AF - 46541sue�ecr P N O.
City of Fridley o 18828
AT THE TOP OF THE TWINS g U I L D I N G P E R M i T �
�
; � EIPT N
� `L _ _� COMMUNITY DEVELOPMENT DIV. /+�
r � � � PROTECTIVE INSPECTION SEC. � Qvf �
1 � � L l
`.--. � �/'�','j CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY
i J� 612-571-3450 810-F15 3/20/87 / /
JOB ADDRESS 441 Hugo 5treet N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 78�79i E 0` of Lots Q,81,82,83, Block A, Ri.verview Heights SHEET
2 PROPERTYOWNER MAILADDRESS 21P PHONE _- -_ _
Ri.chard �Jcaczik
3 CONTRACTOR MAIL ADDRESS Z�P PHONE, ' UCENSE NO.
Tkaczik Construction lhc. 12323 Gladiola Street N.6d. , Coon Rapic3s, 5�5433 421-9009 ,'
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PH�NE UCENSE NO.
5 ENGINEER MAIL ADDRESS Z�P PHONE CfCENSE NO.
8 USE OF BUILDING '
Residential
7 CLASS OF WORK NEW � ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
�
8 DESCRIBE WORK
Construct a 34' 6° x 34� D�aellinc� and a 22 � x 20' Gaxage
�EPAR
LUMB[lVG A[�E} SCG6VS.
9 CHANGEQFUSEFROM TO
STIPULATIONS provide a hard surface driveway. Provide sod in the front and side
yards. Provide City with copy of verifying survey before capping. Foundation
block must be 12" block. Check for walkout elevation.
SENiER LOCATION: No Service: 8" VCP at centerline of Hugo, approximately. B21' Deep.
WATER LOCATION: 6" CIP 10` So. of centerline of Hugo - MUST BE TAPPED
DRIVEWAY ESCROW: 16'+6'=22' x $13.50 = $297.00
THE CITY OF FRIDLEY DOES NOT GUARANTEE THE �������
ACCURACY OF UTIUTY LOCATIONS AIVD ELEVATIC?N�. �e�0� diggittg ���� �OcaO utili#i��
THIS DATA IS FOR INFORMATION PURF�SE� OR1LY, �'ELEp�lO�i� S ELE�TRi+G � a#1� �t€�s
AND PERSONS USING THIS INFORMATION SHOULD
VERIFY IT ON THE SITE. �����R�� �Y �a���
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATINO, �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 OH ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. • NO. DWLG. UNITS OFFSTREET PARKING
I HEFiEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �. STAILS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORHECT. AlL PROVISIONS OF IAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIED r,H�2OO $29•lO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS Of ANY OTHER STATE OR LOCAL LAW REGULATING CON- ��� $310.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $SZS.00
PLAN CHECK FEE TOTAL FEE
$77.50 $941.60 + PF & DNT
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (OATEI � WHEN PROP RLY IDATED � I�O P PERMIT
� — Z�' � c� � ' C�[' � %
r (
SiGNATURE OF OWNER IIF OWP ii BUILDERI IDATEI BLOG iNSP � �ATE
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NEW [�
ADDN. [ �
�,T�tt. L 7
City of Fridley
R-1 AND R-2
Building Permit Application
�I
.���,,�
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Effective 4/1/86
Construction Address: �`"�� �� �'� �e � —
�
Legal Description: d-� �'� �& A��� � �'� �T � ���, £�'°m� �! as2 �� �-� �1� e'c� ��. �- �!a�� � ��� ��
���� � , �a e aa� � ,
�,? � ,, ._ d �0�.�� �a � Tel . 4 �� '��� �
Owner Name & Address: 1�^�"""
Contractor: �/���"�-s�� �- �� � `�'- �, �� Tel . # � �'�'��
Address: 1� � � � _� � �
LIVING AREA:
GARAGE AREA:
DECB AREA:
OTIiER:
a
Attach to this application, a Certificate of Survey of the
lot, with the proposed construetion drawn on it to saale.
