AF - 46422BUILDING PERMIT
Village of Fridley, Mi.nn.
� �
Date ":'. � `•": :�. .� . . . . . . . . . . . . . . . . . . . . . . . . . .
N° 2392
Owner �� Y. .�,:'�� .�:;�.±. . . r�.+: : ;`.?s,r. . . . . . . Builder .�'.`:4:�° . . . . . . . . . . . . . . . . . . . . . . . . .
�fa-
Address . : �'s��A . . .�"rl�� � :"�:SP: . .�•!�/.A�� Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
LOCATION OF BUtLDING
No. . .���� .. . . . Street ./.�°�CeC-.�l�i�r.�:�t.L.-:tl. . . �r. n'!E:!'. . . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . . . .
Lot . . . ..��. .. . . .. . $lock . . . �p. .. . . . . Addition or Sub-Division . �6�'.`�� .. .. . . .. . . . . . .'!J!�/�+swr■-
� �� �
♦
Corner Lot ............ Inside Lot .i�'.'`....... Setback ��. tJtt. Sideyard �Q./!�`4�t•' .................
DES�CRIPTION OF' BU[LDING
To be Used as:
,t�L � r ♦
.�,1�C�iWK�..... Front .a��i.... Depthor�i�'..... Height �...�*.... Sq. Ft. i%{��. Cu. Ft. ........
1
.................... Front ........ Depth ........ Height ......... Sq. Ft. ........ Cu. Ft. ........
Type of Construction �i�f"�� . Est Cos�j�.F�.d�:� . .� . . . . . . . . To be Completed .fj� :'.���:" .
In consider�tion of the i�ssuance 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.
...................................................
��In onsideration of the payment of a fee of $. //t�.".". , 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 worlur►en, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
F'ridley, M'uuiesota regarding loca.tion, consfruction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upo#� viola of any of the provisions of said
ordinances. ,�"'"�f�� _,��
...... Building Inspector
NOTICE:
This permit does not cover the construction, installation or alteration for wiring. plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these items.
� �.
`i �--
Date:
Owner:
Addres;
City of Fridley, Minn.
BUILDING PERMIT
N° 4788�
__..._..._ ...�-----------�^._._._._�._..__
,
.
,�.._� -....W--
:• „ .
-----�---ar.�-. _..__ :_ ... ..__: _..�t:._......__•--•--•.__..__..
- ILDING
No....., ....f•� �----- Street _- �- }•---� , ��C�_� � �%F.���,�.... Part of , t ....._.......------.�..._. -� b. . ...__-----...�_..--
� +�'-
Lot .._.._..�. .. .:.._...:._. Block ..-�--••- �--.�...._ ....._...-�--- Addition or Sub- ' � � r- �a�-"��-�'�'���� ��=�'--�'�--' ���--�-'�'
- ��
Corner Lot .......................------� . Inside Lot ....._........._......._.............. i�!'iback .�"' ..: �G.S�.�Sideyard -�..- ------��-----...--------�-------------
SewerIIevation ----�----�--��---��- .............-••----_..-�---•--�--�•------......--•-------�--_...._.---.... Foyei�dation Elevation .........---.................._..._............._........---.._............._......._...._..
DESCRIPTION OF BUILDING
To_� Usea as:°�
,° �' �
. ` ��;:�'.�'�.al.. Front ��----.. Depth �,,�,�..:_.--- Height .,��..... Sq.
...._.._.....:._ . ._..-----. Fro . ..... Depth .... eight �.� Sq.
. . n�� �� •r,�..�'"""'�.*
Type of Construci3o „�!'''�.:��',�`�''l�Est. C ..�e� r_,�. _. � ...---... To be
�
Ft�„� .� Cu. F��'`_'...._�
Ft....._ ............._.. Cu. F�
Completed
� �.,a�+°;�� 11. � V1a�'�i,S-
C�• ��--�— ; ; ri0R �.1D
nn`"� ji`, • .., I�tlll �`
t5 PER,�,� ,.�--�''� p •�� ����NAN�S
THN �c ���Y f'��,��-�1�Nc�'
� ������ RL�
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 description above set forth and in compliance with all provisions of
ordinances of the dty of Fridley. K,
In consideration of the payment of a fee of $.....,,�'..: _'..'..."'��........, permit is hereby granted
.—_._ to construct the building or addition as described above. This permit is graz►ted 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 iri`'�all respects to the ordinances of
Fridley, Minnesota regardiug location, construction, alteration, maintenance, repair and moving of buildings
within the dty limits and this permit may be revoked at any time, u,�°n� violatian nof any of the provisions of said
ordinances. ,"i;, fr`� . �
Building Inspector
NOTICE:
This permh does nof cover �he tonsiruetion, installafion for wiring, plumbing, gas heatiag, sewer or water. Be sure to see
the Building Inapee�or for separafe permhs for these items.
