AF - 46882��
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BUILDING PERMIT
�i
Villa.ge of Fridley, Minn.. N° 2 7� 5
Date J/•.."".'..� .�:..Y.' .........................
Owner. .�v..,�.. ... ................. Builder . .........�.�..�......................
Address�.r�.. . ... ... ................. Address .........................................
LOCATION OF BUILDING
No. ..�.��....... Street .. ... ................... ....... Part of Lot .......................
Lot . ��''.�'I� . . . .. . Block . . . . . .. . . . . . . . . . Addition or Sub-Division . . . �� r? i� .�. �? ��, �?. , , ,��, ��': .�i ,, ,
Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ..........................
DES�RIPTION OF BUILDWG
To be Used as:
s
. . . . . . . . . . . �� � . Front . � . . . . Depth s� � . . . Height �. . . . . . . Sq. F't. r�j � . . Cu. Ft. . . . . . . . .
..� ... . . Front . . � Depth ... . . .. . Height . .. .. . . .. Sq. Ft. . . .... . . Cu. E't. . . . . .
Type of Constructioa�.1�'YG.�( . . Est. Cost . .�. .�.�. . B�. . . . . . . . . . . To be Completed �. . �l:G��i°aG�
In Considerati��n di the i�ssuanCe to me of a permit to construct the buiiding ed scribed above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
di��inance� �i the villa�e of Eridley. �p _
�����^ —�:�r��*��
In consideration of the payment of a fee of $. .�—. , permit is hereby granted to ..C.:..
, . . ..... ....
. . . . . . . . . . . . . . . . . . . . . . . to construct the building or ad dition as described above. This permit i5 grant upon
the express cohdition that the person to whom it is granted and his agents, employees and worl�nen, in all work
done in, around and u�on said building, or �.ny part thereof, shall conform in a1l,respects to the ordinances of
Fridley, Minnesot,�, regarding loca.tion, construction, alteration, maintengnce, repair and moving of buildings with-
in the village limft� and this permit may be revoked a4 an� time upon violation of any of the provisians of said
ordinances. � � �g �
-- : •` ��0'�`���/ a. . Building r*+cnPetor
NOTICE:
ThPs permit does not cover the construCtion, installation or aiteration for wiring, plumb(ng, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permlts for these items.
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�_ dsscribed land� p� of fhe loaotioe of�Yl bvildiR�s� ib�r�4a ded ott vialble en�sraachRteet�� ii aAy� ironi or on"
safd land. I!s sur�erid br a�i tl�f�,l„_day o1�„�1�.0. '(0� . `
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sue.,ecr PER
c�ty of Fridley 33524
AT THE TOP OF TNE TWINS g � I L D I N G P E R M I T
r
; � RECEIPT NO.
� `� __��� COMMUNITY OEVELOPMENT DIV. �
� � � PROTECTIVE INSPECTION SEC.
