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AF - 46574SUBJECT , City of Fridley WRECRING � �- , PERMIT Z ��e�4 AT THE TOP OF THE TWINS r � � RECEIPT NO. i • COMMUNITY OEVELOPMENT DIV. � `�: ----^� r � � PROTECTIVE INSPECTION SEC � � � . � � � /"'1 � CITY HALL FRIDLE� SS4.�Z NUMBER REV OATE PAGE UF APPROHED BV �----�: �.� 612-571-3450 910-F15 8/21/95 � � JOB AODRESS 540 Sugo Street NE t LEGAI LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. �F9,50 H Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE City of Fridley Housing & Redevelopment Authority 572-3591 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO Herbst & Sons Construction Co Inc 2299 Co Rd H, New Brighton MN 55112 784-8510 I ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE �] FiEMOVE 8 DESCRIBE WORK Remove 40' x 20' Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Clean site of all demolition debris. HRA: $195.88 Water Bill Owing. SEPARATE PERMITS ARE FEOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GfiOUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTEF WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ]. STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHE P CIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT N/A DOES T P ESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEHMIT FEE SAC CHARGE PROV IONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STR TION R THE PE NCE OF CONSTRUCTI �� NO F@e /� f �� PLAN CHECK FEE TOTA� FEE No Fee SIGNATUR occoN� n OAORAU oai DnGENT DATEi HE PAOPE VALI TED THIS IS YOUR PERM T / l___ SiGNATUAE OF OWNEA iIF OWNEA BUILOEFii IDATEi � BLDG iNSP r�arE CITY OF FRIDLEY 6431 University Ave NE Fridley MN 55432 572-4604 :: C � Effective 8/1/95 - MOVING ( � OR WRECKING [�PERMIT APPLICATION Job Address : �� U� � ��. ` Legal Descript n Go�s �l�/ �'►�+ �� /oc1-� �, Rive�vre� �/-�r` �� Owner & Address : 2 r L� � V O e.vr � e��#_ s7a 3s�%,� Contractor : .��'r ►^ �i �j�? S ��57"2t1 c.i i e'�1 �'o , �ia. Tel . #��y.- s.s�� Address : Co � State License # ,/1,/�%� N��'`� Rr�y�'`'' '�� N OF BUILDING HOUSE : Length `�� Width .�' Height lC� Sq. Ft . gg� Cu . Ft . 8�0 GARAGE: Length � Width —" Height `"' Sq. Ft. —" Cu. Ft. °�' OTHER: Length � Width ' Height —= Sq. Ft. "' Cu. Ft. � Estimated Cost $ ,�4t`7 � Approx. Completion Date � —�s UTILITIES City Water/Sewer Minnegasco � N S P U S West NOTIFIED: 571-3450 [vjJ� 372-4720 [f/�� 566-9120 [�j� 663-6000 [�j� Water Bill Paid: Yes {] or Collect $ ��►�� ] Signature d ,/ i n Moving Route: /. The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to do all work in strict accorda.nce with the City Ordinances and rulings of the Building Division, and the Staxe Code which requires any water well on the property to be sealed by a State licensed water well driller, and hereby declares tha:t all facts aad representa.ti ted ' ' application are irue and correct. ^�� — ` — Date Signature Moving: Principle Building into Fridley .... $300.00 Accessory Building into Fridley .... $ 42.00 Through or within the City ...... $ 20.00 Move a building out of City ...... $ 80.00 Wrecking: For ea.ch 1,000 cubic feet or fraction ..$ 1.25 For structures which would be impractical to cube the fee shall be based on the total cost of wrecking at the rate of $6.00 for each $5�.00 or fraction. PERMIT FEE: STIPULATIONS: C��r�� _ �_ t. Minimum Fee: $20.00 IVIinimum Fee: $15.00 . , . - . - e � ZI � . r a r . l�,� ± ..`' � - /.. .. v. . .. . .;t � . . � � _ . .. s s r . . 0 sue�eCr p '� City of Fridley 2 8 5 5 7 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T � ��°�J�� RECEIP � ; v �� COMMUNITY OEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. 7�? ^ � = i � /'��1 � CITY HALL FRIDLE� SS�32 NUMBHA REV OAiE PAGE OF APPROVEO 8Y �----� • •,� 612-571-3450 910-F15 11/10/98 � / JOB ADDRESS 540 Hu o Street NE t LEGAL �OT NO. BLOCK TiiACT OR ADDITION SEE ATTACNED DESCR. (}9, 50 H Riverview Hei hts SNEET 2 PROPERTY OWNER MAIL AODqES$ ZIP PHONE Gu W. Jordan 571-5347 3 CONTFACTOR MAIL ADDRESS 21P PHONE LICENSE NO Owner 6540 NE East River Rd 4�224 Fridle 55432 571-5347 4 ARCFIITECT OR OESIGNER MAI ADDFESS 21P PMONE LICENSE NO 5 ENGINEER MAII AODRESS 21P PFIONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK C��c NEW � ADDITION O ALTERATION O REPAIR O MOVE O REMOVE B DESCRIBE WORK Construct a 50' x 24' home and a �4' x 24° garage 9 CHANOE OF USE FROM TO STIPULATIONS Paid driveway curb cut 30' _$472.50 See notations on plan. Provide city with copy of verifying survey before capping. Provide sod in the front and side yards. Provide a hard surface driveway. WATER LOCATION: See City Engineering Dept. SEWER LOCATION: See City Engineering Dept. SEPARATE PERMI7S ARE REOUIRED FOR ELECTRICAL, PLUMBING, MEATING, TYPE OF CONST OCCUPANCV GROUP OCCUPANCV LOAO VENTI�ATING OR AIR CONOITIONING THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONS7fiUCTION ZONING SQ. FT CU fT AUTHORIIED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTFiUCTION OR WORK IS SUSPENOEO OR ABANOONED fOR A PERIOD OF 1� OAYS AT ANY 71ME AFTER WORK IS COMMENCED. NO DWLG. UNITS OffSTREET PARKING I NEREBY CERTIFV TNAT I MAVE READ ANO EXAMINEO THIS APPLICATION STALIS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWg yp�UAT10N SUFTAX AND OROINANCES GOVERNING THIS TYPE OF WORK WIL� BE COMPLIED WITH WHE7HER SPECIFIED HEREIN OF NOT. THE GRANTING OF A PERMIT $99102 �F9. SS OOES NOT PqESUME TO GIVE AUTMORI7Y TO VIOLATE OR CANCEL THE pERMl7 FEE SAC CMARGE PROVISIONS OF ANY OTMER STATE OR IOCAI lAW REGUlA71NG coN• Fire SC STRUCTION Ofi TME PERFORMANCE OF CONSTRUC710N �88],2S �1 OO �99.I.O PLAN CNECK FEE T I�L FE 3 90 + DW �� S�GNATUpE 0� CON7 ACTO R AUTy iLED aGENi i TEi M P V VA� A? 7HIS IS O R P RMIT �.. . �" • , . ,,,� , �-l��_9� S�Ganf EOa � Ep� NEQBUR i� • E B OG �NSp n`rE NEW ADDN ALTER [ j �� CITY OF FRIDLEY �G�!- SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION � ��I �� 1 �� l� / � ConstructionAddress: _ ,��/b �U� (� S 7'—J2�� T �� Legal Description: La �- s �/ �, y� yq Sp �GC�CK }-�- %� � �E/� (�iEw I�i�'/ 6 M� 5 , Owner Name & Address: � �� 'VI%. J o�. pq.�v Tel. #�/ 2- S 7 I- S 3 y% Contractor: _ �yr, �owN�� MN LICENSE # /�'�' Address: ��'yh it/� EAS? /11 U�/L (Z 0#ZZ�! F(t i D�Fy �'� Tel. #(� / Z-S71 �S 3 y 7 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. � T � ��C�:�x�� DESC12iP'I'ION OF IMPROVEIVIENT u/�� /,�� x� Z. 3f- ��'�5�� 77, GG> C,� LIVING AREA: Length ,S C� Width Z. G/ Height �i Sq. Ft. �.cxac5 GARAGE AREA: Length _ Z�{ Width Z�_ Height _�_ Sq. Ft. -��f'I i DECK AREA: Length Width HgdGround Sq. Ft. 9C/9.�' � � �� OTHER: I�. aA.e ►mevti--�- �I X ,� � x g = � � y �o � f ��► �, �� ; Ld _ �°�' f�� Construction Type: 3. I e vel , f,,�,� „�Q�. qa.� Estimated Cost: $ //O �000 � _ � �, (Fee Schedule on Back) Driveway Curb Cut Width Needed: Zy Ft. + 6 Ft =�4 Ft x$ 1 So �7 S —$ � 7,,�, S C� DATE: %�—S-9 8' ApPLICANT: o� Tel. # 6/Z-57/-53t/, CITY USE ONLY /� gr � �.(� !C' -f� - �� Permit Fee $ �7 G�,S° l�ee Schedul� on Revers� Side %� �� Fire Surcharge $ C/� .001 of Permit Valuation (1/lOth%) � L�� State Surcharge $_ �9 q'� $.50/$1,000 Valuation � � SAC Charge $ c��'"� $1000 per SAC Unit �,� y License Surcharge $� $5.00 (State Licensed Residential Contractors) Driveway Escrow $ � S� Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ � Fee Determined by Engineering �� Sewer Main Charge $ �' Agreement Necessary [] Not Necessary []�� TOTAL $��! ` ��v� �� STIPULATIONS: . �. F� •�uTUZe�� a� �inn �utpaa�o.�d aao�aq pa.zmba.� aq iitm pa��tu�suo� uaaq s�u lt s�u �t a�uo uot��puno� au� 3o uoU��oj au� �uinnoqs `�oi ar� 30 �an�ns �o a��c�.ta� d •a�is uoi��n.��suo� au� 3o pu� ain��nx�s pasodo.zd a� �o nnatna.� �ado.�d .�03 nnojj� o� uot��iidde �o auii� a� uTO�3 sinoq �Z 3o umunuiux � panssi aq iiin� uoi��nz�suo� .zo� s�iuuad l�iOIS�'Ql�if103 30 I�iOI.L��I3I��A ' SL' S i$ saun� �aa� 9'snid q�pinn ,��nnani.�Q - qldap q�ui 9�in� u��o�dd� apinn l003 £� ii�sui pu� ia��n� pu� q.zn� 30 �uau�a�eida.� pu� i�nouia21 :��g�� a��ua�i�' •ps•£j$ sawi� aaa� 9 snjd q�pinn �C�nnan►iQ - �Ciuo ia�an� pue qm� �o luaLUa�Eida.� pue j�nowag :,,d„ a��ua�id (�Cjup s�aa.al� Qan� a�a.z�uo�) MO?I�S� I�iOISS�2Id�Q 1i�AA�AI2iQ 3oa.�au� uoi��.�� .�o ppp`I$ i�uoi�lpp� u��a ao3 SL'Z$ Snid 000`000`i$ �s.zi,� a� .�03 SZ'ZIOS$ 000`000`I$ ��Pnj�ui pu� o� `�oa.�a� uoi��i� .�o ppp`j$ I�uopipp� u�ea .�03 SZ'�$ Snid 000`OOS$ �s.�g a� .�o� SZ'LS8Z$ 000`OOS$ �uipniaui pu� o� `�oaiatp uoi��.t3 i� 000`t$ j�uopipp� q��a io� 00'S$ Snld 000`OOI$ 1s.�g .�o� SZ'L88$ 000`OOi$ $uipni�ui pu� o� `�oaia� uop�e.�� ao ppp`i$ I�uoi�rppe q�ea zo3 SZ'9$ Snid 000`OS$ �si� �TO3 SL'�LS$ 000`OS$ �uipnj�uT pu� o� `�oa�au� uoi��ea3 .�o 000`i$ I�ot�ipp� u��a io� 00'6$ Snid 000`SZ$ as�i.3 �03 SL'dfi£$ 000`SZ$ $utpni�ui pue o� `�oaia� uot��.�3 io 000` T$ I�uopipp� u��a .zo3 OS'Zt$ Snid 000`Z$ �s�� 03 SZ'Z9$ 000`Z$ �uTpni�ui pu� o� `�oasaua uot��i3 .�o OOI$ i�uoiaipp� q�ea io� SL'Z$ Snid OOS$ �s.zg ao3 iZ$ (a�i�u�.�ns snid iZ$ sT aa3 Lunmiuiy�) iZ$ dn pu� I00`000`I$ 000`000`I$ ol T00`OOS$ 000`OOS$ �� i00`OOi$ Q00`OOi$ °� i00`OS$ 000`OS$ �� i00`SZ$ 000`SZ$ o� i00`Z$ 000`Z$ �� i0S$ OOS$ �� I$ � S��3 �fl'IdA 'IdZO.L :�tnn-o� papino.�d uia.�au .zauu�ux ay� uc pu� �o� �as nnojaq uta.zau �unou� a� o� saa� 30 �iuuad u�ns .�03 �u��iidd� a� �Cq �uaui�C�d a� aimba.� `azo3aia� uoT��tidd� uodn `a.�n��n.z1s .IO ,`�IIipjiri(i �IIi�SiX2 �CiIE Oj .IIECIa.I .IO IIOIaL'.I2�jE tCiIL' d0� JO `a.�n��n.i�s .�o �uipimq �nt�sixa �u� ol uot�ippe �u� so� .�o `a.zn��n��s .to �uipimq �ue 3o uot��aia au� .�03 sltuuad �umssi a.�o3aq `Il�us i�j�330 �ulPiTng 3atu� au,J, �'If1Q�I�S ��3 ,LINi2I�d �I�IIQ'IIflg T � � y * PIONE6R * eng neer * * � * a SURVEYORS • CIVIL ENGINEERS LAND PLANNERi . LANDSCAPE ARCHITECTS 2422 Enterpriae Drive Mendoto Heighte, MN 55120 (612) 881-1914 FAX:681-8488 62S HighwoY 10 N.E. Bloine, MN 55434 (612) 783-1880 FAX:783-1883 Certifica te of Survey for. G UY W. JORDAN Ho use Ad d ress: 5�0 _ i� .u_�o _. STREET �:7 ►�i �. i i 46 � oF aco�e� : $`f9-! HuGO �� a,o 8 �� $ �'� DRw Y, `� O ;� o�vEwaY . O - zz.so 84y,�o - r -l---- � . ..1. . A�t,_S � O M 0 O Z $47,45 � �� Za�� -- a4b9 STREET 17 � � �,� 17.17 � PROPO�D HOUSE ; S eas 6snr, ` �.