AF - 46908i�■�r■r(I�
� Cit of Fridle Minn�
Y Y�
BUILDING PERMIT N° 4184
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Date: ..- ---------�---..... - ----. �_/-._'.._-�-�----.._L..-...._..._..._..--- --..
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Owner: .��������.U.i�!��r ..K.. .-�Q'�'trQ.r.�►-=\ Build�r
Address
Address
LOC�TION F BUILDING
No. ��.Q__...P Street ..... .. ... ..........._.. - � �- -----� � ---�-�-- -�,r� .._......... Part of Lot . � -.......--�-/ .._....._..._............... �- -- - �---�-�--�-�-----•
Lot ._..._..��........ Block .---.,�.�.......-----.....--..._..... Addition or Sub-Division .��i��-�r►,r.r.,�..._�n'.7!'7 �'GO
Corner Lot .._.�(......._... -...... Inside Lot ............ .... - ................. Setback _...._........_...-- ...._ - . Sideyard ...... - ........ ............_..-..- - ..._ - -� �--._...
Sewer Elevation
Foundation Elevation
DESCRIPTION Of BUILDING
To be Used as:
/ 4 � 1 c • �/ �j�p-
�,(�. s���.... Fron� �---�Depth��.Q Height lQ.- � Sq. Ft :r....�� Cu. F� ...7_....i......� �
..r .. --........ �� -- ....
---_ -.......... -. Front .-- ................ De th __... Hei ht Ft. G�. F�
.._.. -- .... . p _ _..........._. _... �9. _... _.........._ - --.._.......
Type of Construction ...........___._ ._. �/ "� To be Completed .._._............------_......_.__..-----...
_ ................_..._. Est. Cost........_ � -y�-.........
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In consideration of the issuance to me of a permit to construct the es ibed above, I agree to do
the proposed woa�k in accordance with the description above set�rth� 'ance all provisions of
ordinances of the city of E'ridley. �'" ��"�� �/� � �
In consideration of the payment of a fee of $--�..h�'..'�--, Permit is hereby granted to ..................._..._.......---...............__----
/
..----.....---------_-.---...-----------------------........---- to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. � �""
Building Inspector
NOTICE:
This permif does not cover the canstrve�ion, insfallation for wiring, plumbing, gas h�atiny, ssw�r or waNr. d� wn te tM
the BuiWing Inspeetor for separ�fe p�rmifs for these iNms.
4
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APP'LICATION FOR BUILDING PERMIT
CITY OF FItIDLEY, MINNSSOTA
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ss �`�f�i� ' � G ���i
LOCATIO�TT OF BUII.DING
No. � � � ,� Street � � Q . �j . E Part of Lo �_
LOT � BLOCR �'� ADDITION OR SUBDIVISIOA �. ��YN�.-,--�r-�
..^��s2�...— � -
Corner Lot Inside I,OT Setback Side-Yard�
, .�.__
SBWER,ELLVATION FOUNDATI�i EL$VATION
ApplicaaC attach to this �orm �o Certtficstes of Surveq of Lot and proposed
building locaCion drawn on these CerCi��icates. _ �
' DSSCRIP'�ION OF BUILDING
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be used asz
Frant Depth Height
Sq. Ft. Cu. Ft.
Frant Depth Height
�� Sq. Ft. Cu. Ft.`
Type of Coastruction_��� 8stimaCed Cost ��� ��
�
To. be completed_ _ ��/ �G �
.. �. �
The uadersigned hereby.makes application for a permit for the work herein specified,
agreeiag to do ell work in strict accordsace with the City of Fridley Ordinances
and rulings of the Departnment of.Buildi�dgs, aad hereby declares that all the facta
and representations stated in this applfcation are true and correct.
DATB
(Schedule of F�e�Costs can be frnmd on the Reverse Side).
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City of Fridley, Minn.
BUILDING PERMIT
nate: �un° 2, 1965
• � �.a � Y �. ij• : e il �.❑ Y- .:o �r a •
.�� � s � e 1 ���. r�u
30 7 F[
N� '7654
LOCATION OF BUILDING
Na ��_... stseet Horison Drivs DT. E. part o� zat
Iat 1$ _..__� Block �. 3 Additian or Sub-DivJs[an C• 3. Mauor� Nos'tb
Corner I.at ,_ Inside Lot ._.._ Setback Sideyard
3ewer Elevatian —.._.____ � Foundatian Flevation
DESCRIPTION OF BUILDING
��v�a�:
�t neptn �st,t sq. Ft. cv. �c
FY�cnL Depth _..._. Height Sq. Fk __�..�. G�. Ft
Ty�e of Construction Est Cost �• SQQ.i�__ To be Coonpleted �
3t��S E�8m8g9 2'ep83.T
In oaidderatlam of the issuance to me of a per�nit to coostruct the builaing desrribed above, I agree to do
ti� psopo�ed vv�o�k ia aoaordsnoe wlth the descriptfoa abo�ve eet and in oo�n ce with all provisit o�s of
a�+dlmn�oea oi the dq► o! FYidleq. �
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III OOnddeTAtLOIl o� the pBymCIIt O! 8 tEe O[ S. ���-----, PCTID�t �3 �y gi8nted to
t0 OOOSt[11Ct ��D$ OT Sdd�t1031 8S �d 8bdN8. 'lili8 P�t 38 $TBntCd IIpPII
tiiee exp�+ess ooadition tbst rl�eperaoa tu whom it is s�tea ana his agenta employe� anci worl�, in su wozk
dooe in. around and upon said building, a� sr�y part ther�eo� shall oo�nto�m in all resPcets m t� ordinanc�es a�
FridleY. Minn�o� 1oc:atioo. 000�OO. alteratieq maintenanc� rePair and ma'vin8 0! 1�uildinga
wi� dty ]iffita� pe�mit may be revoked at a�► �pe upo�n violati� oi any � the P��� o[ said
i11.e� Jensen Bu�dtne inspecta�
NOTICEs
tYs p�ewtt dea aet �wr fi» e�e�Ne�. tMai�N�a far 'rNy. �biL�. fs MMiy. sawK er w�hr. !� a� to s»
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� - � SUBJECT-�� � . � � - � .