DESCRIPTIOP OF IMPROYEMENT
Length �� PA� Width ��` � Height Sq. Ft. _��
Length �`� ^ Width = Height Sq. Ft. �`°;_
Length � Width _ Hgt/Ground `— Sq. Ft. _ - �'
a
/ 4 � '°
Corner Lot [] Inside Lot (� Ft. Yd. Setback 3�� Side Yard Setback D-�
Type of Construction: f�e� s��� �• Estimated Cost: $�� �
58 "'��?t�,00
Approx. Completion Date: � �-° � � � �
• Z`� Alt. A Alt B
Progosed Driveway Width If New Opening Is Desired: �� �� $��'_ $ -
See Back Page for Explanation
DATE: .�_ � ?� � �? APPLICANT: %��G���'� �c��.� Tel. � 5�'�'��-g'
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
SeWer Maia Charge
CITY IISE ONLY
$ ��Ve�
$ �� , sv
$ �l.11�
� �j Z..�e�V
� � �� n �.fiMJ-
$ -
TOTAL $ c f �091 • (of�
STIPULATIONS: �w °��''�
19 Q�A `t�
�Q—a�.�r,a9 . �e.�,,`a
� �
F�r�.�����I � �� 5� ��
Fee Schedule on Reverse Side
25� of Building Permit Fee
$.50/$1,000 Valuation
$ 525 per SAC Unit
Fee Determined by Engineering
Agreement Necessary L l Not Necsessary []
a �--�" � ' �
�� i
BIIILDING PERMIT FEE SCHBDOLB
The Chief Building Offieial shall, before issuing permits for the erection of aaq
building or strueture, or for any addition to any existing building or structure, or
for any alteration or repair to any existing building or structure, upon applieation
therefore� require the payment by the applieant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-Wit: -
Total Valuation
$1.00 to $500.00
$501.00 to $2,000.00
Fees
$10.00 (Minimum Fee is $15.00)
$10.00 for the first $500 plus $1.50 for each
additional $100 or fraction thereof� to and including
$2,000.
$2,001.00 to $25,000.00 $32•50 for the first $2,000 plus $6.00 for eaeh
additional $1,000 or fraction thereof, to and
including $25,000.
$25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each
additional $1,000 or fraction thereof, to and
ineluding $50,000.
$50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for eaeh
additional $1�000 or fraetion thereoP, to and
ineluding $100,000.
$100,001.00 and up
$433•00 for the first $100,000 plus $2.50 for each
additional $1,000 or fraetion thereof.
DRIYEKAY DEPRESSION ESCRW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus
6 Peet times $13.50
Alternate "B": Removal and replacement of eurb and gutter and install a 3 foot wide
approaeh with 6 ineh depth - Driveway width plus 6 feet times $15.75
VERIFICATION OF FOIINDATIOA
Permits for construction will be issued a minimum of 2� hours from the time of
application to allow for proper review of the proposed strueture and of the
construetio n site.
A Certificate of Survey of the lot, showing the location of the foundation onee it
has been constructed will be required before proeeeding with the framing.
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CA/NE � ASSOC/ATES
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/7720 Highway 65 N. E. Sodervi//e, Minnesolo 55304
434-7646
CERTIFICATE OF SURVEY FOR: Don Chouinard
LEGAL DESCRIPTION: � Lots 78, and .79, and the eaG� ?0.00 feet
of Lots 80, al, 82, and 83,.a11 in Block
A,RIVERVIEW HEIGHTS, Anoka County, Minnesota
Subjeat t� an easement for street and utility purposes over the south
12.00 feet thereof.
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CITY aDUNCIL
s W _ �.� �L���+ �:�.���?�
M�CR Inc.
13562 Central Avenue N.E.
Arroka, NN 55304
May 29, 1987
Ch May 18, 1987 the Fridley City Gouncil ofticially appraved your reque�t for
a rezoning, ZQA #87-02, to rezor�e from R-3, General Multiple Dwelling, to
R-1, �e F�mil.y Dwelling, generally located at 44]. Huc� Street N.E. with the
following stipulations: �
Norze.
If you have any questions regarding the above action, please call the
Planning Department at 571-3450.
Sincerely,
James L. Imbinson
Planning C�ordinator
JIBR/al�n
Please r�iew the nated stipulations, sicyl the statenent belaw anc7 return or�e
oopy to the City of Fridley Planning De�xirbnent by Jime 12, 1987.
Goncur with action taken
_
_
CIIYOF
F'It(DL�.Y
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (61Z) 571-3450
August 7, 1987
Mr. Richard Tkaczik
Richard Tkaczik Cons�uction Inc.
12323 Gladiola N.W.
Coon Rapids, N�1 55g33 �
Re: Verifyis�g Surveys for 441, 951, and 461 Hugo 5treet N.E., Fridley
Dear Mr. Tkaczik:
�'inal inspections have been made on 461 Hugo 3treet, and are yet to be made
on 441 and 451 Hugo Street. We have not received the verifying survey for
any of the addresses and it was a stipulation on the building penni.ts which
must be complied witli.