� �,�,� 99�6,7 99 �o �. � � 8�6.6 90'03' � 8 � O. O ' O z �_4-�--- � 9hb,s �'Qc �- � LOT'S 47— 50 ¢75 I . � � / a � 1 852,8 � WEST � I � � � � /5'� PA-T.oi ,5Z � � W ,� O M 0 O N 51 uA�q � :� ' g'�' �'ric�-�J 8sz.3 l� 2 �� l��rfnK 100.00 � d- ( � � � � PROPOSED BUII�DING ELEVATIONS ■ 900.o Denotes ExTsting Dev�ation � Denotes Proposed Elevotion Lowest Floor Qevction: 8� --� Denotea Dralnage Flow Olrectton Top of Block Elevatfon: $4"8.0 -- Denotes DraJnage dc Utfllty Easement Garage Slab ElevatJon: 7•� _(at door) —O— �@/IOt@8 Monument NOTE: Propoaed bu�ding aite qroding ia in accadonce rith the —� Denotes Offset Iron 9earin s�own are assumad 9roding plona cpproved by tha etty angineer. 9 NOTE: Ca�Voetw mual verify NI dimensia�s k driver+oy desiqn. � LO T'S 4 7— 5 0,�LO CK H RI VER VIEW HEIGHTS ANOKA COUNTY. MINNESOTA We hereby certify thot this survey, plon or report was prapared by me or under my direct supervision end thot 1 o duly licensed lond Survayor under the laws of the State ot Minnesotc. Ooted this }�N doy of 0 c.-in�r' A.D. 19�i (ZE��SE 1�� E�v ''/3�� Signed: PIONEER INEERING, P.A. �� Scale: 1�� 30 eet BY Robert B. Sikich, L.S. Reg. No. 14891 or 1458 18484.00 JMP Terrence E. Rothenbocher, L.S. Reg. 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T � c m O a v v �' � m m w p�i w��`2 c c�i pni � c�u � m � '-I n N N � ai �r � � n � (p �- � y � 7C ��(� N N"� S� O -p � O � 7 2 = ,� � � w O p .p '71 �' � � !D .w+ N (D n �p N. � 'D 7, C � � • * N (�~D 7 �• r- 7 y y� N � � I I cn �� 7 m m � m D� a �' m � ' w � �° "i � � nA'i � * � �' � � � o ,n * � � � = c � � � a .� � m ,-. I � I I �I I � I I I I I� � i � b 0 � � � ca � �» t�► sfl � En �» �» p p p V p�I V V V Ul A V °o °o °o °o °o °o °o °o °o °o °o °o � Q R�.J � c � � � N � � Z 3 3 °� 'm 0 . � � � � W Z n- C -� � � y c� ° °, \ � o � � N �U �D � � Z � � � � � � �� m r Z 0 � v i � C3 � m � � � z 0 � � � � J � � � � r C � � Z � � � � m � � z O � m -� 0 � � 0 00 D v v � � � � c SuB�ECT City of Fridley � AT THE TOP OF TNE TWINS g � I L D I N G P E R M I T � � � `y �_�� COMMUNITY DEVEIOPMENT OIV. r � � PROTEC7IVE INSPECTION SEC. � i--_-� ��"' �'� CITY HALL FRIOIE� SS132 NUMBEp t 612-571-3450 g10-Ft5 J08 ADDRESS 540 Hugo Street NE 1 LEGAL �OT NO. BIOCK TRACT OR ADOITION REV 1 DATE DESCR. !}9,50 H Riverview Heights 2 PROPERTY OWNER MAII ADORES$ Guy & Cathy Jordan 3 CONTRACTOR MAIL ADDiiESS Owner 4 AqCNITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MAII ADDRESS 8 USE OF BUILDING Residential 7 CLASS OF WOF;K 4/99 ZIP VAGE O� � � �H'E"RMIT NO. � 29471 ia��o �� AVPqOVED B� SEE ATTACMED SHEET PMONE 612-571-5347 PHONE LICENSE NO PMONE LICENSE NO. PHONE IICENSE NO O NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE � REMOVE 8 DESCRIBE WORK Basement framinQ 9 CHANOE OF USE FROM STIPULATIONS See original plans. TO SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, NEATING, � rrc vr �.�na� . VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING AUTMORIZED IS NOT COMMENCED WITHIN 80 OAYS. Op IF CONSTRUCTION OR WORK IS SUSPENDEO Oii ABANDONED fOfi A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS I MEREBV CERTIFY THAT I MAVE READ ANO E%AMINED TMIS APPLICATION ANO KNOW THE SAME TO BE TRUE ANO CORiiECT. ALL PFOVISIONS OF LAW$ yp�UATION AND ORDINANCES GOVEqNING TMIS TVPE OF WORK WILL BE COMPLIED @ WITH WMETHER SPECIFIED HEREIN OF NOT. TNE GRANTING OF A PERMIT y�SOO DOES NOT PqESUME TO GIVE AUTMORI7Y TO VIOLATE OR CANCEI TME pEFMiT fEE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR TME PERFORMANCE OF CONSTRUCTION �23.SO � TURE OF CON'aACTOA Op AUTMOAi2E0 eGENT IOATE� �to a �_�-� , � =f�/' �. _ _ T STA�LS OCCUPANCr CU FT. T PARKING IGARAGES $.50 AC CNARGE Fir SC $.50 OiA EE $ 4.50 �S IS VOUR PERI �w [ ] ADDN ALTER Effective 5/10/99 ( ] CITY OF FRIDLEY [] SINGLE FAMII.Y AND DUPLEXES R 1 AND R 2 BUII,DING PERNIIT APPLICATION Construction Address: Lega1 Description: Owner Name & Address: Contractor: Address: C'�� C,� �� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. ��,� � ) � �e1. # �ld -,�j i/ ,-�, �Y� :ENSE # Tel. # d fo� °�'-�`7f SS;3 �f ;� m DESCRIPTION OF IlVIPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: ��2�evt � 1'/��r / Fstimated Cost: $�� c'l�r. C�-�� Driveway Giirb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ /� 9 �� DATE: �l �( � APPLICANT: �/�i�tC S- (ji�G'� Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: � �'3..�"� $ -.�b $ .s� $ $ $ $ $ $ $ ��,�D CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B ° Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessaty [ ] � � - BUII.DIN� PERNIIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structur�9 or for any addition to any existing building or structure, or for any alteration or repair to any existing building or ��acture, upon application therefore, require the payment by the applicant for such permit of fees to the amou�t 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,�0,000 $1,000,001 and up 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 $2,0� 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 $7.00 for each additional $1,000 or fracrion 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 $500,0� $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 $5,608.75 for the first $1,000,000 plus $3.15 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 times � 15.50. 