/'�`�
� f � —
4 ^,,
_ �
, . . .,1�_ . ' . .. . ..? 9
APPLICATION FOR BUILDING PERMIT ' ;
. . �ITY OF ER�ALEY, �J�IldNE30Tfl : • . _ _. � _. : . ... ;
� � �e , /fe� •�?:• Bui].der' . . , 2.i�s e. � �e�e/�� PI,
4WY19�'+9. N8a19 . (� �' �'B r �� �c°! �S l'_ :: !f l � . ,y __
1�.CZT'@88 ��.�� ���d���• �f�� /e� �' �C�T'.888 •���� ��fs'�?��5' � /! �'e ! "/� ,
i
�� � LOCATION OF BUILDING ' . .. '
No. ���3 � , .. � •
. . . _ �Stree� � ��v� �i � �� /0/� Part of Lqt_�'�� r ,
Lot ' �� Block �a Ad.dition or S�b.Div. ��'�� � J ����o,� �� ��'�
CoxKrier Lot Inside �ot `� Se't Back Side-Yax'd� �
S� ELEVATION � � � FOUNDATION ELEVAmIOi� � �
r�ppli�ant attach to this form Certificate of Survey�of Lot and proposed�`building
loca.tion. ._.. .. _ .
DESCR.IPTION OF BUILDING
To be 3?sed as: � � � . . •
` . � � ��
�� r � . _ . . Front . � � � . Depth � Z He ight ° � . -�- y�%Z p, �'c ��
c
�� �
Sa � F�. . S� �- Cu. Ft. .�� � � _.. .... ._ . . _.
� T,. Front Depth .� Height �
S�a Ft. : . G`u.._ �'t. . ' �
..,<<... . .. ' �
Typs •�' Gnstruction ,� ,� r �, ' E8j'.�.IDat�eC1 COSt .��� ,r,i�_
To be completed �� � � �% / � � � . ,
. r, •. .
The _undersigned hereby makes �.pplication for a perm�.t for the worl� � hereiti specif3ed�
ag�eeing to do all work,in strict accardance witl� the �ity Ordinances and ruling of
the Department�of Buildings, and h�reb9 declares tha.t all the fa�ts and representa-
tions s ted in this application are true and c rrect: �� �_ '
� � ./� � � � S.IGN.F.TURE �'����``' � .
D .T�
:;:,; . .
( Schedule of Fee costs caai be .found on ti�e Reverse Side. )'
�`
�,
,�, , � � • - _
BUILDIlt1G PERMIT FEE SCHEDULE .. � `�'
--.,.... ...... _..
Sacti:on �.� The Inspector .Af Buildinga _shall, before �issui.ng any permit
for the erectiq�_ of.-any� building ory structure, or for any addition to
-�any��8xis�ing building or structure, or for any alterations or repairs
to any existing building or s�ructure, upon application_therefor, require
the pa�ment by the applicant for such permit of fees to the amouiit herein
below set forth and in the manner.-hereirr provided to-wit:
2.1. For any su�h p�rmit.for the erection�of any fire-proof building,, other
than �, . gar�ge; �rerehouse � factory or grai.n elevator, or for •the� � erection of
� en�r fireproof addition, for s.imilar�occupancy, to any existing build3rig.
shall be�•�'t'the rate of ��1./{A for each one thousand ..cubi.c���eet, or fraction
thereof, in such cubical contents.- -� . ��_
'�2.2. For an9 such pexmi� for the erection of any fireproof garage, ware-
hQUSe� -fa�f:or�r��or grain elevator, or for the erection of any fireproof
addition, for similax occupancy, to any existing building shall be at the
rate of �1.25 for-each�one thousand cubic feet, classified as :"fireproof"
by Section 502 of the Minneapolis Building Code.
