AF - 46587,�--,
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City of Fridley, Minn.
�UILDING PERMIT
��: MARCH 1, 1966
N� 8s90
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�Qr: IVAN RAWSON g�� IVAN RAWSON
�� A� 573 SIIGO ST. N.E.
FRIDLEY, MINNESOTA 55432
LOCATION OF BUILDING
No. 573 s� HUGU STREET N.E. Part of Lot
� 27 & 28 _ Block �' Addition or Sub-Division ��RVIEW HEIGHTS
Coraer Lot � Inside Lot SEtback � 5ldeyard
Sewer IIevat4on � _ _ _ — Foundation IIevation
To be vaed as:
BEDROOM Front
Front _._.
Type of Construction Frame
DESCRIPTION OF BUILDING
6 Depth 13 Heigt►t 10 Sq. Ft 78 G'q. Ft 780
� Depth fTeight Scl. Fk Cu. FL
��_ 5 00 . 00 To be Completed
Ea consideratton oP the 9esuanoe to me of a permit to construci�he buflding bed above I agree to do
tha proposed work 9n accoraanzce with the dr�acription above set f�i� and c�mp ce with afl provlafona oP
orainances oE the dty of Fridley. .�
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In co�aideratlan oP the PaY��t of a fee oY $ 4.00 . Permit ia hereby graated to IVAN RAWSON
to vonatruct the building or addition ae deacxibed above. This permit is granted upon
the eupress crondil3on that thep�on to whom it is graated and hfs agents, e�nployees and workmen, 9n all work
doae ia, around and upon eaid buildiug, or anypart ther�oE, shall �nPorm ffi all respecte tfl the ord9nancee of
Fildley� Mianesota regarding locatlon, conatructCon, alteratton, maintenance� repafi aad mavfug oY buildinga
within the dty ]lmits and this permit may be revoked at any tl�ne upa�a violatton oP any o4 the 8��� � asid
orrlinanoea
ATT•F.N G. JENSEN Huilair►Bla�ector
NOflC�
'Ihb p�emi! doa no1 emnr tlu coe�nallo�, IeaaQadoe ie� �rUiea, piambleo, �n haNno, arn' er wa1a. B� wn to a�
Na 6QIIdtq les�or !er aparat� pumNt h� fha� N�.
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OWNER ° S NAI�
i�PPLICATLON FOR BUiLD3NG PER�QT
C�TY OF FRTDL�Y, i�QN,'JESdTA..
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�s L%i /� : . t��
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IsiNr�l`�ldA1 OF B�TTrDING j �
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N0, J� .�.� S'1`REE� ' ____,�6��-��P�T OF LOT
..� .
LOT � � �BLOCR ADDITION OR 3UBDIL�SION ��, .. ._
CORNEYa LOT �INSYDE LOT_�SBT�ACR SIDE-YARD .
SEWER ELEVATION ______�,. -- ,_FOUNDATION �Vd�Tl'�
Applicant attach to thi.s form Twa �erti��ca�es� �f Stir�rey t�� Lot �tnd proposed
building locati� drawr► oti theas: Cer�if�cates a
DESCRIP�''�41� t�" B�DiN�
�o be used as�
� , �tl� :
�ro�at�,�.,��t'h .__�,�___Heig�it
���. e �.+i i
Sq. Ft. 7� ` �u. gt. � �'
�-..�- .F..�..� � � - �
Frott� �ep�6�_ Seight
Sq. Ft. C� ��.
Type of Coastruation �2�. Eetima�ed Coat� -��_,_,,� =
� �----
To be completed � O /� � �v �, .,
The undassigaed herebq make� gpplicatian �or a permt� i�r the work hsrein
epecif3ed, agreeing to da 811 work in str3�ct accordaace with t�t� CiCy of
Fridley �sdinances gnd rulings of thd DepartmeII� of Build�t.�qgs, sad hereby
deClare� that all the facts and representations s�ated i�a tk��:s application
ar� �rue and carrect.
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1��Ti� .3 �! ���� SIGNATURE ��—
(Schedule of Fee Coete can be found on the Reverse 3ide);.