1 . �
L.--. A �����;'j CIiY HAL� FRIDLE� SS�32 NU4BER REV OATE VAGE OF AViROVED B1I
L J� 763-571-3450 910-F15 5/16/03 / /
JOB ADDRESS 510 Ironton Street NE
t LEGAL ��T NO. BLOCK TRACT OR ADDITION SEE ATTACMED
DESCR. j� 2� 3 y 4, 58 59, 60 G Rlverview Hei hts SHEET
2 PROPERTY OWNER MAIL ADORESS 21P PMONE
Gary/Kay Wilson 510 Ironton Street NE 763-784-1635
J CONTRACTOFi MAIL ADDRESS ZIP PMONE LICENSE NO
Same
4 ARCHITECT OR OESIGNER MAIL ADORESS ZIP PMONE LICENSE NO.
5 ENGINEER MAIL ADDRESS 21P PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CIASS OF WORK
O NEW O ADDITION � ALTERATION q_ REPAIR ❑ MOVE O REMOVE
X
8 OESCRIBE WORK
Reroof house (18 Sq) Tear-off
9 CHANf3E OF USE FROM TO
STIPULATIONS
Underlayment must comp�y with the State Bu��.ding Code.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICA�, PLUMBING, MEATING, TYPE OF CONST. • OCCUPANCY GROUP OCCUPANCV LOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL ANO VOID IF WORK Ofl CONSTRUCTION 20NING SO. fT CU fT
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. Oii IF CONSTRUCTION
OR WORK IS SUSPENDEO OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WOqK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING
I MEREBY CEi;TIfY TMA7 I MAVE READ AND EXAMINED THIS APPLICATION 1 S7ALl5 GARAGES
AND KNOW TNE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS yp�UATION SURTAX
ANO OROINANCES GOVERNING TNIS TYPE OF WORK WILL BE COMPLIED
WITH WNETHER SPECIFIEO NEREIN Ofi NOT. 7ME GRANTING OF A pERM1T �Z�OH�F �I.O�F
DOES NOT PRESUME TO GIVE AUTMOFi1TY TO VIOLATE OR CANCEL TNE pERMIT FEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE OR IOCAL LAW REGULATING CON-
STRUCTION OF THE PERfOFiMANC€ OF CONSTRUCTION �83.ZS Fire SC �Z.OS
PLAN CNECKFEE TOTALFEE
$86.37
5� OTUAEOfCON' CTOA pAUT GENt IOATE� WMEN PROPERIY VALIDATED TMIS IS V UR ERMIT
�
S�GHa qE0 WNEp OWNEpBU�LDEp� �O�TE� , BLOG �h5o a E
NEW
ADDN
ALTER
[] CITY OF FRIDLEY Effective 1/1/2003
[] 6431 Unive�sity Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name 8� Address: �•,�Rt! �I�t/�V/!S�✓ :S%d�ie�S1' Tel. # 7Y_�-78'S�-/r3`S�
Contractor. �Le�/✓LIQ r MN LICENSE #
Address: Tel. #
LNING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length
Length
Width Height Sq. Ft.
Width HgUGround Sq. Ft.
Construction Type: Estimated Cost:
�%: ,
Driveway Curb Cut �dth Needed: Ft. + 6 Ft = Ft x$ _$
�
DATE��''�So' O � APPLICANT: Tel. #���%��'����
Call (763) 572-3604 for Permit Fees if mailing plication. Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ ��a �.S
$� '' �� °
$ �
$
$ /
$
$
$
$
�
.�i:
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contra�tors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
�� . 4
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BUII..DING PERNIIT FEE SCHEDULE
The Chief Building O�cial sha11, 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 macuier.:he�ein provided°tawi�:; r ,.
- �'OTAL VAI,UE
$1 to $500
$501 to $2,0�
$2,�1 to $25,000
$25,001 to $50,000
$50,001 to $100,000
�� 1:.1 1�:1 �'� 1�1 1�1�!
', 11 11 �'� i 11 111
. �'�- r .
. - . . �. , .� � ��
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$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 $2,000 plus $14.� for each additional $1,0�
or fraction thereof, to and including $25,000
$391.25 for first $25,(�0 plus $10.10 for each additional$1,�
or fraction thereof, to and including $50,000
$643".75 fo�' fi�rst `$50,000 pl�s $7:00 for eacYr additional
$1,000 or fraction thereof, to and including $100,000
$993.75 far first $100,000 plus $S.fO far each additional
$l,� or fraction thereof, to and including $500,000
$3,233.75 for the first $SOO,OQO plus $4.75 for each additional
$1,� or fraction thereof, to and including $1,000,000
$1,�,�1 and up $5,608.75 for the iust $1,�,000 plus $3.15 for each additional
$1,0(� or fraction thereof
cuxs cv�r Escxow
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet times $17.00.
Permi� 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 5urvey of the lot, showing the location of the existing foundation will be required before
proceeding with the framing. New Houses Onlv