HOUSES . - �
._,...�...�-•� z.3. '`�'or an� �such permit for the erection..of any non-fireproof building
other than a garage, waxehouee, factory or grain elev�.tor, or.any.non-
fireproof addition, for similar occupancy,_.to any existirig�building.
Perm3t �1.Ofl;� for ea�b....4a�e- �thousand cubic feet.
_.... .. . . . . .
GARAGES - . . . _ . .
�
G
�
2.�.. For any su�h"permi'� for•the erection of any non-fireproof.garage,
_. wax�ehouse,�factory or grain elevator, or for.the�erection of any non-
fireproof addition,_,�or.similar occu.pancy, to any exiating building or • �.
..for •e�.ch s`ach bui.lding or addition. Ninety Cents for each �one.. thousarid . .
cubic feet;.or �raction thereof,.in th� rcubical content�.thereof witn a .
� • mi:riimum of�.�4.00;;��. ��. . �� . .. � ..` . . . .
�` For the p�iirpose of computing fees for building permits the cubical c.nntents�
of any building or addition to a uniforn��lieight throughout by multiplying
the ground area conered fro�e a point�six (6) inches below the-floor line of
.. the..?aasement�� or` cellar to the average height of the upper surface or to the
average height of the:�roo€ sitrface of the main gable of a pitched roof.
2.5. For repa.irs or alterations to an existing structure, the fee shall be
at the rate of �3.00 for each Five Hundred Dollars (��U0.00), or fraction
thereof in the cost of all proposed work.
2.6. In no case shall the fee chaxged for any permit as set iorth in
Section 2 be less than �L�.00.
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SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T �
�
� �
� �
COMMUNITY DEVELOPMENT DIV.
r � v � PROTECTIVE INSPECTION SEC.
� �
1 = �
� /'�'1 � CITY HALL FRIDLEY 55432 NUbIBER REV. DATE PAGE OF
�.._.�' '•� 612-571-3450 910-F15 7/2/93 / /
JOB ADDRESS 5133 Eiughes Street NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION
DESCR. 13 6 Carlson r s S�u�mi,t Manor South Adc�..
2 PROPERTYOWNER MAILADDRESS Z�P
Anoka County Community Action Program
v rnuraerrna MAIL ADDRESS Z�P
R & M AssocYat
4 ARCHITECT OR DESIGNER
5 ENGINEER
MAIL
MAIL
8 USE OF BUILDING
Residenti�al
7 CLASS OF WOHK � N� ❑ AODITION ❑ ALTERATION �p REPAIR
8 DESCRIBE WORK
Install egxess. window in ba�eiqent bedxoozn; install exterior
9 CHANGEQFUSEFROM
TO
�]�GT�I�i� �i�
����- •
�/ ��
APPROVED 8Y
SEE ATTACHED
SHEET
PHONE LICENSE NO.
770-9322 4391
PHONE LICENSE NO.
PHONE LICENSE NO.
O MOVE ❑ REMOVE
kitchen s
STIPULATIONS
Provide windc�w wel]., E�xess window must meet the State Building Code
for di.mens%ons/location. Hedxoom must ztle�t th� State Building Code �or 10 0 of floor
area in �ntindow a,rea. Provide sadoke detectoa:s as per U&C 1210 adjacent to all
sleeping areas and in basement�
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTFiUCTION
OR WORK IS SUSPENDED OF ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WOiiK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OH CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW FEGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
SiGNATURE OF CONTRACTOR OR AUTHORI2ED AGENT IDATEI
NING SQ. FT.
�. DWLG. UNITS
�- STALLS
LUATION
$1,6Q0
RMIT FEE
$37,b0
AN CHECK FEE
License SC $5�.00
GROUP IOCCUPANCVLOAD
CU
f PARKINC
GARAGES
$ . 80
�C CHARGE
Fire SC $1,6Q.
)TAL FEE
$44.40
THIS IS YOUR PERMIT
ATEW [ ] Effective 5l26193
ADDN [ ] CITY OF FRIDLEY �� ��
ALTER (] SII�i(�LE FAMILY AND �DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: �% .� 3 f��'� �
Lega2 Description:
4wner Name 8c ddress: �- �,� � � ; l�L � i – �G- � � l� Tel. � �3 -- �� �/�
�QQ ,
Co�zactor: ��� � MN LiCENSE #� �l
Address: � �� �� �c� � �' � � ' �/ � � �� s� � � �' S' � f �`� Tel- # 7,T� ' ����
Adach to this applicatian, a�ficate of Smvey of the
lot, with die propo�d c�truction drawn on it to scale.