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BUILDING PERMIT FEE SCHEDII�.B
SECTTOP 2. The Inspector of Buildings shall, before i�suing any permit for
the erection o£ any building or structure, or for any addition to say exiating
building or �tructure, or for any alterationa or repaira to any existiag
building or etr�cture, upon application therefore, require the payme����By►'the
applicant fox.auch..germit of fees to �the amount� herain below set for.th .gnd`'iri `� ��
the manner herein prov4ded to�wit;
2.1. �For auq euch permit for the erection of any fire-proof building,
othei than a garage, warehouse, factory°or grain �ievaCor, or for the erecCion
of any fira-proof_addition, for�similar occupancy, to any esieting building,
shall. be at_the- rate of $1.40 for each.-one thousand. .cubic '�eet, or -�ract_�on •
thereof, in such cubical contenta.
2.2 For any such permit for the erection .of any fiL�e•prQoE;garage,;
warehouse; factory or grain elevator; or for the erection of any fire�pr+�of`'
add�Ltion, for similar;,occupancy, to;any,exiating building ahall be at,the
rate� uf $1°.25 -for° e$cb one thousand� cubic f�et, cfassified as "fireproof"
by Section_502;o�,�he Minneapolis $uildi�g.�Code.
HODSES � °
2.3. For any such permit for,the:�rect�on of any aoa-fireproof
building other than a garage, warehouse, factory or grain elevator, or
anq non-fireproof addition, for similar occupancy, to any esiating bu�lding ,:p
permit $1.00 for each one thousand cubic,feet. . „ . ` � "
GA_RAGES _ _. o�. _ : � `:�. . - - - . . � . : _. _.. _ . . _ . �.
� 2'.4-. `° rFog��any �such permit fb� `the'erection of anq non-fireproof garage,
warehouse, f$ctory or gra�in elevato�, or for the �.rection of any non-fire-proof
additioa; for af.m�lar� occu nc � to a� ���istin buii�li
� 3�� Y S ng or for each su�h � °� "
bu3lding or addition - ninety cents ($0.90)_for each one thous.and cubic feet
or fractic�n thereaf, in the euli3cal' con•t�ants thereof with the minimum of $4.00.
, : _..
,...
For th�-gurpose�of`computing fees for Buildiag peimits,'�the cu'[i3ca1 contenta •�
of any buildiag or addition to a uniform height throughout by multiplyimg,�.the..
ground�ares�covered f�om a pofnC`six (6� inches below the floo"r�line of the �
basement or cellar to the average hr�ight of the upger surface or to the average
height of �he roof �urf.ace o�' the .main. gable of a, p:itched roo£. . •
. . . . . . . . . . . , . , , . . , E :
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2,5. For r-epairs or altexations_ to. an existing struGt�}re, .the �ee .shall �,.. ..
be at the rate ,of $3,00 per each. Five. gundred` Do],lare ($500..�0}. or� ��actl�n �- �
thereof in the cost of all proposed work. " � ' ' '``
2.6. In no case shall the fee charged for any permit as aet for�h in
Sectio 2n be lese than $4.00. , . .
STORM REPAIR DAMAGE FEES:
Residential; Estimated Cost of work up to car�rCp -$5o�?a
Estimated Coat of c��or;<, c-� ,� '�:�.;.;;_�::;� ., %' �,�,0
Y�
a
(�'i'��IH�TC�B�. � Estimated�'�Q � C+¢ �wi �ris �1� � � , : e � ;': � iy�� „ �3 L'� >. - - .
Estimated ,�st of ��u���c ovc:r $ �t���+.�p - Y�U.�J
I��7v [] City of Fridley EEfective 5/L88
�N I ] R-1 ADID R-2 �� � 3 � � � �
AL�R [ ] Building Permit Application
a�nstructian �ress: � ��3 �' S� %�� � �2 i �(r�- - �I//• .�.��%3 �.