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 $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allo�✓ for p��r review of the proposed structure and of the consiruction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has b�n �o��cte� �✓�1 be required before proceeding with the framing. � - - �- � _ C�lYOF FRlDLEY FRIDLEY MUMCIPALCENT'ER • 6431 UNNERSITYAVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287 June 2� 1999 Mr. � Mrs. Guy Jordan 6540 East River Rd NE #224 Fridley, MN 55432 � Re: Final Inspection at 540 Hugo Street NE, Fridley Dear Mr. & Mrs. Jordan: A final inspection was conducted on June 1, 1999 of the above address and the following items were noted which must be completed before the building can be finaled; 1. Complete the final grading and install sod in the front and side yards. 2. Provide a hard surface driveway. 3. Provide a garage slab. We, will expect these items to be completed on or before September 1, 1999, and a reinspe�tion called for. Occupancy of the structure is approved. If you have any questions on this matter, please feel free to contact me at 571-3450. Sincerely, �� A RY W. RIESCH Building Inspector BWR/mh ICYNENE — Spra Formula PRODUCT SPECIFICATION �� The Icynenelnsulation System. 1. PRODUCT NAME Icynene is the registered trademark for polyicynene insulation manufactured by Icynene Inc. Icynene spray formula is a 1/2 Ib. density open celled material 2. MANUFACTURER The air permeab�lib� or wail assemblies incorporating Icynere s reduced by the mcorporation of ali ot�er wall components inro a monolithic assemb y and by the skins of the foam. Where mawm�r� a�r tightness is required. spaces wrere Icynene is not installed such as beC.�een double studs and between fioorirg and oase plates should be caulked. In a tight building adeq�ate ven[ilation/air supply should be plarred to avoid combustion equipment backdrafting and humidity probiems. Inadequate ventilatior is hazardous. Water Vapor Permeance Icynene is water vaper permeable and allows Icynene is made on site from liquid structural moisture to diffuse and dissipate. It components manufactured by Icynene Inc will not entrap moist�re in materials to which it Installation and on-site manufacturing is is applied. supplied by independent certified contractors. 3. PRODUCT DESCRIPTION Icynene insulates and "draftproofs" a building at the same time. Its performance is less installation sensitive than factory manufactured insulation materiafs. It is an effective "breathing" air barrier that can adjust wrth the building ro mairta:n a seal against energy-robbirg air leakage for the life of the builc�ng. Cor.vective air movement inside wall cav�bes is virtually eiim�natea. proviaing more �niform temperatures throughout the building. The result is super.or q�a;ity construction. wlth higher comfort levels at 'c�ver thermostat settings ar.d ;ower neat rg and cooiing costs Savir.gs vary. The �cyrene is appi�eC b� spray�ng liquid comporerts onto ar oper �,val! or ceiling surface where they expanC 100: t in just secor,ds to provide a fiex:c�e foam blanket of miiliors of tiny air cells corcpleteiy filling builcing cavities and sealing cracks and crevices in the process. It adheros to virtually everything it rouches, sea"ng out air infiltration. Excess materia: �s easily trimmed off, leaving a surface reaCy for drywalling or other finish. 4. TECHNICAL DATA (Based on Core Samp;es) Thermal Performance Thermal resistance (R-value) ASTN1 C-518 R 3.6 hr.ft °FIBTU. in. RSI 0.62 m"C/W per 25 mm Average insulation contribution in stud wall 2" x 4" = R13 2" x 6" = R20 Icynene provides more effective performance than the equivalent R-value of hand fitted a�r permeable insulation materials. It is not subject to loss of R-value due to aging, winC� conditions, convection or a�r infiltration: nor �s it likely to be aifected by mo�sture related conditions. See FACT SHEET or reverse. Air Permeance/Air Barrier/Air Seal icyner.e completely fills ar.y shaped cavity and aaheres to other build;ng matenals. creaUng assemblies with very low a�r permearce fJo additionat ,ntenor or exter or air infiitraGOn protec60n is recessary A�r permeability of core foam - ISSN 0701.5232 1 6 Usec./m �a? 3° (76 mm) at 75 Pa. press�r_ 1 0 I/sec./m g 5" (127 mm) at 75 Pa. press�ra Water vapor transm�ss on properties: (ASTM E96) 16 perms 941 ng/(Pa•s•m-) � 3" (76 mm) thick 10 perms 565 rg/(Pa•s•m-) @ 5" (127 mm) thick Because of its low a�r permeance, Icynene is not infiltrated by moisture laden air. When appiied to a vapor permeable surface, condensation will not occur within it. It does not require a vapor barr'er unless appiied to a non-vapor permeab e surface in extreme vapor drive conditiors. A vapor retardant pairt is adequate in s::ch situations. Water Absorption Properties Icyr.ene is hydrophc� c. It does not wick and is water repelient. V'/a*.ar can be forced into the foam under pressure because it is open celled. Water will dra r by gravity rather than iravei horizontaiiy or �;ortically through the foam. It dries quickly ard thermal performance is fully res[ored. Acoustical Properties (performance in a 2"Xd" wood stud wall @ 125 250 500 1000 2C00 4000 Hz. freq.) STC Sound Transm�ss:on Class - 37 19 30 31 42 38 46 (ASTM E-90) NRC No�se Reducticr Coefficient - 70 11 .43 .89 .72 71 .67 (ASTM C-423) Acocst�cal pertormarce is less installation dependent than that cf hand fitted sound biankets. Burn Characteristics Icynene wiil be cons�med by flame, but witl