We will expect the verifying surveys to he submitted to us by September l,
1987. Further inspections�for final approvals will not be conducted unless
the surveys have been suFIInitted.
If y� have any questions on this matter, please feel free to contact me at
571-3450.
Sincerely, •
DARREL G. CLARK
Clzief Building Official
Dcc/mh
�
SUBJECT P N 0.
c�ty of Fridley o 19 9 7 7
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
r
� � RECEI .
COMMUNITY DEVELOPMENT DIV.
r � L � PROTECTIVE INSPECTION SEC. ��� �
�
I i �
, ��"1 � CITY HALL FHIDLEY 55432 NUMBER REV. bATE PAGE OF APPqOVED BY
�""'� � ��� 612-571-3450 910-F15
6/3Q 89 � �
JOB ADDRESS 441 Hugo Street N. E,
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 7S �%9 & E 2� � O� LO 80 � 8�. � 82 � 83 � B�.00iC A� R].VP.Y'V1flNi Heights SHEET
2 PROPEHTYOWNER MAILADDRESS ZIP PHONE
Ted Fortier & Marlys Oney 44I Hugo Street N.E. 786-9143
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENCiINEER MAII ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION f,�} ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a, 10 `5"` x 5� Deck with 5torage underneath.
8 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S0. FT. CU. FT.
AUTHORI2ED 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 OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 HAVE READ AWD 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 WOfiK WILL BE COMPLIED $8OO $.SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRAN7ING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OFi CANCEL THE pERM1T FEE SAC CHAqGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $2].,OO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
Pl N CHECK FEE TOTAL FEE
$21.,��
SIGNATUREOFCON7RACTORORAUTHOR12EDAGENT (DATEI WHEN PqOPERLY VA ATED THIS IS YOUR PERMIT
� O
SiGNATUREOFOWNER�IFOWNERBUILDER� �DATEI $1.DG �NSP qTE
� []
� [ ]
ALTII2 � �
a.; _ . .: ..� -
_. . � - «• .� .�.
OWt�et NaQtIB & AddrESS:
;�.i�l ��n •)
f�l AND R-2
Building F�eraiit A,pplicatio�
sia�ii�'�i: _ �,i s/%
Effective 5/l,/88
� � r�� � � � �P1 � � �'�,. � � �� �
�. �
Attach to this applicatioaz, a Oerkificate of Survey of the
lot, with the pro�pased oo�st�ct3aon drawn cai it to scale.
��J."�1� 1�y /.\ 1�� �vIJ�•�I�IJ..I.lI��
I�IP� A�A• 7P171�1 W� __� �^'l�t ___. �• F't• —.__
��i: Length Width __ Heic�lt __ Scl. Ft. __
DECR AREA: Iergth Width Hg�/(�aurl Sq. Ft.
�: ��� �dC� f� `o � L � ° �-� � � e �1 � .
obrner Lct [] Inside Iot [] Ft. Yd Setback Side YaYd Setbacks
�YP� of �tructiaaz: Esti�mated Oost: $ So�, Od
ApProx. omnpletia� Date:
PrvpoEed Dtives►,ray Width If New Openirg Is Desirecl: Ft. $ $
Width + 6' See Bac1c paqe
nATE: AP�7�Q�TP; �. �
Permit Fee $ `Zf 6 pG
State S�haxge $ �
SAC � $
Driveway Escrow $
Park Fee ' $
Sewer Main Q�3rge $
• �� �
s'r�r�,zza�s:
Y �,
,�
$ �lp��
�li'Y DH� �iII,Y
F�ee Sd�eclule aaz Reverse Side
$.50/$1,000 Valuat3an
$575 per SAC Ut�it ,
Alt. nAn C�" Alt. �B° AboVE '
� r�ro,�,�;rr�7 bY g�Ji�'�4
��zY I 7 N� Neoessary I J
:
�a� v, o c�
�o, o �� !j , OC�
�JC "Z ,6
_
�i•�U
I:_i1� � �,_ y:�;.,,�yi ��+: _•:ir� �i s
�e �ief Buildi,r�g Official r�all, before issuing permits for the erectia� of any
�,; � dir�q or stn�ire, -a� for any additian t� any existirig building or struc4ire, or
for arYy alteratiaai or repair to any pxistirg building or stn�ture, � aPPlicatiaaz
therefore, r+equire the payme�t by ti�e applicarYt for sudi permit of fees to the amamt
2iereiTl belcw set foZ'th and iri tile �na�+r herefl� pzwided to-wit:
Z�0►I�,L VAIIJE '
$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
� a.