DESCRIPT`ION OF IIvIPROVEMENT
0
LIVING AREA: L�gth Width Height Sq. Ft
QrARAGE AREA: I eng�th Width Height �. Ft.
DECR AREA: Len�t6 WidtL HgtlGrouad Sq. Ft
�T�R: C-P �%- lt � S S <'.,1; iJ.)L' � J i� ��/�� C Gl l�t°1J! �� l� Cu'.�� �'6'1 ' �% C( (f'�J �k" I� d i�ftL
oc��2 .
Corner Lot [] Inside I.ot [] Ft. Yd Setback Side Yud Setbacks -
T�e of Constcuctioa: � �- x S� Q.�. � � ,� ,� r •� f �� � �, Estimated �t: � � �i°� — .._
Approx. Co�letion Date:
{Cosi �► Back)
Driveway Curb Gtirt Width Needat: Ft. + 6 Ft = Ft x$ _$
DATE: / � % � APPLICANf: Tel. # ��'o �`� � ���
Permit Fee
F'u�e Succb�arge
�ate Swrchazge
SAC Charge
License Surcharge
Driveway Fscrow
Erosian Con1ro1
Park Fee
Sewer Main Charge
TUTAL
$ �7.00
$ /� (� O
� �v
$
$
$ J,00
$
$
$ _
� y� ��c�
CfTY USE � �a ���� �-e�
Fee Schedule on Reverse Si
.001 of Permit Valuation (� �� f 2f� � – ��zC ,��
$.501$1,000 Valuation � 1 Z �5 —%� o_�����.��
$750 p�a SAC Unit
e�.r
$5.00 (State Licen�xi Resid � � ( 2 I C� •– �2,���
L'11t "A� or Alt ~B° AbovE
Conservation Plan Review :
Fee D�ined by Engiaee
Agreement Alecessary [ 1 �
STIPULATION5:
BUII,DINQr PERMIT FEE SCHEDULE
The Chief Buildiag Official shall, before issuing permits for the erection of any building or structure,
or for any addition to any existing bailding or strucbure, or for any alte�ation 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 die manner herein provided to-wit
TOTAL VALUE
$1 to $S00
$501 to $2,0�
$2,001 to $25,000
$25;001 to $50,000 - .
$50,()Ol to $1(�,000
.$100,001 to $500,000
$500,001 Co $1,000,000 .
$1-,OOi},001 and up
FEFS
$15 (Minimum Fee is $15 plus svrcharge)
$15 for first $500 pins $2 for each additional $1Q0 or
fraction thereof, to and including $2,000 -
$45 for first $2,000 plus $9 for each additional $1;000
or fraction the�eof, to and including $25,000
$252 �for first $25,(l00 pi�s $6.50 for each add�itioi�al $1,000
or fraction tfiereof, to. and including $50,000
$414.50 for first $50,000 plus $4.50 for each additional
$1,000 or frac4ion thereof, to .and iacluding $100,OW
$639.50 for fust $i00,00U plus $3.50 for each additional
$1,000 or fra�ction th�eof, to and including $500,000
$2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,�O,aiO
$3539.50 for the Srst $1,0�,000 plus $2 for e�ch additional
$1,Q00 or fraction �thereof �
DRIVEWAY DEPRESSION ESCROW
(Concrete Cbrb Streds On1Y)
Alternaf.e "A" : Removal and replacement of curb and gutzer only - Driveway width plus 6 feet times
$13.50.
Alternate °B": Removal and replacement of cnrb and gutter and install a 3 foot wide.
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for constructioa will be issued a minimum of 24 hours from the time of application to allow
for proper review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation oace it has it has been
constructed wiil be required before proceeding with the framing_
�.�
t ,�
sue�ecr MIT .
City of Fridley 2 5 5 9 5
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � RECEIPT NO.
� � COMMUNITY DEVELOPMENT DIV.