City of Fridley . 14409
AT THE TOP OF THE TWINS B U I L D 1�� P E R M I T
�
; � ECEIPT NO.
� • COMMUNITY L3EVELOPMENT DIV. �
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� � PROTEC'f}1�E #NSPECTION SEC.
� .
1 . �, � , . -�. .
�i � �'��1 � CITY NALI. �� �;�Af01.E� � 55432 NUMBER �� REV. DA7E PAGE OF APPROVED BY
��11`•t ,�� 6f2-580-3450
910-F15 10/11/77 � �
�os no�RESS 5388 i#arizon Drive N. E.
1 LEGAL LOT NO. -BCOCK TRACT OR ADD�TION SEE ATTACHED
o�scR. 15 3 Carlson's S�mit Manor North SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Alfred W. Oprahl 5388 Horizon Drive N.E.
3 CONTRA�TOR MAtI ADDAESS ZIP PHONE LICENSE NO.
$dm@
4 ARCHITECT OR DESIGNER MAIL AODHESS ZIP PHONE UCENSE NO.
5 ENGINE�R. MAIL ADDAESS ZIP PHONE UCENSE NO.
B USE:OF Bii1LDING
R�Slf�@At7,d1
7 CLASS OF WORK
❑ NEW ❑ ADOITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
B OESCRIBE WORK
Chimne
9 GHANGE OF USE FROM TO
STIPtlLA710NS'
SEPARATE PERMIFS ARE RE�UIfiED FOR ELECTRICAL, PIUMBING. HEATING, TMPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTiLATiNG OR AtR CONDITtOMNG.
THlS'- pERMIT BECOMES NULL AND VOID IF NtORK OR CONSTRUCTION ZpNING SO. FT. CU. FT.
AUTH4RIZED IS NOT COMMENCED WITNIN 60 DAYS; QR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A,`PfR10D OF 120 DAYS AT
ANY TIME AF7ER WORK IS COMMENCE0. NO. DWLG. UNITS OFFSTREET PARKING
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPUCATION 1 STALLS GARAGES
AND KMOW.THE SAME TO BE TFiUE AND CORRECT. ALL P�tOVISIONS OF LAWS yp�UAT10N SURTAX
ANp ORDINRNCES GOYERNING THIS TYPE OF WORK WILL BE COMPUED
N+ITH WMETHEA SPEClPIED NEREIN OR NOT, THE GRANTING OF A PERMIT $i5Q $. SO
DOES NOT PRESIJME TO GIVE AUTHORITY TO VIOLATE AR CANCEL THE pERM1T FEE SAC CHARGE
•PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STqUGTIbN QR THE PERPORMANCE OF CONSTRUCTION. yfi%.SO
� PLAN CHECK PEE TOTAL FEE
- 8.��
. S1GNA7tJREOFCONTR TOAORAU7HORIZEDAGENT �DnTE� � � WHEN PROPEFLY VALIDA7ED 7HIS IS YOUR PERMl7
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� AT E OF OWN 11 O ER U� RI � IDATEI -- BLDG �NSP r DATE
�
C I TY OF Fil I llLEY
' APPLICATIOPJ FOR RESIDENTIAL BUILDING PERi�1ITS
iNEW, ALTERATIONS, ADDITION.S, OR �EPAIRS)
. OWIiSR: BUILDER:
Address: �. � Address:
Tel. No.
�,
No. : ��-3 � � Street:l�/�w��_ ��,
LOT: �� BLOCY.: � .�j ADDITI�N: �'�, ��� �,�--R.� ,��
CORNER LOT: v INSIDE IAT: S;_:TBACK: SIDEYARDS:
Applicant attach to this form Z�ao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRI PTIOfd OF BUI LDI NG
To Be Used As: .
� Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Seight:
� � Square Feet: Cubic Feet:
Type of Construction: Estimated Cost: $
Zb Be Completed:
Alt. A Alt. B
Pxoposed Driveway Width If New Opening Is Desired $ S(1- °�$
(3EE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
speeified, agreeing to do all work in strict accardance 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. See reverse side for additional information.
DATE: lO — �� �r% SIGIIATURE:
,
Stipulations:
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s�e�ecT PE NO.
c�ty of Fridley - 1718 6
AT THE TOP OF THE TWINS B U I L D I� G P E R M I T
�
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� • COMMUNITY DEVELOPMENT DIV. / rj
r � L � PROTECTIVE INSPECTION SEC. " �� �
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� � �"'1 � CITY HALL FRIDLEV 55132 NUMBER REV. OATE PAGE �Of APPROVED BV
�""'� � ��' 612-571-3450 910-Fi 5
6/6/83 � �
JOB ADDFiESS
5388 Horizon Drive N.E.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1rJ 3 Carlson's Suu�nit Manor North Addn. SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Alfred sahl 5388 Hori9on Drive N.E. 572-1014
3 CON7RACTOH MAIL ADORESS Z�P PHONE UCENSE NO.
n Jo 781- 48
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS Of WORK
O NEW � ADDITION � ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
9 CHANGE Of USE FROM TO
STIPULATIONS
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE fiEQUIRED FOR ELECTRICAL, PLUMHING, HEATING,
VENTIIATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN fi0 DAVS, OR IP CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AfTER WORK IS COMMENCED. NO. DWLG. UNITS OFFST(iEET PARKING
I HEiiEBY CERTIFY THAT I HAVE REAO 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
WITH WHETHEH SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �`2 OOO $�.. OO
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 PERF N E OF CONSTRUCTION. 32. 5O
� PLAN CHECK FEE TOTAL FEE
4 � �.j . $33.50
SIGNATUREOFCONTRACiO RAUTHORIZEDAGENT � nrE� :��; ,._ yyHEN PROPER�Y � LIDATED THIS IS YOUR PERMIT
SiGNATURE OF OWNER I�f OWNEF BUILDEAI IDATEI BLDG iNSP TE
CITY OF FRIDLCY E�fective �ug. 1, 19e1
APPLICATIOE� fOfi RESIDL-NT114. 6U1LOli�G PLRi�fITS
�N�+,r, A1 terations. Addi tivni. or Repa i rs )
OWI�ER: �� S
�Dp.�,ss: 'S3 -- o ` e.�
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6UI LDER : i L �J ��l �J o 1 �.