$15 (Minim�nn Fee is $].5 Plus surahaige)
$15 for fitst $500 plus $2 fc�r each additiaa�al $100 or
fi3ction theYecf, to ar�d ]ncludir�q $2, 000
$45 far first $2,000 plus $9 for eacii additional $1,000
or fractian ther+eof, to arri including $25, 000
$252 for fizst $25,000 plus $6.50 for each additional $1,000
or fracticx� thereof, to and including $50, 000
$414.50 fos first $50,000 plus $4.50 for eaeh additional
$1, 000 ar' fraction thereaf, to and ]szcltbdir�g $100, 000
$639.50 for first $100,000 plus $�.50 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2039.50 for th+e first $500,000 plus $3 for each additional
$1, 000 oZ' fractian thez�eof, to at�d incltuling $1, 000, 000
$1, 000, 001 ar�d up $3539. 50 for the fi�st $1, 000, OfYJ plus $2 for each additional
$1, 000 or fraCtiaa� thel�eof
�tIVE�C �'PRF�SI�T ffiCiiOW
(Oo��crete Ctirb Streets On1Y)
Alternate ��p,�� ; R+Pmoval and replao�ent of curb ar�ci gutter a�ly - Driveway width plus
� 6 feet times $13.50.
Alternate "B" : Resnwal and replaoao�xYt of curb ani gutter ar�d install 8 3 foot wide
approach with 6 ini� d�tii - Drive�ray width plus 6 feet times $15.75.
�•��i�v,�iM �:, •7� {�_�i,���Ti�i;;]
Pezmits for �io�l ta311 be 3s.Sl1+Bd a mir�imrn Of 24 hour5 fZ�aD the tSme Of
applicatiw�► to allow for p�ape.r review of the propoEed stn�c4�r�e arid of th+e
OO�Y11Ct10�1 61tE.
A C�ertificate of Stuvey of the lot, st�owing the locatioai of the fanr]atian a�oe it i�as
it has been constructre�d tri7.l be required before p�irig with the fraani,ng.
CA/NE � ASSOC/ATES
LAND SURVEYDRS, /NC.
/7720 Highwoy 65 N. E. Sodervi//e, Minnesofo 55304
434-7646
AS-BUILT SURVEY FOR: Tkaczik Construction
LEGAL DESCRIPTION:
Lots 78, and 79, and the eaG�. ?0.00 feet
of Lots 80, 81, 82, and 83,:"�11 in Block
A,RIVERVIEW HEIGHTS, Anoka County, Minneso�a
Subjeat to an easement for street and utility purposes over the south
12.00 feet thereof.
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� OFMOTEB FO(/ND /RON MONUdiEN�
BFAR/N68 SNbWA/ ARE ASSi/'IYED.
�y� �
/ IiEREBY CERT/FY THAT TN/S SURVEY� PLAN�
OR !�`EPORT IYAS PpEPAREO BY A/£ OR LWDER
MY O/RECT SUPERV/S/�ON AND TNqT / AM A
OULY l�£Q/STERBD LAND SURVE'YOR UIU�ER
THB LAWS OF TIiE SR4TE OF A//IYpESOTiO.
C�� Ci6�/ t. F
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LLOTE a c ��RE6. HO. /8&'.i/
1
CA/NE � �I�SOC/ATES
LAND .�'URI/EYORS, /NC.
/7720 Highway 65 N. E. Sodervi//e, MinnesoJo 55304
434-7646
AS-BUILT SURVEY FOR: Tkaczik Construction
LEGAL DESCRIPTION:
A. ♦ , ^ � � .
Lots 78, and 79, and the eaG�. ?0.00 feet
of Lots 80, 81, 82, and 83,.-all in Block
A,RIVERVIEW HEIGHTS, Anoka County, Minnesota
Subject to an easement for street and utility purposes over the south
12.00 feet thereof.
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Mr OJRfC� SfJPERV/S/ON AND TMA� I AM A
sucE: i aACN• •?O fEEr.
O oENOrrs vt iKav iROM y� sar.
� DEMOfES faflMO /IIEIOM MOA7JMEM�
IfA/PtNG9 1MON'N ARE ASSYIIED.
DI/LY REO/STfREO LAND SUAVEYOR fIXAEIP
TN[ LAIrS Oi TdE S1i0TE Oi Y/NNESOTA.