not sustain fiame upor. removal of the flame source. It leaves a charcoal residue It will not me't or drip. It must be appiied in accordarce �vrth all applicable b�'c�ng codes. Oxygen Index ASTM D-2863 ?3�; N.Y. State Fire gas toxiciry LC • 12 These test results are not indicative of performance under actual fire conditions Electrical wiring Icynene has been evaluated with both 1-1,3 and 12/2 residential wiring (max. 122°F/SC'C1. It is chemically compatible with electrica! wiring coverings. Note: Not to be used with knob and tube wiring. Corrosion Icynene did not cause corrosion when evaluated in contact with steei under 85°� relative humidity conditions. Bacterial or Fungal Growth and Food Value Icynene provides no support to bacterial or fungal growth. It has not food value for insects or rodents. Environmental / Health / Safety Icynene contains no formaldehyde or ozone destroying CFC s or HCFCS. It has been thoroughly evaluated for in-situ emissior,s by industry and government experts. After 30 days from application it has no detectabie emissions of any type. Limitations Not intended for exterior use. Must be covered by an approved fire barrier. Not [o be installed within 2" (50 mm) of heat emitting devices. 5. INSTALLATION Icynene is installed by a network of professional contractors trained and certified in the installation of Icynene. Installation is generally independent of environmental conditions. It can be installed in hot. hum�d or freezing conditions. Surface preparation is similar to that required for painting or other products requiring surface adhesion. Within minutes the foaming process is complete arc the walls may be covered. Any instaliation deficiencies are subject to immediate visua! qualiry controi and remedial action. Installers are responsible for trimming foam as required and removal of scrap for recycling 6. AVAILABILITY Check regional yellow pages or contact Icynene Inc. at 1-800-758-7325 7; �� ARRANTY �E COMPANY WARRpNTS TMAT THE PtiOPEHTIES OF THE ODUCT MEET THE PRODUCT SPECIFlCATIONS OUTLINED IN THE U S� �- COMPANY�S LATEST PtiODUCT SPECIFlCATION, NfHEN INSTALLEO S�rface Buming Cha'dC[@f�S6CS Of BUiI� �ME STANOARD EOUIPMENT AND IN ACCOROMICE WITH ITS hlaterals ASTPA E-84 �j TALLERS MANUAL, ANY LIABILITY UN�ER THIS WARRANri WILL Fiame spread � 20 �T EXCEED A REFUND OR REPLACEA�ENT OFTHE NATERIAL.THE Srroke Developmert <400 G�� PANY A4AKES NO WARRANTIES, EXPRESS OR INPUED, F�@I COfllfibUGOn REGAROING THE PROOUCT OR RS dIERCHANTA8ILITY 08 FlTNESS O. FOR A PARTICULAR PURPOSE. TME COlAPANY SHALL NOT BE CANaDA ��-� LIABLE IN CONTRpCT OR TORT FOR ANY SPECIAL, INOIRECT OR Comer wall test CAf la•S t 02 a CONSE�UENTIAL DAbtAGES SUFFERED OR INCURRED BY THE CONTRACTOR AND RELATING TO PpODUCT, INCLUD�NG BUT NOT Flame spread 510-530 UMITED TO LOSS OF USE, LOSS OF WORK IN PROGFiESS, DOWN Smoke developrrert 95-150 nME OR LOSS OF PROFITS EXPERIENCED BY THE CONTRACTOfi. �� :� S. TECHNICAL CerUfied contractors and Icynene Inc. provide support on both technical and regulatory issues. Model architectual specifications are available on request. Extended services include air leakage [esting, thermography and energy consumption modelling. 9. RELATED REFERENCES Polyicynene insulation Icynene has been evaluated by materials evalua[ion services in both the United States and Canada. Confirmation of acceptance by specific local governments and copies of evaluation reports are available upon request. All physical properties were determined through testing by accredited third party agencies. Icynene Inc. reserves the right to change specifications in its effort to enhance quality features. Please confirm that technical data literature is current. Council of American Building Officials NER- 420 Canadian Construction Materials Centre 12070-R 9. PACKAGING AND STORAGE Packagmg - 55 U S gauon. (45 Imperial gallon) open top stea� drums Component 'A' - 550 Ib. per drum - Pory�cynene MDI Component 'B' - 500 Ib. per drum - Polyicynene Resin Storage Component A must be protected from freezing. Component B can be frozen but must be protected from over�eating (120°F) and prolonged storage aoove 100°F. Component B separates during srorage. 10. OPERATING SPECIFICATIONS Operating Parameters : Pressure - use maximum settings Preheater - 130°F - 160°F Line Heat - same setting as preheater Preparation Component B is viscous and separates when left stand�ng. It should be heated to about 80'F in the drum and mixed thoroughly to achieve a homogenous mix prior to and during use. Yield Yield will vary with the temperature of the substrate but an average of 15,000 bd.ft. per drum set can be expected, with higher yields expected in warm weather and lower yields in cold weather. Refer to Icynene Installers' Manual for expanded information. Insulation Fact Sheet This is a polyicynene cavity fill insulation. READ THIS BEFORE YOU BUY. WHAT YOU SHOULD KNOW ABOUT R-VALUES R-value, A.S.T.M. C-518, Btu. in/hr. ft' °F. R-3.6 per inch R-13 based on 3 1/2' R-20 based on 5 1/2' The chart shows R value of this insulation. R means resistance to heat flow. The higher the R-value, the greater the insulation power. Compare insulation R-values before you buy. There are other factors to consider. The