�oauss: ��l 3� C,� ; R a L N�'
.
� No: 7l/ - ��'� d'
Construction Location
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• STRIT►T NO r J 3 6 6TJtEET: J �J I� ���
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IATs � G HLODC: � 11D TION: � ei�..•-�� yllu/y'Y �t�i ^
'—_".� - ----r
Corner Lot: Inside Let: 6etback: Sideyards:
Ap�licar�t attach te t1�is iorm b+o Certificates of bvrvey of iot arsd
pzoposed building locatian dzawn on certificates to scale.
OESCRIPTIOit OF CONSTRIlCT10��
� Fmnt: Depth: Hefqht:
bquare Faet: Qibic Feet:
Front:
Square Fe�t:
Depth: Hefght:
A�bic Feet:
l � � �
'lype of Cbr.struction: ��N/1� % ��A� �►- �v T % �C'I�► Est�mated Cost: S a� � � ' �'
. �� - T�• _ e-
1b Be Cbr.�plcted:
111t. 11 I►1 t. 8
Proposed Dzivc�++ay iiidth If New Openinq Is Desired: ;' S
. . . SEE RiVERSE SIDL OF SHEET �
Zi�e unde�rsigned hereby ma);es applic�+tion for a permit fcr the work herein specified,
agreeing to cb ,all vork ir, strict accorda�r�ce �+ith the City of Fridley Ordinances end
xulin9s of the Dei�.�=bne�t of Duildings, and hereby declares t?�t all t]�e facts and
repres�t�ticns stated � this npplication are true and rrect.
l��TEs F L SIGNATV?�: �
Stit,ulations:
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GZYOF
fRIDLEY
CiViC CENTER • 6431 UNIVERSITY AVE- N.E.. FRIDLEY, MINNE50TA 55432 • PHONE 16121 571-3450
Iugust 16� 1984
t�lr. Peter L. Bonesteel
169 Horizon Circle N.E.
Fridley, !�l 55421
Re: Intersection Vision Safety Zone Obstruction
Dear Mr. Bonesteel:
q- i S -d-�s
In order to provide safe passage for vehicular and pedestrian traffic in the
City of Fridley, periodic inspections of street intersections are condueted.
An inspection on August 13, 1984 has dete�ined that the sightline for the
intersection on your property is obstructed and could present a hazard to
traffic.
Section 205•15u of the City Code requires that� "On a corner lot in a vision
safety control zone, nothing shall be erected� placed, planted or a1loWed to
grox in such a manner as ta impede vision.... the vision safety control zone
is described as folloWS: That area bounded by the street right of Way lines
of a corner lot and a straight line joining points on said right of xay lines
Lxenty five (25) feet from Lhe intersection of said right of way lines."
Therefore� the City is requesting you� the property o�ner, to correct the
follo�ing problem and to make the City's streets safer for travel. A
reinspection will be conducted on or about to determine
compliance. /o � / - �'�/
�le are confident in your cooperation to correct this problem, but if there 1s
any problem with the interpretation of this letter, please feel free to call
on me at 571-3�150.
The inspection of your property indicated that the fo2To�ing obstruction
ezisted and should be corrected:
Cut and �aiatain tbe hedge to s height
of not more Lhan tvo and one-ha]f feet.
Sincerely�
ST � J. a.SON, R. S.
Environ�ental Officer
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CIVIC CENTER • 8�31 UNIVERSITY AVE. N.E.. FRIDLEY. MIiJNESOTA 55432 • PHONE 16121 571-3450
3eptember 20, 1984
Mr. Alfred Opsahl
5388 Horizon Drive N.E.
Fridley, l+B�1 55421
Re: Intersection Vision Safety Zone Obstruction (SECOND NOTICE)
Dear Nr. Opsahl:
Enclosed you Will find this department's letter dated August 16, 198�1. This
letter brought to your attention the need to remove the loxer branches f rom
the Spruce tree and trim tbe floxers to provide a better sight line for
motorists traveling on Horizon Drive.
As indicated, a reinspection Was conducted on September 19, 1984 and it was
determined that no effort has been made to correct the intersection
obstruction.
At this time the City must again require you to remove any sight line
obstruetion and maintain a clear viex for motorists travelfng on Horizon
Drive N.E.
To determine compliance, a reinspection xill be conducted an or about October
1, 198�. The City is confident in your cooperation and if any questions or
problems result from this letter, please feel free to call on me at 571-3450.
Failure to abate this violation may result in this matter being turned over
to the City Prosecutor for his legal consideration.
Sincerely,
3T EN J. OLSON� R. S.
Eavironmental Officer
SJO/mh
ENC : 1
.
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� .Jc� S�T�.� �% D /l1 .L -,� P �J �
D� ZD : Jock R�obertson. GlcxmauiitY 'Develognent Ac�ministxator
rg�D F�M: Darre7. C�,ark, �hief Building Official
, H�ND DATE: August 4, 198$
�Il�: Foundation Prablens in Carlson's Simnit Mamr North Addn-
pl�se be advised that siryce July 21, 1988, I have received calls from six
hc�neowr,ers who awn hanes in the vacinity of the 5300 block of Horizon Drive,
requesting that I inspect their house foundations because of apparent
differencial settlements. Prior to these calls we had inspected 5 other
fourr3ations duri� 1987 ar�d 1976 that were in this ge�exal arfla.
There appears to be a pattern of things that prab�ablY have caused these
settlenents to occur or are prese� at each location:
1. They have all occured ciurir�r3 long dty spells (1976. 1987 & 1988) .
2.
3.
4.
All have had reature trees growirg in the general vacinity of the failure.
Yazd arid street settlenent has also occured in fn�nt of those hanes that had
mature trees in the front yard near the failure.
All those that have had soil tests done have had a layer of moisture
receptive or active soil at ar below the footiryg elevation.
5. All haneaar�ers l7ave been advised to contact a soils engineer to test arxi
rePort their findirgs arrl to su93est the method of co�ection.