� C..���% � �Lri�r
-;. U r /
LLITB '• `�� RBG. M0. /p8�J/
sue�ecr pE
City of Fridley 2 5 6 4 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.
1 ` �
`--_. A����,•, CITY HALL FRIOLE� SS43P NUMBER REV DATE PAGE OF APPqOVEO BV
ti. �� 612-571-3450 910-F15 10/28/97 / �
JOB ADDRESS 441 HUGO STREET NE
1 LEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACHED
DESCR. ]$, 79 Pt f Lots 80- 3, Block A, Riverview Heights SNEET
2 PROPERTY OWNER MAIL ADDRES$ ZIP PMONE
Ted Fortier 441 Hugo Street NE 786-9143
3 CONTRACTOR MAIL ADDRESS IIP PHONE UCENSE NO.
Phalen Siding & Trim 1528 Lincoln Ave, St Paul, MN 55105 731-2092 6216
e ARCFIITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
- 5 ENGINEER MAII ADDRESS ZIP PMONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION C� ALTERATION p REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOHK
Install aluminum trim
9 CHAN(iE OF USE FROM � TO
STIPULATIONS
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTIIATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE FEAD AND EXAMINED THIS APPLICATION 1 STALLS GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORFECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND OfiDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHEF SPECIFIED MEREIN OFi NOT. THE GRANTING OF A PERMIT �3s3OO �1.E)S
DOES NOT PRESUME TO GIVE AUT ORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER ST E OR LOCAL LAW REGULATING CON- @
STRUC PERFORM CE OF CONSTRUCTION. W87 • 2.5 re .S�', �3. 3�
, PLAN CMECK FEE T TAL FEE
Licens C $5 00 $97.20
SIGNATUREOFCON' CTOR RAUTMOp12EDAGENT IDATEi HE PR LY VALI A D THIS IS�UR ERMIT
$
SiGNATUREOFOWNEAiiFOWNERBUILDER� IDATEI BL G�NSP q E
NEW
ADDN
ALTER
[l
[]
[]
ConstructionAddress:
Legal Description: _
Owner Name & Addr
Contractor: �
Address: ���
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTI�R:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�/S// �t s �
Effective 1/1/97
� ���
� ��e
'S�S �d.L Tel. # %� �' _ � Z
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
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction T e��� ��, ���� Estimated Cost: ��� G
YP $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
, _.�.._._ � ,
DATE:��'.�b — � APPLICANT: �� Tel. #��1—�� � Z
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ o�"���
$ . ��
$ l . G-,�
$
$ � ��Z�
$
$
$
$
$ -� (�'
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$950 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 [ J Not Necessary []
.�v � �
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 %r �ny alteration or repair to any e�sting building or
structure, upon application therefore, require the pagy��t :byff the applicant'fpY such permit of fees to the amount
herein below set forth and in the manner hereui provided to-wit:
�� �a,4�� A �,'�-'�
��. N
�
�3
$1 �''
'�, a
�, � M� �°'!
$501
,�OT.E'� VALUE
+-� �
�O �'� ��.4.�p
�JP7U
`j
ti ,r u
� '.: �.:
to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
9�..L. `- �. -z.
� � -'� �:'� � � _ , • ^$
$100,001 to $500,000
$500,001 to $1,000,000
$1,OOO,Q01 and up
FEES � �. s , ra ..
� �` :�, � �
8 'fi q_s � �� , �.F,. x,�; d�a k'�'
$21 (�+V�uu�um l�ee i� $2� pltts s�rahar,ge)
�p`.� �_tv�' � y ', o r •g � r. F�� ,
ti �y +e �� e; n �+ F �� °t�;; ;�
$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 additional
$1, 000 or fraction thereof,,, tot and including $10d, OQO
,j � ' '
�T�f�-Fa w"'� �� �c� �'8�j,�i, %;�' �
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet tunes $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 $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been coaistructed
will be required before proceeding with the framing.
. . � ��
City of Fridle�
AT TME TOP OF TME TWINS g�J i L D I N G P E R M I T
:,
� �
' ' COMMUNITY DEVELpPMENT DIV.
� ; V ����•� .
r � � PFlOTEGTIVE INSPECTION SEC.