� � �: ----- �
r � � PROTECTIVE INSPECTION SEC. /a� ��
i � �
� _ �"'1 � CITY FIALL FRIDLEV 55032 NUMBEP REV DATE PAGE Of APP OVEO BY
�""'�'� �'� 612-571-3450 910-F15 10/15/9 / /
JOB ADDRESS 5133 Hughes Avenue NE
1 LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 13 6 Carlson's Summit Manor South Addn SNEET
2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE
ACCAP 783-4747
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Ovall ROOFING & Const 6730 213 Ave NW, Elk River MN 55330 753-2959 3604
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUI�DING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION 0 ALTERATION �7 REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WOFK
Reroof House (17 Sq) Tear-off (5 Sq Garage)
9 CHANGE OF USE FROM TO
STIPULATIONS Underlayment must comply daith the State Building Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV IOAD
SEPARATE PERMITS AHE REOUIREO FOR ELECTiiICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SG. FT. CU. fT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED POR A PERIOD OF 120 DAYS AT
ANV TIME AFTEH WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED TMIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VALUATION SUATAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @ @
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT ���'� � 1, 834 �i�'�� W• 92
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGULATING CON-
TRUCTION O PERFOR O CONSTRUCTION. ��" �59. SO F� 0 SC �*�.-�=�i � 1. S�
• PLAN CHECK F T T L FEE
s SC .00 -$-.'�.S�.�Fr3 $67.25
51GNATUREOF �FACTORORAUTHORI2ED G T IDATEi f{E P Y VALI A D THIS IS VOUR PERMIT
�
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ConstructionAddress:
Legal Description:
Owner Name & Address:
Contractor:
Address: � � �1��-
LIVING AREA:
GARA.GE AREA:
�ECK AREA:
�"THER:
Construction Type:
' CITY OF FRIDLEI'
S[NGLE FAM[LY AND DUPLE7�ES R-1 AND R-2
BU[LDING PERMIT APPLICATION
0
Effecti��e 1 / 1 /97
A / -
1� +
� Tel. #��J?''7'�`r` �
� � MN LICENSE #
�%� e �i% Tel. # ��3^Z ��7
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEME\T'T
Length �idti� I�eight
Length Width Height
Length �Vidth HgtlGround
�/�o��S���a��se _ �"�% �
0
Sq. Ft.
Sq. Ft.
Sq. Ft.
�_ , Q ,o
Estimated Cost: � � — J % ��%,
(Fee Schedule on Back)
Driveway C�ub G�t .Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: D%� �� APPLICANT: Tel. #%r� � z-ln��
_ ��5� �2 �3
CITY USE ONLY ___
�/.___ ---.
Permit Fee ,� j S� $ ���. ��--> Fee Schedule on Reverse Side �'� �/. C�
�ire Surcharge ��c�� $ � , �% .001 of Permit Valuafion (1/lOth%) � t � �
State Surcharge g� $ . f� %$.50/$1,000 Valuation t��
SAC Charge $ $950 per SAC Unit �
.,
License Surcharge � $ �, C�C'R $5.00 (State Licensed Residential Co�tractors)
�riveway Escrow $ Alt. "A" or Alt. "B" Above �-
srosion Control
�'ark Fee
iewer N[ain Charge
TOTAL
�'('t I't 1 Ln `I'[ O i\� S=
$
$
$
$
� � �� A
�
$450.00 Conservation Plan Review �' ��� ��
Fee Determined by Engineerin�
Agreement N�cessary [ ] Not Necessar5� [ ]
.: -��.� OI�►��
��
I�U![,D(N(� 1'E[t�i('C FEE SCfiEUUi,l�:
'I�hc Chief Building Ofiicial shall, lx;fore is,suing pem�its for the erection c�f any building c�r structure, or toc
any addition to any existing building or structurc, or for any alteration or repair to any existing building or
strucwre, upon application therefore, require the payment by ihe applicant for such permit of fees to the am�unt
herein below set forth and in the manner herein provided to-cvit:
TOTAL VALUE
$1 to $500 .
$501 to $2,000
�?,OU1 to_$25,000
$25, 001 to $50, 000
$50, 001 to $100, 000
' $IOU,001 to $500,000
$500,00� to $1,000,�p .