6. A11 of the hames were buil t in the mid 195 0' s.
The cost of x�epair will deperr3 u�on the exterit of the failures. We estimate the
cost of such repair to range between a minimum of 5504. �0 to a maximum of
$20,000.00 or possibly higher. On�e hane repaired in June, 1987 paid an
estimated $3,000.00 to a oontractor to r�eplace the l�ck wall (32 feet) of their
basenent. That repair consisted of the follaaing: temporarily supporting the
strvcture on post arxi timbers; renoving the back fourx3ation wall ar�d footings
digqing cbwn through appro�xiinately six feet of clay or silt to granular gravel
at three locations (each hole was about 4'x 2' ) t pouring each hole full of
cor�crete; pouring a reir�orced cor�crete gzade bea�n wer the top of the new Fads
to fonn a r�ew footing; layirx,� up a riew block wall ; ar�d setting the house back
dawzl.
A ca�osit m-�p is being m3intained that st�ows the reported c7ates and addresses
of all �ported pn�blens•
If anyor�e wants mc�re irsEoanation on this subject, please contact cur department
and we will be happ� to nevia�r au' files. We cb have ir�dividual records on �ch
reported p�nbl an. �
Its possible that there oaul.d be more failures that have mt been called in for
our revi�a.
DGC/mh
ATTAC�i : l�p
OC: Mr. Jahn Flora, Public Works Director
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City of Fridley�
AT THE TOR OF THE TWINS
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COMMUNITY DEVELOPMENT DIV.
r � �' � PROTECTIVE INSPECTiON SEC.
� ,. i
� � �"'1 : CITY HALL FqIOLEY 55432
�'-"� � �'� 612-571-3450
SUBJECT
BU ILDING PERMIT
NUMBER REV. OATE PAGE OF
910-F15 5/6/94 � �
JOB ADORESS 5388 Horizon Drive NE
1 LEGAI �OT NO. BLOCK TRACT OR AD�ITION
DESCR. 1S 3 Carlson's
2 PROPERTY OWNER MAIL ADDRESS
Alfxed/Connie Opsahl 5388 Horizon
3 CONTRACTOR MAILAODRESS
Lundgren Bros Construction 935 E Wa�.za��
4 ARCWtTECT OR DESIGNER MAIL ADORESS
5 ENGINEEH
MAIL
ZIP
ZIP
ZIP
PE
�2465
ECEIPT NO�
APPROVED BY
SEE ATTACHED
SHEET
PHONE LICENSE NO.
PMONE IICENSE NO.
6 USE OF BUILOING
Residential
7 CLASS OF WORK
O NEW O ADDITION � ALTERATION O REPAIR ❑ MOVE O REMOVE
X
8 OESCRIBE WORK
Construct a 12' x 18' Three Season Porch Addir;nn
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan. Provide smoke detectors as per UBC 1210 adjacent
to all sleeping areas and in basement. Soil reports maybe required.
I�VARH�N�
Before digging calf f�r
all �tibt�t IOCatiats
45�4-01102
R�QUIRED BY LAVI�
Every s{eeping room shafl haye at least one
window with a sill height cf not more than
44" above the floo; und shall provide not
less than 5.7 sq. tt. of openable area with
a min. height of 24" and a mi�. width oi p�';
TYPE OF CONST.
SEPARATE PERMITS ARE HEQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITtONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTpUCTION
OR WORK IS SUSPENDED OA ABANDONEO fOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS
1 HEREBY CERTIFY THAT 1 HAVE REAO AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �5,034
OOES NOT PRES TO GIVE AUTHORITY TO YIOLATE OR CANCEI THE pERMiT FEE
PROVISIONS Y OTMER TAT OR LOCAL LAW REGULATING CON-
STRUC THE PERFO AN OF CONSTR TION. �HI.00
PLAN CHECK f EE
� License SC
S�GNAT OFCONTRACTOROAAUTMO AGENT IOATEI WHEN PR�
SQ.
STALIS
GROUP OCCUPANCVLOAD
CU. FT.
OFFSTREET PARKING
GAAAGES
SURTAX
$2.50
SAC CHARGE
Fire SC 5.00
TOTAIFEE
93.50
fED THIS IS YOUR PERMIT
� �—` v —��
�aTE
L
trr�
NEW O
ADDN �'
ALTER ( �
CiTY OF FRIDLEY -
S[IYGLE -�FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective 1/1/94
���-�
,
Construction Address: �/ //-e�� �a �� � � �i �J�l% _� ____ __ _. �
----- --- - ---- - ------ ---- ,—t
b � -----;� ��� -�. � f�/�L�?��` �.il�il����.�-��o6z N _--
Le al Descri tion: �C i/S ; _____� ______ - - —
Owner Name & Address: �-3 � � f� r, Z � . /� Tel _ � % � �6 � �
_ ��rt � _`
:_.
__ __. ._��
� - <._. � � ,� `, e. l° LiC NS # p � C� �`//.3
Contracto�-. - _ _- - _ _
- --- _ _ _ _ C� . - Tel. # �/��- ?f6�v
_- . _
Adciress: - �
�_ . __ _ _ � �
Attach to this application, a Certificate uf S ey o���
lot, with the proposed const�uction drawn on it to scale.
.� - S�- �-s�
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROYEMENT
Length /�
Length
Length
width � �
Width
Width
Height / � � Sq. Ft.
Height Sq. Ft.
HgtiGround Sq. Ft.