�
i i �
� �"'1 � CITY NA�L FRIDLE� SS132 NuMBEN 11EV DAT@
�'""�� ,'� 612-571-3450 9�0•F�5 4/22/02
�
!OB ADDRESS 441 Hugo Street NE
t LEGAL �OT NO. 9LOCK TRACT OR pD01T10N
oescR. 78,79, Pt 0-83 A Riverview Heights
2 PROPERTY OWNER MAIL ADOR�S$ ilo
Ted Fortier 441 Hugo Street NE
3 CONTRACTOR MAII ADDRESS ZIp
Same
0 ARCHITECT OR OESIGNER MAIL ADORE3S ZIP
5 ENGINEER
kIA1L ADDRE$S
21P
V�GE OF
/ �
'32519
T NO.
�C��
AVPqOVED B�
SEE ATTACMEO
SFiEET
PMONE
763-786-9143
PMONE LICENSE NO
PMONE LICENSE NO
NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK '
❑ NEW O ADDITION ❑ ALTERATION f�J REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Install 2nd layer of roofing on Fiouse & Garage (20 Sq)
9 CHANGE OF USE FqOM
STIPULATIONS
Roofing can be �he 2nd layer but not the 3rd.
SEPARA7E PERMITS ARE REQUIRED FOR EIECTiiICAL, P�UMBING, HEATING, TrPE OF CONST.
VENTILATING OR Alp CONDITIONING.
7HIS PERMIT BECOMES NULL ANO VOIO IF WQRK OR CONSTRUCTIOM pONINO
AUTHOR12E0 IS NOT COMMENCED VjIITHIN 80 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANQONED fOFi A PERIpO OF 120 DAYS A7 "
ANY TIME AFTER WORK IS COMMENCED ' NO. DWLG. UN17S
I HEREBV CERTIFV TNAT I MAVE iiEAD ANO EXAMINED THIS APP�ICA710N 1
AND KNOW TME SAME TO BE TRUE AND CORRECF. ALL PAOVISION$ Of �AWg yq�UATION
AND ORDINANCES GOVERNING TMIS TVPE OF WORK WILL QE CpMPL�ED @
WITH WHE7MER SPECIfIED MEREIN OR NOT. TME GRANTING OF A pERM1T y�1,610
9
DOES NOT PRESUME TO GIVE AUTMOqITY TO VIOIATE OR CAMCEL TME pERMl7 FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON-
STRUCTION OR THE PERFOFMANCE OF CONSTRUCTION �C)O.lO
4uTMOa4E0aGEar iO�TE�
�
STAILS
OCCUPANCYLOAO
CU FT.
f PARKING
GARAGES
�.8�
SAC CHApGE
Fire SC $1.61
TOTALFEE
2.51
�ATEO 1�IS IS VOU PERM17
�
u
NEW
ADDN
ALTER
[ l CITY OF FRIDLEY Effective 1/1/2002
(] 6431 University Ave NE, Fridley, MN 55432 (763) 572�604 Bldg Insp
I] SINGLE FAMILY AND DUPLEXES R-1 AND R 2
BUILDING PERMIT APPLICATION
Construction Address: � � � _ e, � ,
Legai Description:
Owner Name � Address: �%c� r- � � �; � � Tel. # ?!03 % g!o -9 / �-3
Contractor. _ ��/ F MN LICENSE #
Address: � i N-1 �-a�� ^�7' Tel. # 7� 3�°78 �^ RI �f-3
Attach to this application, a Certificate of Survey of the
lot, with the proposed constn�ction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
UVING AREA: Length Width Height Sq. Ft
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length Width HgUGround Sq. Ft
OTHER: f{� v s e `�' �/� h41�4 � Se�o vvcl L.f1V �i� '
y� �
Construction Type: �� -%2G�F 2D��,,� �„� Estimated Cos� $ ��(�
Driveway Curb Cut Width Needed: F� + 6 Ft = Ft x$ = g
DATE: �� ZZ —D � APPLICAN?: _ ��� �a� Tel. # 7�O 3— % � "Q/�3
Call (763) 572,3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if ustng credit card and we will
call you for cand number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ �.lC�
$
$_ ��P�
$
$
$
$
$.
$
�• ..
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Consenration Plan Review
Fee Determined by�Engineering
Agreement Necessary [] Not Necessary [ j
STIPULATIONS:
�
BUII..DING PERNIIT 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�cisting 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 $5(�
$501 to $2,0(�
$2,001 to $25,000
$25,001 to $50,000
$50,�1 to $100,000
$100,001 to $500,000
$500,001 to $1,000,U00
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,Q00 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.(m for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5,608.75 for the first $1,0�,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - Driveway width plus 6 feef times $17.(�.
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. New Houses Onlv