTIFY THAT I MAVE READ AND E%AMIN�O THIS APPLICA710N ], STA�LS GARAGES
AND KNOW THE SAME TO BE TAUE ANO COFiRECT. ALL PROVISIONS OF LAW$ ypLUATION SURTAX
AND ORDINANCES GOVEFNING TMIS TVPE Of WORK WI�L �E COMPLIEO
WITH WMETMER SPECIFIED MEREIN OFi NOT. TME GRANTING OF A PERMIT �2,706 $1.35
DOES NOT PRESUME TO GIVE AUTMORI7Y TO VIOLATE Oii CAMCEL THE pEFiMl7 FEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE OR LOCA� LAW REGULATING CON-
STiiUCTION OF TME ERFORMANCE f ONSTFUCTION �]�}. ],rj Fire S �2. %0
�� � ti�`s" � ���✓ �� 1� PIAN GMECK FEE TOTAL F
� � '� Lic $5 0 $ .80
S�GNAT RE OF CON'�7A ,TOA Op AUTMOp�2ED AGENT �D�iE� EN O ALIDATE 1�5 VOUR PERMIT
' r / �
�_ ��
S�GN4TURE O� OWNEp��� OWNEp BWIDEfi� iDAiE� Bt G�NS� ' � f�vT �,
'aii� ��
rrEw
ADDN
AL1'ER
[]
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ConstructionAddress:
CITY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ti� _s � 7�� ��;1 /�, ��-� r�( �� .
Effective 1 / 1 /99
��
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a` �'�
I.egal Description:
Owner Name.& Address: ,� ._ r 1�� � v� Tel. #
Contractor: �� � � � �,�� � .= �� � L � 7 2u z '� ;.��, <�,� � �� �
� 1 ��i Y l MN LICENSE #�77
Address: L f����3 �� l� �: ?�- �� .� �� Z( Tel. # 5 7� f�z��
Attach to this application, a Certificate of Survey of the
�lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
LIVING AREA: I,ength Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECB AREA: Length Width Hgt/Ground Sq. Ft.
OTI�R:
� i �`fi � ����- �v i��°� �-�� �S Q ���.����o _7 � �� / �� %.
Construction Type:��p�(�,�s �, v�,,��� c.� i, �s c� r� timated Cost: $ f� �
�'`'�'' `" (Fee Schedul e on Back) � �
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ �
� � ,.
DATE: � � 2 � � � ��APPLICANT: ,��� ' G� � � ti �� �- �' Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
�
$ •
$ _%�
$ �
$
$ •��
$
$
$
$
$ c�3�c�
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 / l Oth %)
$.50/$1,000 Valuation
$1050 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 [ ]
�•
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 e�sting 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-wits
TOTAL VALUE
$1 to $S00
$501 to $2,000
$2,001 to $25,000
$25,001 to $SO,OQO
$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 $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additiona.l
$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 C�rb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
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 $15.75.
VERIFICATION OF FOUNDATION
Pertnits 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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Building
Inspections
763-572-3604
STfE ADDRESS _
THIS APPLICANP IS:
UW1vER/
TENANT
SUBNIIT A COPY OF
YOUR STATE
LICENSE W1TH
PER1t�IIT TYPE
�trE oF woRx:
DETAILED
PLTJN�ING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR
a
■ • ., �,
rxor�: ���°`� 71— (�Co..� 4-
STATE LICENSE #_
ADDRESS�:�� ac. -
PHONE_L(�
�GLE FAMIIY
O NEW
[(?N OF Vf10RK _
3i�7i L.�T'r.�.L�
■ , � u ■ �� •
■ • �� • � i�
Permit No..
Received By:
��
, J��� �
PER MS 16B.665 the permit fee is a minimnm of 515.00 or 5% of t�e total cost np to $500.00, wluchever is �, for the
improvement, inatallation or reglacemeat of a residential fixture, excluding the fixhues. (This shouid reflect only tbe cost of labor )
Labor cost under $3a? _$15.OQ. Labor cost between $3� to $SQO = cost of labor x.OS =
FOR PItO]ECTS Wt�RE I.ABOR EXCEIDS $500, FEES ARE BASED O1V $10.� PIIi FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOVI�
_ BATH SINK/LAV �I,OOR DRAiATS _ SHOWER _ WATER PII'ING
_ BATHTUB _ GAS PIPING (a�ssn ctarvc�se) _ 5WII4A�QG POOL , WATER SOF1NElt ($3S�
_ CLOTHES WASi�R _KITCfIEN SINK WATER CLOSET _BACKFIAW PREV. ($1�
_��pr,�S�¢R I,p�(JpDtty Tgpy WATER HEATER ($35) FOR IRRIGATION
�YATIIt METER _ OTHER
FEE
Fee
PERMLT FEE FOR PR(iJ�i:l'S ()Y�tt �JUU
Number of fixUms @ $10.00 x $10.00 = $
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surchazge = $ .50
T.,.�i = e
THIS IS AN APPLICAIION FOR A PERMIT NOT VALID iTNTII. PROCESSED
I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; t1�at the wark wiil be in
confoxmance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a pennit but only an application for a permit and work is not to stazt without a permit; that tbe work will be in accordance with the
approved plaa in the case of work wlrich e ew d approval of plans.
SIGNATURE OF APPLICANT Nf'RIIVT NAME `� ��DATE C� �
Pi.F.ArtF. NnTE_ :SEPARA P S ARE REOUIRED FOR BUILDING, ELECTRICAI., AND MECHAIVICAL WORK
City of Fridley
Bnilding Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977