Corner Lot j] Inside Lo � j] Ft. Yd Setback Side Yard Setbacks
,1 � .� b 3N . °t (�
Type of Coa�iruction: (�� � y� t�"i2 r1-ia1 �' ��� �= �
Approx. Completion Date:
(Cost on Back)
Drivewa Curb C�t Width Needed: Ft. + F= Ft x$ _�
DATE: ��G�� APPLICANT: ` Tel. # �/�-S ����v
1�� '
cr�r usE ox�.Y
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
s �.��
$ ,Ob
$ �.S
$
� r
� � D�
$
$
$
.S
$ '� �� ►�'
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/1(�h%)
$.so��i,000 v��aon
$800 per SAC Unit
$5.00 (State Liceased Residential Contractors)
Alt. "A" ar Alt. "B" Above
$450.00 Conservation Plan Review
Fee D►��ermined by Engineeting
Agreement Necessary ( ) Not Necessary ( )
STIPULATIONS: �,,,� ,,�;�:�„c..��� -� � �`�"���'
��,:�.� ,c.�,�.�� �.�.� �� �`� �-r�
�,,
a7
a
GONFORMANCE SPECIFICATION FOR POLYSTYRENE PANELS
PHYSICAL PROPERTIES OF THE POLYSTYRENE PANELING AND ATTACHING EXTRUSfONS:
FACING - ASTM 3004 H154 AILUMiNUM ALLOY; SIZE 0.024' X 37.1875"; YIELD STRENGTH - 33,400 psi,
ULTIMATE STRENGTH = 34,600 psi; ELONGAIION 1% TO 3.1%
CORE - ICA-UTE BRAND EXPANUED POLYSTYRENE; RIGID CIOSED CELL; SIZE 2 15/16' x 35 3/S';
COMPRESSIVE STRENGTH (10°k DEFORMATION) 15-21 psi; FLEXURAL STRENGTH 40-50 psi; TENSILE
STRENGTH 18-20 psi; SHEAR STRENGTH 26-32 psi; SHEAR MODULUS 460-500 psi; ELASTfC MODULUS
320-360 psi.
FACING ANO CORE ADHESNE - A CONTACT ADHESIVE COMPOSED OF SYNTHETIC RUBBER RESfNS
AND SOLVENT$ THAT MEETS THE DURABILITY AND STRENGTH CRITERlA OF ASTM C-297, ASTM D-
1780(MODIFIED), ASTM D-2918 (MODIFIED). .
ATTACHING EXTRUSIONS - ASTM 5063 T 5 ALLUMINUM ALLOY TENSILE STRENGTH 22,000 psi; ELON-
GATION 8%.
TRANSVERSE LOAD (ROOF LOADING DATA)'
ROOF SPAN (F�
10
12
14
ROOF PANELS + H-S7IFFENER LBS PSF LBS RSF L8S PSF
ALLOWABLE ROOF LOAD" 1,400.� 51.3 1,310.0 40.0 800.0 21.0
' Panels tested to ASTM E-72 on 3' thick specimens with two-point loading at
quarter span.
" Founded on the lesser of a) the uft+mate roof load with a factor of safety of 2.5, or,
b) the roof load at deflec6o� = spanll S0, or, c) the roof load used in the 24 hour bad
/ defledion recovery test.
^����A ``���.���������t
p,Q� � •'`' °•� • tii ���',
.p".•` '• ��I �f
� �C`��_��:.?£RE9 ���i
, � :r,
; �= ;� -�� �:�.�a� : �
i = Et!^oii�i.ER : �
� h
%,� u'>, :, OI9855 6 � �Q�
� �5_
.
i�+ >.�;.,.� �,�0_
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��� �l� �
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� CONFORMAMCE SPECIFICATI�IS
-----•----- --------------
( HONEYCOMB RifOf PANElS ) �
----•--------------------- -- -- - --
GENERAL : CONSTRUCTIOH OETA1l5 AND CONf4RMANCE SPECIfICAT10NS 1HAT NERE SUBriITTED IN 9UIlDIN6 4ffICIALS AND CUOE
AOhINISTRAT�RS RESEARCN REPORi 85-46 (REYISEO TO 82-66) TO BUIIDIHG OffICIAIS ANO CODE ADMINISTAAiORS INjEANATIONAI
INC., 1051 NEST FIOSSM00R R�AO� C�UNTRY ClUB NIIIS� ILLIN�IS, b0417-5745.
PHYSICAL PROPERTIES OF NONE1'COMB PANEi1N6 AND ATIACHING EXTRUSIONS :
FACING - A".S.T.M. 3004 H15� AIIUMINUM AllOr; SIIE 0.02�'x37.i815'; YIELD StRENGiM 33,400 P.S.I.;
UITIMAiE STREN6TH 3/�600 P.S.I.; ElON6ATI0N It TO 3.It.
CORE - 9918. KRAfT PAPER; 3/4' CEII SI1E; Ilt RESIM IMPRE6NATION; OENSITY 1.86 lBS%CU F1.;
CRUSHING STREiiGTH 85 P.S.I.; STRQN6 PLANE SH�AR /2 P.S.I.; MEAK PIANE SHEAR 23 P.S.I. �
'fACIMG ANQ CORE AONESIVE - A CONTACT ADNESIYE COMPOSED OF SYNtHE1IC RUBBER RESINS AH� SOIYENTS THAT MEETS THE
' DURABIL�tII AND STREN6IN CRITERIA OF�A.S.1.M. C-297� A.S.T.q. D-1780 (b00IFIED), A.S.T.M.�D-2918 (flOOIFIED).
� ATTACHIN6 EItTRUSIONS - A.S:1.11. 5063 1-S ALLIqIINUM AllOY TENSILE 22,000 P.S.I.; ELOM6AIION 8�. �
--------------•--------------..._---•----•------
TRANSYERSE LOAO (ROOf LOADIMG DATA) : 1EST i0 A.S.Y.M: E72-80 ON 3" INICK PANELS; TiiO POIhT lOADIHG AT DUARTER SPAN
ROOf SPAM (FT.) 10 12 14
-------------------------------------------------------------------------------------------------
RQQF PANEIS NITH N� H-SiIFFElIERS LBS PSF l8S PSF L8S �Sf
ULTIPfA1E ROOF lOAD • 4013.1 141.1 3901,2 119.� 3511.2 41.8
-----------------------------------------------------------------------------------------•-------
ROOF PANELS NITH N-STIFFENERS l8S PSF l9S PSF. L8S PSF
UITIMATE ROOF LOAD - - 2910.0 88.9 3003.3 18.1
. cONfOR�aKCE SPECi'riCAii9�S
� ----------- --------------
. ( NO�E�COMB MAIL ASSE"B.iES �
------------=---=-=----=-==-------------=-:_......------•-------------•-------=-=------=•--.._.:..---=------=--------
---•-------- --- - ---- - ------------- - ----•-----._.._-------------------- - ------ ----•-- ----- -...-- -•------
',KA�iSVEAS� LCAO (�Atl �OAD:rG DAsA) :'fSi 'J A.S.?.�. E72-80 C� 3" ?c?CX PRti�LS; U�IFQRy �CA�:S6 USi`+G Fa3-3P.G.