$1,00O,OOl and�up
FEES
$21 (Minunum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additionat $1Q0 or
fraction thereof, to and including $2,000
S62.25 for first 52,000 plus $12_50 for each additional �i.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 $�0,000
$574.75 for first $50,000 plus $6.25 Cor each additivnal
�1,000 or fraction thereof, to and: including $1U0,000
$887.25 for first $100,000 plus $S.00. for each additional
$1,11Q0 or fraction tliereof, . to aad iacluding $SOO,Q00
$2887.?.S for .the.;fust $500,000 pivs $4:25� for each .additional
$1,OU0 or.fradion thereof, to and including $�1,�,p00 '-
$5012_25 for ihe first $1,Opp,ppp plus $2.75 for each additional
$1,� or fraction thereof
DRIVL�WAY DEPRESSION ESCROW
(Concrete (�rb Sireets Only)
Alternate "A"•: Removal and replaceme�t of curb and gutter only - Drive�vay width pius 6 feet times $13:50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with b inch depth - Driveway width plus 6 feet tiiiles $15.7�.
VERIF'[CATION OF FOUNDATION
'crnaits for construction will be.issued a minimum of 24 hours from the tiriic of application to allow for prop�r
•view of the proposed stiucture and of the construction site.
�:�ectiticate of Surve�� c�f� the lot, s(�owinR the location of"�he f�undatio.� c+��ce it }ias ii has hc;cn c�nstr-uctc::{
:!�� r�c�uir-cc1 h�tore j�r�r:���dii��� �c•iti� th� 1�ramin�.
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uo�����n g��ss ax� a�t�un��
ble Housin and
A o��a g
Su o�t. Se�vices o�
pl�
�'eo le �vith
�
Ment�l
1�Iealth I)isabilities
• Indepencient Living Services/
Housin� Support Servi�ces
• Homelessness Outreach Services
• Family I�omeless Prevention
• Affordable �Iousing Program
Mission Statement: The primary purpose of Rise's Affo�dable Housing and Support
Services Corporation is to provide outreach, advocacy, housing development, referral
information, and housing support services for people whose lives are affected by
mental illness. Our programs acknowledge the role of poverty and displacement on
personal mental health and we provide assistance and support needed for more
inclusive community living and increased self-dependency. Our goal with people
who are already homeless is resettlement in quality housing with support services
of the individual's choice.
-47-
� - ILS an d
Housin
g
Su O�t
��
Se�vices
Program Address /Phone:
8406 Sunset Road
Spring Lake Fark, MN 55432
(612) 786-8334 (voice and TT�
Fax: 786-0008
Corporation /Subsidiary:
Rise Housing Services
Program Manager:
Becky Fink, 783-2800
Specific Eligibility Criteria:
• People who have a mental health/psychiatric disability
• Anoka County resident
• People who can benefit from coordination of housing and
related support services
Primary Program Purpose:
Provide outreach, housing referral, and assistance for people
who are homeless or in a housing-related crisis leading to safe,
affordable, and stable housing outcomes.
Principal Service Activities:
• Nutrition & meal planning/prep
• Laundry/clothing care
• Personal hygiene/grooming
• Housekeeping skills
• Learning transportation systems
• Budgeting
• Grocery/personal shopping
• Income taxes
• SociaUfamily relationships .
• Recreation/leisure
• Living arrangement services
• Crisis assistance
• Roommate metliation
• Landlord dispute resolution
• Medication awareness
• Assistance with public benefits
• Homelessness outreach
• Affordable transitional and permanent housing
Primary Funding Sources:
• Minnesota Rule 78
Transportation Options: Self-arranged
Program Capacity: 70
Number ofAssigned Rise Staff.• 4
Referral Contact:
• Intake: Peggy Kraemer, 783-2813
• Contact an ILS counselor for program information
Zf:�
' � � �� Sue�Bt► • '
C;ty of Fridley
AT THE T TME TWINS g u � L D I N G P E R M I T
; , . ����-����
� �
� ; y �_��_ COMMUNITY DEVELQPMENT DIV.
r � � PqOTECTIVE INSPECTION SEC.