amount of insulation you need depends on the climate you live in. Also your fuel savings from insulation will depend upon the climate, the type and size of your house, the amount of insulation already in your house, and your fuel use patterns and family size. If you buy too much insulation, it will cost more than you'll save on fuel. To get the market R-value, it is essential that this insulation be installed properly. � �� The Icynene Insulation System. Sooner or later every home will have it Icynene Inc. 376 Watline Avenue Mississauga, Ontario, Canada L4Z 1 X2 (905) 890-SEAL (905) 890-7325 1-800-758-7325 FAX (905) 890-7784 "GOLDSEAL, ICYNENE, THE INSEALATORS AND INSEALATION are trademarks of Icynene Inc. PRINTED iN CANADA oi 90 CITY OF FRIDLEY PERMIT NO.: 2004-020�0 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: lUi6/2004 ° 763 572-3604 FAX: 763 571-1287 ADDRESS : 540 HUGO ST NE 1� `� ��;� PIN �: 033024230226 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : HEATMG PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATI01�1 . # A/C UNITS 0 VALUE OF APPL OR WORK 0 # FURNACES 0 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 1710 APPLICANT HEATING PERM[T MINIMUM FEE 25.00 AIR MECHANICAL INC FURNACE SHELL/DUCT WORK 0.00 16411 ABERDEEN ST NE GAS RANGE FEE 0.00 HAM LAKE, MN 55304 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 OWNER TOTAL 25.50 JORDAN GUY W& CATHERINE S PAID WITH CHECK # 029047 540 HUGO ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work 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 rype of work will be complied with whether specifiec� herein or not. The granting of a permit does not presume to give authority to violate or canael the provisions f any other state or local law regulating construction or the rform ce of construction. Applicant Date Bldg Ins D�! / CFPARATF AFRRATTC RF(1TT1RFfl F(1R UV(1Ril (1Ti-IFR TNA1V f1FC('RiRFTI AR(1VF ��"�f'�C'1�: 1b� �'� � � � 7� �= p � � S �� ci� � � m � .� � � � � `" �� a � � � a � � � �d � � � % � �, � e'^� �. i 4 � � o � � � � � - � � 4a 1 � v� . ..'__— N � a� � �� a � � � � � � � � � � ��,� ww� �A� w A Q ' �� $" .. �� -a, � �. ., � � Q�� '�� i� � � c � �� W � � � � � �� N� � W � 4n 1� m � � �� ----------�-- g _ g -�,� � �t � � � � � � , Q � �, � � � � � � � � ,��,g2� � � � W � � �! � � � N A � � � � � � 1 � s � J � � � � � � � � �� 0 �* �, , � � � a . �� A v� � � � � � � � cNn �i o � o � � � � �� o� r LL� � _ �� 3 r�-' a � ' � � � �� , � � I � � � �. o� � c � -� .� � � -..� �i T u �� n � � �, �� a � � Qe �, - ,�- -- - o ,c�n �; $ vo k6 � � b � � �: � � � �L .� � ' � � � 3 0 � -� 0 c`yy �" �' ti w�N� � N � �a w � t -r1 �� W �v �N�� c N � N � O,�o � � m � � �o_ a �� 0 p" tii � � � � � � � � � a � A � � � � � -a � v � � � � � � � � � � � M' � �� ,n � iII � � '� � � � � � � � � � � Z � � ► � a� � � z � �� ` Np (7 A w a U[: f-l�' (-z'V�4 � 1 b��d u l� r ur r �c a�r. � FlLL iN CC��II�L�T��.�' �C�R R�P1.dAC�lUlE1el�' FUEL �URNtN� A�I'LiP�hO�E PER4VOli3 �C�N1lYiON 1JENTd �Nl' C�,3�+ffNE�TtiR /Wf� Ct�Ni�OJ�'T1�N�Q �IERIFICATIQN When reafa�irtd �n �xisti�s� farn�ca, tl�t� unde�igned hereby v�� that the vsnting has l�een examined and is fr�e frdm rust, deterior�tion, obstruciions, _ and is s�CUrely supported ar�d fire�topped where req�ired. Yes () tdo i) The venting systern i� p1��4i�P'i0C a�d meets a11 c�arr�nt codes and rnanuia�turer �pe�lflr.�tions irtduding �izing, le�gth, numla�r t�f eibow� r�nd t�rmin�4ior�. Yes ()'_ No () Tkte undersigned also ve�if6�s that the repl�c�m�nt unit is � Iisted a��embly and m��ts the current codes and manufact�+��r's specfic�tions. This does in�lude A�aA-GAMA i�#egory I C�ntral Fumace Venting T�bles tor f�an aseisted and naturel draft �pplianc�s. TI� existin� c:omb�ist�ore aor is siz�d and in�t�ll�d to meet the cuR�nt codes �r�d ment�ac�. ui'ei 9 sp�Citir� v�t .- -- Y�s ( �j/ N� t. � 1`8�-{ -}— PI� ( � When required to in�tall � nov�r combu�tis+n �r, it uvill be siz�d and installed . to m�t the curr�nt codes and manuf�cturer'� �p�ci6�ati�ns. Yes ( j l�flten i�itins� a n�w v�ntina svstem, �he undersiQn�d hereby v�rifies that it i� � tisted assembly and m�ts ihe curr+snt c�d�s a�rtd ma�utacturer's spea�c�tions. This does indud� AOA-CiAAA/� �ategory I Ce�+iral Fvmac� ,, Venting T�bl� f�r fsn assist�d and �takural draft appfi�ncea. Y�a (;) Is tf�� ommon v�r�t amd vent conn�ctors si�d �nd ir��tai9ed ccrrrectly af��r �n �apliance has �n remov�d frorn 4h� cammnn vent a�td venteci s�parately as p�r current codes. No ( ) No ( ) Y�� > �p c a Applian�� nd �izel�amn��o� !/ent �ead Vent Conn�ct�r I�ffar�m�ii�� AppliBrtCe #1 �ype BTU lr�put F�n Ass+sted or Na�t Appli�nce #2 iyp� �T�1 lnput � F�n As�isted nr N�t Appliance #3 Type �TIJ Input ,� �an Aasiste� or lVat � T�tal Appli�nces ic�al �tu Onput � Cammon Vent Type Ven4 H�ight Di�m�tgr � inci�es Appli�n�e #1 Vent Connec��r H�lght ft 1_ength � Diasneter in Typ� Appli�nce #2 Vent Connectvr F4�ight ft l�ngth it C�i�rtt�ter in Type Ap�li�nce �3 Vent Connector Height ft Ler��th ft Ol�meter in Type �� . �. , y _< �f .� Fr J...� ,Ea....._ < �� . • / � � � r ,�. • l i , r. -i. .�• t .