----------------------------------------------------------------------------------------------------------------------------
( �All SPAV (FT.) 6 6
----------------------------------------------------------------------------------------------------------
iYPE Df eAll ASSEriBiY SO�ID (y0 OPENIy6S} �RA�ED (DOORS�aINDOMS)
� (PSf) (PSF)
-------------------------------------------------------------•--------------------------------------------
�A%InUM MALL 10A0 100 100
----------------------------------------------------------------------------------------------------------
KAII 10A0 AT UEFLECTIUN =(SPAN/1@O) 100+ 86
----------------------------------------------------------------------------------------------------------
�All i0A0 USED IN 24 HR 10A0/DEFN. TEST 80 80
--------------=-----------------------------------------------------=-------------------------=-----------
AIIQMA@�E MALL LOAD = 40 <0
------------------------------------------------------------------------------------------------•---------------------------
= FOUNDED ON THE IESSER OF a) THE nAXIrUr �All lOAD KITH A SAFETY FACiOR OF 1.5 Oa b) T�E YAII 10A0 A�
DEFIfCTION =(SPANJ180) OR c) TNE �All LOAD USED IM THE 24 HOUR iOAD J DEF�ECTIDU RECOVEar t�st.
------------------•------------------------------------------•---•-------•----------------------------------------------------
-------------------•-------------------------------------------•--------------------------------------------------------------
24 HOUR LOAD / DEFIECTION RECOVERY (MALL lOADING DATA} : IEST TO B.O.C.A. NAIIOHAI BUIlDING CODE (1988 SUPPLEyEYT),
ScCTiON 1305.0 ON 3' 1hICK ASSEhBIIES; UNIfORM lOADIN6 USiNG AIR 8A6.
------------------------------=------------------------------------------------------------------
KRLL SPAN (FT.) 6 b
----------------•---•----------------------------------------------------------------------------
InrEO. RECOV.
RECOV. �FTER 2lNR
-------------------------------------------------------------------------------------------------
SOIID KAII ASSErBIr (12'7"xl'1"x3") 84.82= 92.SSt
-------------------------------------------------------------------------------------------------
� FRAr,EO «Alt ASSEnelr (12'S"x6'6"x3") 87.T�t 92.16=
-•-------------------•------...------------------------------•---•----------------------•-----•-------------------------------
------•--------------------------------------•-------------------•----------------------------------------•-----•-------------
pXIAI COrPRESSIti'E LOAD (NAII lOADI�6 OAIA) : TEST IO R.S.t.M. E72-80 ON 3' THICK QANELS. �
-------•-----------------------------------------------------------------------------------------------------------
1YPE OF iiAlL ASSEKBII' SOLIO (AO OPEIC:!�6S) fRAMEO (OOORS/'R:7VDOKSj
(L8S) (LBS/Fi) (LBS) (l9S/FT)
-----------------------------------------------------------------------------•----------------------------
UL1i!'A?E AXIAL COMPAESSIVE LOAO 29�00 Y336 4�<15 3660
-----------------•------------------=---------------------------------------------------------------------
ALlOiiABLE AXIAI IiAll lOAD =i# 111b0 435 18118 1<64 .
-----------------------------------------------------------------------------------------------------•----
�� FOUNDED ON TNE ULTInATE AXIAL COMPRESSIVE lOAD IiiTH A FACTOR Of SAFETY Of 2.5
----------------------------------------------------------------•---------------.__..--•----....__.------------------•--------
------------------------------------------------------------------------------------------------------------------------------
RACKi1�6 CDA� (iiAll RACKIN6 LOAD DAiA) : TEST +0 A.5.1.K. E72'BO ON 3" PANELS
-------------------------------------------------------------------------------------------------------------------
TYPE OF fiAll ASSErBIY SOlIO (�i0 QDE�?�6Sj FRANEO (D�O�SJeiN00iiS)
(LBS) (LBS/FT� (L8S) (L9SJFT)
----------•-----------------------------------------------------------------------------------------------
uITIrAtE RACKIKG t4AD == 2130 �10 2360 190
----------------------------------------------------------------------------------------------------------
ALLOfiABi� AXiAI 1►ALl == 852 b8 944 76
-------------------------------------------------------------------------------------------------------------------
_= h0 CIEAA ?OihT Of fAIIURE, RATNER, �e�06RESSiVE DFTERIDRATION AT PANEL CORNERS ANO EDfiES OUE TO INDIVIDUAL
ROTAiION Of PAHELS iiITH RESPECT TQ iHEIR CENTERS.
--------------•-----------------------------•------------------------------------------------•---------------------
( _= fOU�IDEO ON iHE ULTIyATE RACKI�16 tOAD iiITH A fACTOR OF SAFETY OF 2.5 --
\. --•-------=-----=-----------------=----------=-----•------=---•----------...---------•----------=----------------• "- _ _ .
-------•-- ----- --•--•--•---•--•- ---------- ------------ ------------------------------------- --------------------
v
�
CONFORMANCE SPECIFICATIONS (HONEYCOMB ROOF PANELS)
Gene�al: Construction details and coniormance specitications submitted in 8uilding Offictals and Code
Administrators (BOCA) Research Report 85-46 (Revised to 82-66) to Buildinp Olficiais and Code
� Administrators i�ternational Inc., 4051 West Flossmoor Road. Country Club Hiils. IlHnols. 60477-5795.
Phystcal properties of Honeycomb paneltng and attachin� extrusions:
�
�
Facing -
Co�e -
-Facing &
Core
Adhesive -
A.S.T.M. 3004 H154 Aiuminum Ailoy; Size 0.02d" x 37.1875"; Yield strength 33,400 P.S.I.;
Ultimate Strength 34.600 P.S.t.; Elongation 196 to 3.19�0
991b. K�aft Paper 3/4" Celt S[ze;1196 �esin impregnatton; denstty 1.86 Ibslcu ft.;
Crushing strength 85 P.S.i.; strong piane shear 42 P.S.I.; Weak Plane Shear 23 P.S.1.