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- Descriptian: �
`�� N�ne & Address: 6 � TP1. # l�% �%�%6 8
Q�ritr actor : Tel. #
�� : _ f 96 ��-s-� .�'-�vCo.�, s-Fi�, �,�?_- .s'�- ��vL ; �1��N ss l t 8
Attach to this appl ication, a Certif icate o� �arvey of the
lat, with the proposoed construction drawn on it to scale.
L�SQtIFPION OF I1�RaVII��
LIVII� ARFA: Length Width Height St�. Ft.
GARAGE AREA: Length Width Hei�t SL�. I�t.
D�Ctc AREA: Length Wiclth Hgt/Groima SL�. i�t.
�:.
Q�rner Lot [] Inside Lat [] Ft. Yd Setback Side Yard Setbacks
Z�ipe of Gonstruction: Estimateol Cost: S
Approx. Completion �ate:
�
i/ �� "✓ Al� A Alt. B
Propos+ed Drive�ray Width If New Opening Is Desired: ��'` l a' � �f�3 • S7J 8
Widkh + 6' See Back Page
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n�: � �-6 s�- �,�r.,zc�,xr: l � - Te�. �7 �%�6 �
OSE �II.Y
Pe�i.t F�ee
State Surcharge
SAC Charge
Drfveway Escrow
Park l�ee
S�wer Main �arge
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Sur�u�uicx��:
S
S
$
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S
�
S
F1ee Schedule on R�everse Sicle
8.50/$1,000 Valuation
5550 per SAC Unit
Alt, �," or Alt. '�° Abave
P1ee Determir�ed by Ealgir�eering
Agreenent Neoessary I l No� Neoessary []
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: 1� � �. �i�v 4 �al `'M;1�l�< J
The Chief Building Official shall, before issuing permits for the erection of any
builcling or structure, or for any ac7dition 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 belaw set forth and in the manner Y�rein prwided to-wit:
'!�'PAL VALUE
$1 to $500
8501 to 52,000
52,001 to $25,000
525,001 to 550,000
$50,001 to $100,000
5100,001 to 5500,000
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�1S (Minimt�n Fee is S15 plus surcharge ) ,
$15 for first �500 pl� S2 for each additional 5100 or f raction
���r to and including $2,000
�45 for f irst S2, 000 plus �9 for each additional �l, 000 or
fractio� thereof, to and including 525,000
�252 for first 525, 000 plus 56.50 for eacd� additi�al S1, 000 or
f raction thereof, to and inclucling 550, 000
5414.50 for first 550, 000 plus 54.50 for each ac�itional S1, 000
or fraction thereof, to and including 5100,000
� 639. 50 for f irst �100, 000 plus S3. 50 for each additi�al $1, 000
or fraction thereof, to ancl includi,ng 5500,000
5500,001 to 51,000,000 $2039.50 for the first $500,000 plus S3 for each additional
51,000 or fraction thereof, to and including 51,000,000
51,000,001 a�d up 53539.50 for the first 51,000,000 plus $2 for each aclditional
51,000 or fraction thereof
DRiVEL�Y EP�g�n�► F�
(Concrete Curb Streets Only)
Alternate °A°: Renwal and replaoement o� cairb and gutter only - Driveway width plus 6
feet times 513.50.
Alt�rnate °B": Renoval �d replaoemertt of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times 515.75.
��i�; :� i � • , • � a•���� �-- M •,�
Permits for construction will be issued a minimum of 24 hours f rom the time of
application to allow for proper review a�f the proposed structure and of the o�nstruction
site.
A Certificate of �uvey of the lat, shawing the location of t,he foundation on�e it has
been aonstr�ted will be required before prooeeding with the fraaning.