�� . _,. „M i . �O fF�L F. �2 ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 l+'AX: : 540 HUGO ST NE : 033024230226 : UNAVAILABLE : LOT BLOCK : ELECTRICAL : RESIDENTIAL : ADDITION/ALTERATION 571-1Zif7 PERMIT NO.: 2004-02116 DATE ISSUED: 11/18/2004 VALUATION . NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. # INSPECTIONS 2 ZOTZ ELECTRICAL 21528 140TH AVE MILACA, MN 56353 (320) 983-2500 APPLICANT STATE SURCHARGE, ELEC FLAT ELEC PERMIT FEE - MIN (RESI) TOTAL PAID WITH CHECK # 1059 OWNER JORDAN GUY W& CATHERINE S 540 HUGO ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby ceitify 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 wor� will be complied with whether specified herein or not. The ganting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating cdnstruction or the performance of construction. Applicant Date Bldg Insp Date ��w. R60�9 �crr+� i� rniuvil t J tcnllVltc�L rvic wulctt V 1 ri�K 1 riA1V L��C;Klti�ll AtiUV�. 0.50 40.00 40.50 ,,, CITY OF FRIDLEY PERNIIT NO.: 2004-02157 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: ii/22/2004 ` (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 540 HLTGO ST NE PIN : 033024230226 LEGAL DESC : UNAVAII..ABLE : LOT BLOCK PERNIIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 0.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPEI�IINGS) 0 # GAS WATER HEATERS 0 # GAS DRYERS 0 # GAS RANGES 0 # OF NEW FIXTURES 3 VALUE (FOR NIINIMUM CALC) 1000 # WATER TRMT APPLIANCES 0 APPLICANT PLBG PERNIIT NIINIMUM FEE 0.00 JORDAN GUY W& CATHERINE S PLBG FIXTURES (NEW OPENINGS) 30.00 540 HUGO ST NE PLBG FIXTLJKES (EXIST OPENINGS) 0.00 FRIDLEY, MN 55432 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00 GAS RANGE FEE 0.00 OWNER GAS DRYER FEE 0.00 JORDAN GUY W& CATI�RINE S PLBG REPAIR/ALTERATIONS 0.00 540 HUGO ST NE STATE SURCHARGE, PLBG FLAT 0.50 FRIDLEY, MN 55432 TOTAL 30.50 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if constntction or work is suspended or abandoned for a period of 120 days at any time aiier work is commenced. I hereby certify that I have read and examined this application aad know the same to be true and correct. All provisions of laws and ordina.nces 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 or cancel the provisions of any other state or local law regulating co tructif��. °t performance of construction. Applicant �= 6�� Date /- �� Bldg Ins Da� SEPARATE PERMITS Q D FOR WORK OTI�R THAN DESCRIBED ABOVE. _u n �� W C � � Z A � � 2 r r � m -o � 0 v m 0 -o m � C � C� � m � O Z cn 0 .p .-. D Z v D � r m � .D � m � � 0 � � � m � m m � � � o � -o v < m o. � 0 c � � 7 v rt � -n � a� v a� m � � N � N � O N 2 p o m .. � � � � � Z c�D o v� -n O o �.�o m m= o D � �� • Z �v D � rn � 0 Z � pWj ��<< G= N N W f�D � N � � �' �' m m m � � ci � � Q' � � � N � N N � � N � � 0 -8 �I � �' :D rt e�-f LU f7 :� Ul Q7 � . C 'o � m m = �• � w � � m � �-, -, > >,� �.� N m � � co Z m c� Q � � � m -� -� m ' � � v, � �°- °' � -n -, ��.� � � � � � c � m � c m Q v � � � � 0 0 � � � C Z � m W ,v Z �� 1 � O �� D z . � � .-< --� m r z 0 � w a ��{ V � � � �� .., w w w -� -� -� -. � j -. 0 0� w�+ o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 d C umi c � � � Z � v_ ,� z � � v c � � U o r" v � � � t� � � � � � >- 1 9 v `� � m � � � � \ ` � rn � � z 0 i" � O �%J .c.� c�u 2 �; � � � Q- m y � � . � W � m : � � Q � c� o � • a o. � , � O ,c cc ID : v � d < � . y O . � (A 'o � ? � a � � a : Q � ' • 3 S11 O � � � 1 � � O , Q a � � . � � � � g � N � � 3 0 . � � � °� m � d o m � o � -� Q, m y �' m � 'D r C W Z � � � c � m � m � . � m � O D r � O W � �2i � T � � W Q' C� � N CIi `_< C O W Z N � � � � � _.°a � `�` � „N�v � Zm � m� w Z � � � , m � � � O z � < � � = < m D v = N 0 °� : a�ea :�(8 pauBig �O� JNIl�d3H ( ) oN aq��saQ :SNOI1Htl31�d acU(1 ui �a�aweia }} y�6ua� }} �y6iaH �o}�auuo� �uan £# a�uei�ddy ad/�l ui aa;aweia �} y�Bua� }} �y6iaH �o}�auuo� �uan Z# a�uei�ddy adi(1 w �a�aweiQ }} y�6ua� }} �y6taH �o��auuo�;uan �# a�ueJddy say�ui �a�aweia �y6iaH �uan acU(1 �uan uowwo� �ndu� n}8 �e�ol sa�uei�ddy I��ol �eN �o pa�sissy ue� �ndul f118 ad�(1 � a�uei�ddy �eN �o pa�sissy ue� �ndul f118 " ad�l Z# a�uei�ddy }eN �o pa�sissy ue� �ndu� �18 acU(1 �# a�uegddy uoi;ew.io�u� �o;�auuo�;uan pue;uan uowwo��azig pue a 1 a�uei� d ( ) sa� �sapo� �uaLn� �ad se �(�a�e�edas pa�uan pue �uan uowwo� ay� wa� panowa� uaaq sey a�uei�dde ue �a}}e ��a�o� pa��e�sw pue pazis s�o}�auuo� �uan pue }uan uowwo� ay} �� () oN () sa� � �sa�ueydd� }}e�p �em�eu pue pa�sisse ue� �o� sa�qel 6ui�u�n � a�twn� �e��ua� � tio6a�e� ywy�-y�y apn��w saop siyl �suoi;e��i�ads :s,�a�n��e�nuew pue sapo� �ua�n� ay� s�aaw pue �(�qwasse pa}si� e si �i �ey� sa�uan �(qa�ay pau6is�apun ay� `wa;s s ui�uan nnau e ui��su� uayjN ( ) oN ( ) Sa�l ( ) oN ( ) SaJI �suoi�e��i�ads s,�am��e�nuew pue sapo� }ua.�n� ay} �aaw o� pa��e��ui pue pazis aq ��uv� �i �ie uoi�snqwo� w►au e ��e�sui o� pa�inba� uay� •suoi}e��i�ads s,�a�n��e�nuew pue sapo� �ua.un� ay} �aaw o� pa��sui pu� pazis si �ie uoi;snqwo� u�;sixa at�l () oN () sa� �sa�uei�dde }�eap �e�n}eu pue pa�sisse ue� �o� sa�qel 6w�ua� a�ewn� �e��ua� � Aao6a�e� yWy�-y�y apnpui saqp siyl �suoi��i�ads s,�a�n��e�nuew pue sapo� �ua�n� ay} s�aaw pue �t�qwasse pa�si� e si }iun }uawa�e�da� ay� �ey� sa�uan os�e pau6is�apun ayl ( ) oN ( ) oN O sa� �upi�eui�.wa� pue snnoq�a �o aaqwnu 'y�6ua� `Buizis 6uipn��w suoi�e��ads �a�n��e�nu�w pue sapo� �uaLn� ��e s�aaw pue �nd/�i�se�d si wa}s/�s 6w}uan ayl () sa� �pa�mba� a�ayrtn paddo�sa�� pue pa�oddns �(�a�n�as si pue 'suoi��ru�sqo 'uoi�e�oua}ap `�sru wa� aa�� si pue pauiwexa uaaq sey 6ui}uan ay� }ey} sa�uan �(qaaay pau6is�apun ay} `a�eu�n� ur�sixa ue u��e� a� uay/N NOIl�d�I�la3A 211d N011;�f18W0� aNd 2101�3NN0� 1N3A �1N3A NOWWO� SlIW213d 3�NHIldd�d JNIN?