A contact adhesive composed ot synthetic rubber �esins and soivents that meets the durabiiity
and strength crlte�ia of A.S.T.M. C-297, A.S.T.M. 0-1780 (Modified)� A.S.T.M. D-2918 (Modified)
Attaching A.S.T.M. 5063. T-5 Aluminum Ailoy Tensile 22�000 P.S.1.; Elonpatlon 896.
Extsusions - �
Transverse Load �Rooi Loading Data): Test to A.S.T.M. E72-80 on 3" thk�c panefs; two poiM bading at quaAer span.
Roof Span (Ft.j
10
12
14
Rooi Panels . L8S PSF � LBS PSF L8S PSF
�lNimate Rooi Load 4Q13.7 1472 390T.2 119.4 3544.2 92.8
CON�ORMANCE SPECIFICATIONS (HONEYCOMB wAU. ASSEMBl.1ES�
Transve�se Load (Wind Load Data tot wal!): Test to A.S.T.M. E72-80 on 3" thick panels; unitorm foading using
air-bag. �
Wall Span (Ft.) 8 s
Type oi,Watl Assembly Solid (Na OpeMngs) Framed (Doors/1Mndows)
Maxtmum Walt �oad (PSF) 100 100
Axial Compressive Load (WaN Loading Dataj: Test to A.S.T.M. E72-80 on 3" thick panels
Type ol WaQ Assembly Solid (No OpeMngsj Framed (Doors/Windows)
' (LBSj (LBS/F'n (LBS) (LBS/Fn
Uitimate Axial Compressive Load 29400 2336 45445 3660
�• � Raskfng Load (Wali Racking Load Oaia): Tesi to A.S.T.M. E72-80 on 3" thick Paneis
Type ot Wati Assembly Solird (No Openings) F�amed (Doors/Windows)
. (LBSj (LBSJFTj (L8S) (LBS/FTj
Uitimate Racking Load " 2130 170 2380 190
'• No clear point ot 1aNure. �ather. progresshre dete�ioratbn at panet come�s and edges due to indhriduai ____
rotation of panels with respect to their cente�s. -- -�-
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TABLE 1
Pa¢3d6
iRJ1SSViUiSB LOl1D (ROOP L011DIPG Dl\TA)
ROOP SP71lT ( pT. ) 10 12 1 �
ROOF PANELS itITH NO H-STIFFENERS y85 pSP LBS PSP LBS PS!
11LLOFiJ18LE ROOF L011D• 1100.0 �0.3 820.0 25.0 630.0 16.5
ROOF YI�NELS WZTH H-STIFFENERS LHS YSF LBS PSF 2.BS YSl
ALLOWABLE ROOF LOAD• 1120.0 3�.2 8t0.0 22.0
•FOUndad on the lassor of a) the ultimate roof load vith a safety faMOr of 2.5 or b) the zoof load at defleetion �
�span/180 or c) the roof load used in the 21 houz load/deflnetion recwery test.
TRAltsv8RS8 LO11D (ti1►LL LoADiHG DATA) �
i1AI,L SPAN (FT. ) 6
ALS.OWABLE NALL IpADR (45F) {0
+FOUndad on the le�ser of a) The mazuu� vall loid vith a•afstY factor of 2.5 or b) tha vall load wt daflsction �
�pan/180) or c) the wall load used ia the 2� hour load/defleetion recwery te�t.
71IW. CO!@NffiSIVB LDAD f�7d. L0�7►DIPG OI►SA1z �'SZ 10 �b'fll E72-t0 Gf 3-iffiQ P11M�S.
(LDS) (LHS%?'T)
ALLOHAHLE AXIAL i1ALL I.OAD•• 11760 935
•FOUndad on tAe ultimate uial aompressive load vith a factor of ufety of 2.5
RJICICZAG LOi1D (i111Id. RAClCZPG LOAD DATJ►y: 1855 TO 1151R E72-80 � 9-iffiQ ?71IIffiS
(LBS) (LBS/PT)
ALLOitABLE RAClCING NALL•• 852 68
• Founded on the ultimate rackina load with a factor of �afetr of 2 S
.n.
•r usc -�+'
3.110—
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.160 ^ � t I �
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EkPOSED SVR[p�GE
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CORNER POST DETAII,'�`
FIGURE 2
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Paae 4 of 6
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94i18i94 12�42 �215 438 7110 AMBRIC •- ��3.
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CORNER POST TABLES FOR VARIOUS UNIFORMLY
DLSTRIBUI'ED ROOF LOADS (STUDIO R0011+i)
TABLE RB-1: 15 FT. HONEY COMB PANEL (14 F1'. SPA1V)`
RIDGE BBAM SPAN
iAAD (PS� 9 FT. 12 FT. 15 Ff. 18 PT.
30 pIC OK O1C OK
�1 OK OK OlC OK
50 OK OK OK OK
TABIB RB-Z 13 FI'. HONEYCOMB PANEL (12 F?. SPAI�`
RiD�GE BEAM SPAN
IAAD (PS� 9 FT. 1Z FT. 15 FT. l8 PT.
30 OK OK OIC OK
�!0 ` OlC OK OK OK
50 OK OK OK O�
TAB1.8 R�3: il PT. HONEYCOMB PAIVEL (10 FT. SP1�`
RIDGH RBAM SPAN
'tAAD'(PS� 9 FT. 12 FI'. l5 FI'. �8 FT.
30 OK �K OK OIC
40 OK OK OK OK
50 OIC OK OIC OK
� = SATISFACTORY � � UNSATISFACTORY
�lr0'I� l.�tiowiwr�d��NsqNS3-�16
_. La�lelmed�lsree 6.�eiaw aeedfeed �voo.d snew
Ie�is d�6glMS aot beew e�uidaaa.
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AS ►ER 1MSTAlIATlOM MAMUAI.
n
RAlN Guttfa SECT10t+.
1
, DEiA1L A
A
RIOGE BEAM SECTION.
ME� ROOF SUPPORT STSIEM
ON COMa05lTE NEADER BEAM.
SCREuS - 8 x 1/2 MEx SCREUS.
RlV£TS - t/8 x 318 RIYfTS.