1 •1 �
i.---�; �'��,., CITY MALL FFiIDLEv �j13Z NUMBEp REV DATB PAGE OF
� 612-57�-34b0 s�aF�s 1/15/99 � �
lOB AODRESS
5133 flu hes Avenue NE
1 IEGAI LOT NO. BLOCK TRACT OF AODITION
DESCR. 13 6 Carlson's Summit Ma.nor South Addition
2 PFOPERTY OWNER MAIL ADORES$ 21P PMOI
An.oka County Community Action Program
28841
�
RECE�N�
� ��
APPNOVED BV
SEE ATTACNED
SFIEET
3 CONTRACTOR MAII ADDRESS ZIP PHONE LICENSE NO
Enviro Therm LLC 35499 Dol�hin St NW, Princeton, N�T 55371 389-9521
4 ARCNITECT OR OESIGNER MAIL ADDRESS 21P PMONE LICENSE NO.
5 ENGINEER
8 USE OF BUILOING
Residential
7 CLASS OF WOFiK
O NEW
6 DESCRIBE WOfiK
Reside House & Ga�
9 CHANGE OF USE FROM
MAIL ApDRESS
❑ ADDITION O ALTERATION C� REPAIR
STIPULATIONS
Call for building wrap inspection before covering.
TYPB OF CON
SEPARATE PERMITS AqE REOUIRED FOR ELECTRICAI, PLUMBING, NEATING.
VENTILATING OR AIR CONOITIONING
TMIS PEFiM1T BECOMES NULL AND VOID IF WORK OFi CONSTRUCTION ZONING
AUTMOR12ED IS NOT COMMENCED IfY1TMIN 80 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOEO OR ABANQONEO fOR A PERIOD OF 120 DAYS AT '
ANY TIME AFTER WORK IS COMMENCED. ' NO DWLG. 1
HEREB TIFY THAT I HAVE FlEAD AND EXAM�NEO THIS APP�,ICATION 1
A 0 K TM ME TO BE TF1UE AND CO�iRECT. ALL PROVISIONS OF LAW$ VAlUAT10N
A OFi IN CES VEpNING THIS TYPE Of WORK WILL 8E COMPIIE� @
WI WH TME PECIF MEREIN Oii NOT. TME GFANTING OF A PERMIT W8s8SO
DOE NO PRE E TO VE AUTMORITV TO VIOLATE OR CAMCEL ?NE pEqMIT FEE
PROV IONS O AN OTHE STATE OR LOCAL LAW REGULATING coN• �149.%.5
STRUC ION O THE P fOR ANCE OF CONSTRUCTION
PLAN CMECK
q License
TU E OF N'AACTQA Op oU1MOp�ZEO oGENT IOATE� E
OCCUPANCY
FT
IICENSE NO
O MOVE • O REMOVE
OCCUPANCVLOAO
CU f T
OFFSTHEET PARKING
STALIS GARAGES
SURTAX
$4.42
SAC CMARGE
Fire SC $8.85
TOTAL F E
5.00 168.02
$�V ALIDATE� T IS IS VOJ�
% '
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r��rE
rrEw
ADDN
ALTER
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ConstructionAddress:
CITY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
���
Effective 1 / 1 /99
�o
�� ��
��
Legal Description:
Owner Name & Address: V�c) ` Tel. # 7�i33 - L�'14 4
Contractor: �t�v �tz o�'�i�enn �., �„� . MN LICENSE # a! La. I
Address: �4�'i S i� o�� u��.► �� �1. �• t�, ��c�s�ec,� �S 3'1 � Tel. ���zl �gS• 4'S Zl
Attach to this application, a Certificat� of Survey of the
lot, with the proposed construcrion drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
01'HER:
DESCRIPTION OF IlVIPROVEMENT
Length 2� Width Li, G� Height Sq. Ft.
Length Width Height Sq. Ft.
Len�th , Width Hgt/Ground Sq. Ft.
Construction Type���. Estimated Cost: $��� ��
j _ __
� - ��� (Fee Schedule on Back)
Driveway Curb Cut Width Needed: C�� Ft x$ _$
`�
DATE: I �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
Tel. � ,�. 9• SS �
$ �� Fee Schedule on Reverse Side
$ r�,, ��� � .001 of Permit Valuation (1/lOth%)
$ � $.50/$1,000 Valuation
$ $1050 per SAC Unit
$ � � � o�� $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 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 $1,0OO,OQO
$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,Q00
or fraction thereof, to and including $50,000
$ST4.75 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 thereo�, 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)
Alterna.te "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 foundarion once it has it has been constructed
will be required before praceeding with the framing.
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