sue�ECT • pE
City of Fridley 2 9 718
AT THE TOP Oi THE TWINS � � I L D I N G P E R M I T
;,
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� ; v __��� COMMUNITY DEVELOPM�NT DIV. 7
f � � PROTECTIVE INSPECTION SEC �5�� �
1 . , V
l---. w ��10�;', CITY NALL FRIDLE� SSIai NUMBER REV DATE PAGE O� AVPRpVED BY
t �� 612-57t-3450 910-F15 6/18/99 / /
JOB AD�RESS 573 Hugo Street IVE
t LEGAL �OT NO. BLOCK TfiACT OR ADDITION SEE ATTACHED
DESCR. 2] , 2g G Ri ve rvi ew Hei ghts SHEET
2 PROPERTY OWNER MAIL ADOR�S$ ZIP PMONE
A1 Fletcher 4611 Colfax Ave N Mpls 55412 651-415-5658
3 CON7RACTOR MAIL ADDRESS ZIP PMONE LICENSE NO
Zehm Bros Const. 7876 Hudson Rd Ste 5 Woodbur MN 55125 651-501-762 20173039
A ARCNITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
5 ENGINEER MAII ADORESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WOHN
❑ NEW O ADDITION D ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house 9 S Tear-off
9 CHANOE OF USE FROM TO
STIPULATIONS `
Underlayment must comply with the State BuildingCode.
SEPARATE PERMI7S AqE REOUIRED FOR ELECTRICAL, PLUMBING, MEATING, TYPE OF CON T. OCCUPANCV GROUP OCCUPANCV LOAO
VENTILA7ING OR AIR CONOITIONING
TMIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SO. FT CU FT.
AUTHORIZED IS NOT COMMENCED V�IITHIN 80 �AYS. OR IF CONSTRUCTION
Of1 WORK IS SUSPENDED OR ABANOONEO FOR A PERIOD OF tpp DAYS A7
ANY TIME AFTER WORK IS COMMENCEO. NO DWLG. UNITS OFFSTREET PARKiNG
I HEREBY CERTIFY TMAT I NAVE READ AND �XAM�N�D THIS APPLICA710N STALLS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAWS VALUATION SURTAX
ANO ORDINANCES GOVERNING TMIS TVPE OF WpRK WILL QE COMPLIED
WITH WHETHER SPECIFIED MEREIN Ofi NOT. TNE GRANTING OF A PERMIT �787 $.JO
DOES NOT PRESUME TO VE AUTMORITV TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CMAFGE
PqOVIS10NS OF ANY O R STAT R �OCAI LAW REGULATING CON-
STRUCTION OR T E P O A F CONSTFUCTION �32.65 Fir C�.79
j �� � PLAN CMECK FEE TpTA F E
� Li e S $ . $3 4
S�GN4TU�7EO�CON'A FQqaU M � EDAGENT � ATEi HE P VAUOA NIS IS �R� Iy�IT
� /�
S�GNOTUAE O� OWNEp��� OWNEp Bw�DEp� �O�rE� BL G�NSP ' qpTE
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ADDN
AL1'FR
Effective 5/10/99
[ ] CITY OF FRIDLEY
�C] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUII.,DING PERMIT APPLICATION
Construction Address: �7 3
Legal Description:
Owner Name & Address:
Contractor• �
Address: �i�%� �
LIVING AREA:
GARAGE AREA:
DECK AREA:
.� _M��_ c
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i� �4 �y Tel. #�p.S—/—z%/S —�.5�
_ 11 N LICENSE � �.?S � 730 � %
/��' Tel. � ��/�S �%�- T� 2;
Attach to this application, a Certificate df Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
DESCRIPTION OF IlVIPROVEMENT
Width Heighf' Sq. Ft.
Width Height Sq. Ft.
Wi Hgt/Ground Sq. Ft.
��s � � �.� , / �1-i2 -�F�
i U '
Construction Type: OJ �G� Estimated Cost: $ 3� � �%
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ �
DATE: � �� APPLICANT: �� /1 � ,� Tel. # ��� -�a � 7�2�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ �S`
$ %%�
$ ��
$
$ - C�
$
$
$
$
G
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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 Necess�y [ ]
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BUII.DING PERMIT FEE SCHEDULE
The Cluef 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 $25,0�
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$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 $2,0�
$69.25 for first $2,000 plus $14.00 for each additional $1,0�
or fraction thereof, to and including $25,(�0
$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 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,(T00
$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 $1,0(�,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 tune of applicadon 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 h� been �oa��ac�� �vill
be required before proceed.ing with the framing.