CSM G��►ZED SIIDING OOOR ON
Sll� SECTIOM ON OOOR f100R
Ex�ANDER iJXiO TO OECK OR
C�CREtE 5��9 �S Aaca0vE0.
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AMBRIC � J
RIDGE BEAM°TABLES FOR VARIOUS UNIFORMLY
DISTRIBUTED LOADS
TABLE RB-1: 15 FT. HONEYCOMB PANEL (14 FT. SPANj'
RiDGE BEAM SPAN
LOAD (PSFj 9 F1'. 11 FT. 13 FT. 15 FT.
30 OK OK OK OK
40 OK OK OK
50 OK OK
60 OK OK
70 OK OK
TABLE RB-2: 13 FT. HONEYCOMB PANEL {12 FT. SPAN)`
RID�E BEAM SPAN
LOAD (PSF) 9 FT. 11 FT. 13 FT. 15 FT,
30 OK OK OK OK
40 OK OK OK
50 OK OK OK
60 OK OK
70 OK OK
TABLE RB-3: 11 FT. HONEYCOMB PANEL (10 FT. SPANj• �
RiDGE BEAM SPAN
LOAD (PSF) 9 FT. 11 FT. 13 FT. 15 FT.
30 �OK OK OK OK
40 OK OK OK OK
50 OK OK OK
60 OK OK OK
�0 OK OK
. ^
u = �R � �SrAGTORY Lj � UNSATISFACTORY
'NOTES: 1. Catcutationc based on allo �
2. Table values baced on'fuUr sn traint bsi '
Aid�e geam hom the Hons ��°��d �° ��mpnssion t�anpe of the
9• loadin� inte�sities ue baseY�mod (ied pround c�ow loads and drihinp t�aa oot been oontide�od.
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sue�ecr PE N .
City of Fridley 2 6 3 51
AT THE TOP OF TME TWINS B U� L D� N G � E R M I T
f
� ` RECEIPT NO.
COMMUNITY OEVEIOPMENT DIV. � `_ /_ �
r � v � PpOTECTIVE INSPECTION SEC. ��«
� �
� _ �
� /"'1 � CITY HALI FRIDIE� SS13P NUMBER NEV OATE PAGE O� APPNOVED 8Y
�""�' �'' 612-571-3450 9t0-Ft5
b/25/98 / /
�oe nooaess 5388 Horizon Drive NE
t LEGAL LOT NO. BLOCK TRACT Op ADOITION SEE ATTACHEO
DESCR. 1S 3 Carlson's Summit Manor North SHEEt
2 PROPERTY OWNER MAIL ADORESS Z1P PHONE
A1 0 sahl 5388 Horizon Drive NE 572-1014
3 CONTRACTOR MAIL ADORESS ZtP PHONE LICENSE NO.
R& B Construction 1814 214 Ave I3E, Cedar, MN 55011 434-1206 20072653
1 ARCHITECT OR DESI!'aNER MAIL ADOpESS Zlp PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS IIP PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CIASS OF WORK
❑ NEW O ADDITION O ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Gara e(22 S) Tear-off
9 CHANGE Of USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE Of CONST. OCCUPANCY GROUP OCCUPANCV LOAO
SEPARATE PERMITS ARE NE�UIRED fOli ELECTRiCAL. PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULI AND VOID IF WOFiK Op CONSTRUCTION 20NING SQ. FT. CU. FT
AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONED FOR A PERIOD OF 120 DAYS AT
ANV TIME AfTER WORK IS COMMENCEO. NO. OWLG. UNITS OffSTFEET PARKING
I HEREBY CERTIFV THAT I HAVE FiEAD AND EXAMINEO THIS APPLICATION 1 STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. A�L PROVISIONS OF �AWS VAIUATION SURTAX
WN H WHETHER SPECIFIEO EREIN'OR NOTOTHE GRANTING OF AO ERM T � 1, 834 W• 92
DOES NOT PqESUME TO GIVE AUTNORITV TO VIOLATE Oq CANCEL THE pEfiMlT FEE SAC CHARGE
PROVISIONS OF ANV OTHER STATE OR LOCAI LAW REGULATING CON-
STRUCTIOW OR TNE PERFORMANCE OF CONSTRUCTION. �S9 . SO Fire SC � 1. H3
,/� PLAN CNECK FEE TOTA� FEE
� -rt.C.G`7 � � ��i����'�r � ` Z ��'i� License SC $5 . 00 $67 . 25
S�GNATUAE OF CON'RACTOA Op AUTHOA�ZEO AGENT �DATE� WNEN PqOPE VA�IOATEO THIS IS YOU^R PERMIT
W� �iv� �
-_ S�GNATURE OF OWNEA UL OWNEA BU�LDEA� iDATE� 8 G�NSP q4 TE
c.+J '"y+�.�
�—
NEW [ ]
ADDN I ]
�,T�1t [ l
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: c���� ��o � �� Z �� � \� �
Effective 1 / 1 /98
�"��'�'��
�
Legal Description:
Owner Name & Address: � t o�,S �,, �, ( Tel. #t��oZ. - i� 1� 1
Contractor: �C��' o r. S+� uL- '� t o�^ MN LICENSE # 7�U 7Z (-�..�
Address: i� ��1 2, I`l ��' �✓� �r/'� � c. d�� v,, h S�� �� l Tel. #�I � �I-f ZO�, -
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTFIER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
Length Width _
Length Width _
Length Width _
Tc,, rc n.�' � �� �-c t: c,, Yt �
Height
Height
Hgt/Ground
vc a, 1
Sq. Ft.
Sq. Ft.
Sq. Ft.
�Z_so
`-� �r� / v
COI1Strl1CL10II T�: ' ESt1I111tP.(� COSt: $ l��
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � - ��-°�8� APPLICANT: �-c�,��► � � _ Tel. # %��/ - I Z�76
CITY USE ONLY
Permit Fee $ �. S� Fee Schedule on Reverse Side
Fire Surcharge $_�� .001 of Permit Valuation (1/lOth�)
State Surcharge $ �}� $.50/$1,000 Valuation
SAC Charge $ $1000 per SAC Unit
License Surcharge $ S,.(� $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULAT'IONS:
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ J Not Necessary []
$ � �. �zs.�'
Y� �