�f18 �3f1� 1N3W3��Id3b 210� A13131dW03 NI ��I� � � �� .� CITY OF FRIDLEY PERNIIT NO.: 2004-02158 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: i i/22/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 540 HUGO ST NE PIN : 033024230226 LEGAL DESC : UNAVAII.,ABLE : LOT BLOCK PERMIT TYPE : BUII.,DING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 750.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF TI� DWELLING PER R317 OF TI� 2000 INTERNATIONAL RESIDENTIAL CODE. APPLICANT BUII.,DING PERNIIT FEE 32.65 JORDAN GUY W& CATHERINE S PLAN CHECK FEE 21.22 540 HUGO ST NE FIRE SURCHARGE 0.75 FRIDLEY, MN 55432 STATE SURCHARGE, VALUE 0.50 TOTAL 55.12 OWNER JORDAN GUY W& CATHERINE S 540 HLJGO ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and conect. All provisions of laws and ordinances goveming 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 or cancel the provisions of any other state or local law regulating construcrio - i p rformance of construction. Applicant -- Date //- � � Bldg Insp Da� % SEPARATE PERNIITS QUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �. NEW �] CITY OF FRIDLEY Effective 4/1/2004 ADDN [] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp �►LTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION , Construction Address: -� �l � � � � � S�� Legal Description: Owner Name 8 Address: �`��_� ��rc�c�v► — �.�44� � - Tel. # 7 6 � �- 7/ � � �� Contractor. MN LICENSE # Address: Tel. # LMNG AREA: GARAGE AREA: DECK AREA: Attach to this application, a Certificate of Survey of the bt, with the proposed construction drawn on it to scale. R DESCRIPTION OF IMPROVEMENT ' Length Width Height Sq. Ft Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft OTHER: G'��5t �� 6��(n".�-, Construction Type: Fiiv�s I� ��- Estimated Cost: $ % ST�, bv Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$ � . DATE: // °�7- � `� APPLICANT: .� !� , Tel. # �� 4 ° 7/7- O��/� .------°'° Call (763) 572-3604 for Permit Fees if maili g in pplication. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL s $�'-� $�m� $ � �✓ � s � $ .$ $ $ $ $ $ ..�� > CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) � -�"� $.50/$1,000 Valuation $1350 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 [ J STIPULATIONS: BUILDING PERMIT FEE SCHEDULE , .� The Chief Building O�cial 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 bWilding 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 FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $10� or fraction thereof, to and including $2,000 q $69.25 for first $2,�0 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,0(}0 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 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,Oa0 or fraction thereof, to and including $5(10,�0 $500,001 to $1,000,000 $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 $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof CURB CUT ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter orily - driveway width plus 6 feet, times the annuallY detemnined rate 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. VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the location of the existing foundadon will be required before proceeding with the framing. New Houses Onlv ** � * PIONEBR * eng neer * * ** 2422 Ent�prise Drive Mendoto Heiqhla, MN 55120 uwo suRVEra�s • dWl ENdNEERS (612) 681-1914 FAX:681-9488 W�D PWVNER� • uWDSCAPE ARCMITECTS 8i9 Highwoy 10 N.E. Bloine, MIN SS434 (612) 783-1880 FAX:783-1883 Certifica te of Survey for. House Address: �:7 �� i i 46 7oP oF 6toC�r, : s�a , G UY W. JORDAN o HuGQ STREET �5-�3�ic.T i2/�sJ9s � u G 0 STREET �° INF�T�s.9 � nn nn a�. � 1 �°'� 8 'f'f'� DRK+Y, � Op � or�veMU►r � O . O O• z2.s 27,4� � � _.._ � _ _�_____ 9.d7 _____ � � 8 8 �----- --- P 23.17 + '+ 17.17 � � 6Xr S�f. H«,� � � 51 ~ � N � 5 eas 6swr. N 3 e 0 � � � 0 °z � � �t • sw.o Denotea Exiating Elevotlon "� Oenotea Proposed Elsvotlon —� Denotes Drolnoge Flow Dlrectlon -- Denotes Orofnage dc Utfllty Eaeement —o— Denotes Monument LOT'S 47-50 i � � WEST � � —♦— Denotes Offaet Iron Beortngs ehown are assumed i 100.00 d� I � � � -W R 0 � M 0 � � �I1II.DlNG ELEVATIO1Vs Lowset Floor Qevatfon: �✓Q � Top of Block Elevatlon: $4'8•O✓ Garage Slab Elavatlon: 76'� (at door) NOTE: Proposed bupolny site qrodinq ia in oeeordunce with the 9��9 P��t opproved br lha dty enqMeer. No�: co�a�ea mw� vvilr all dim�nsion� e� atw.or aa�. LOT S 47-50 . BLOCK H_ RIVERVIEW HEIGHTS ANOKA COUNTY. MINNESOTA We hereby certify thot this survey, plon or report was prepored by me or under my direct superviston ond thot I o dulr licensed lond Surveyor under the laws of ths Stote ot Minnesoto. Ootsd this I�TN doy ot �Q�� A.D. 19,� �E��SE l�O� E�� 3/�g Signed: PIONEER INEERING, P.A. --�--� Scale: 1� a 30 set BY Robert B. Sikich, L.S. Reg, No. 14891 or 458 18484.00 JMP Terrence E. Rothenbecher, L.S. Reg. No. 20595