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AF - 46920
Date: ��'�T� Addr City of Fridley, Minn. BUILDING PERMIT o � N. 4934 �� ,..�.. �.,�',.... s�: .___�_. �'.._.___.� ._.._..�.� __.___._ ��._ ,�� � � �, �. �a { --•-- ' '�� �. � � ,_ `� .-.fi�.'�` .(1'"`�.�._�;.r•� -_::,^ .__-- ----�'� � � .......%_ Builder �� _._ �` � _.�lr,_ . ,_� �, .�.r�,� --... ..--- "��� . �..��.,� .,�,. �, , _._.___. � � --�-� ____.R"°�:?'�t�"''�i ���`� Address �f � - �. �� LO A ON OF�ILDING � �4_. � .�'..�....._. s�t __. �.=��,�t,.�..�:_.._;.�� : No. ...�---- -`-- .„...._...�.,�„�.--..y..�i Part of �.ot ..--------� M/ ��i... � �� I' ,Ar-_-___.._.._---�-�--' .t -_ ,.._._----- Lot _�. .i.�... .. ... lock ._. ... ,►........--._.....__........ Addition or Sub�vi n �.(�_...>*�t'.�!�'���. `. �. �. ..�.�..,.-.-y---_... _ r�._.----_.... Corner Lot ... •- ............................. Inside Lot ....._.::....... -. . � � _. . �� . .............. �!ltback �- -�--..:.....::fi'� Sideyard .- - � ..,,t:.._..._ ..........................�---... --��------_... Sewer IIevation .-- �-�-----�-------�•-�-�----�--•------•-•- ............._.....----.._-•------�-- --...._ Fou�dation IIevation •--� ---�--� � -- - - � �� .� <. '"' --� o � � S �:�.�!.:�.... --_ ��''� _ ...� :...:.............. �:�'-�-- TYPe of Construction DESCRIPTION OF BUILDING Front ....�,.�'_-- Depth ..� _�=-,.�,. Height --�e±�.�.._.. Front :...� ......-- Depth ..._..... ��._..� Height ... ff.�l� ._.,.... ...........--� --.. ..- ---- - - � - � Est. Cost'�,0� -:-'S.. f �---_-- - - �. �. .._�.�.,�� Sq. Ft ..._�.....,�"�_.. To be Completed Cu. F� � � ��� Cu. F'� ..[�....�',�. � In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed waa�k in accorda.nce with the description above set forth and in compHance vvith all provisions of ordinances of the city oP Fridley. ---�__..-•---.....�______.W In consideration of the payment of a fee of $�„�:n �:"----.-, permit is berebY 6�ted to....--..-----•-----.-••---_- -- _- ... ... _ ....--�-----• ----...._..•---------•---...___.._.._.... to construct the building or addition as described above. This permit is granted upan the express condition that the person to whom it is gran,ted and his agenffi, employees and workmen, in all work done in, around and upon said building, or any pax�t thereof, shall conform in al1 respects to t� o��� of Fridley, Minnesota regarding location, construction, alteration, maintenance, repa.ir and moving of buildings ���J� '�e a�3' �� �d 'this Permit may be revoked at any time u on violation of any of the provisions of said �LUUI��$� ���! � T� � -;s'A.�, +� !'�A �- -_.. 4 _�:�::t,��� Building Inspector _.�:,�_..�_ _ _. NOTICE: This permit does no1 cover the eonsfrueFion, insfallaffon for wiring, plumbing, gaa heating, sewer or wator. Be sura to see fhe Building Inspeeto� fo� separate permifs for these ifema. �, � �� r 4 ,1� r�--;-�' i � � . APPLIGATION F�R BU[I�DiPJG P�T CITY OF FRIDLEY, M�F�OTA � 6 " Owners Name � ��� Buil.der ,�� Ad.dress �A.�� �.����'a� �� °�/� �`� �dress ���� .° IACATION OF SOILDTNG �,, ATo. � (� � 3-tree� ���� ��,�� � � t of Lot - �p�' � ., Lo�.������ °_� �%,�Blocic . � Ad.dition or Sub.Div. ;�� Gorner Lot� side Lot ��Set Back� �, Side-Yard �` � \�`� . . 8� ELEVATION F�UAIDATION ELEVATIOAI Applic�nt attach to this fo�cm Cert3fic�.te of Survqy of Lot and propased bwU.dirig location. D�CRiPTIOiG OF BUILDIlJG To be used as: _,_,a � �� : �' .�z F`rant � � Dept �.�. �ie�.gh� � ...�.._._,,�_ . . ,..., _._. . .� Sq. Ft. ��� _.,.�. Ft. .. n � • � � � ,.,� , �. Ft.�,� � Cu. Ft. � Type of Construat3on �»a Tstimated Cost �� �� F , _._..� ..���� �,.�.._r. To be The undersigned hereby makes ap�3cation for e. permit f or the work herein apecif3ed, �---.y� a�ree5.ng to do a11 work in striat accordance with the C3t� Ordinances and ruliug of the Depart�en� of Bui�.dinga, and hereb� declares� that all t, Pacts and repres ta- tions stated 3.n th3.s application are true an ������ � r � DATE /� s � ` � � SIGNATtA�E : � ,3y�.� • (A Schedule of Fee costa can be found o�th� l�eeerse Side. i �, �z� � �� ,��a � :� BIIILDING PERNlIT FEE SCI�EDULE S`e�et3o_, n 2. The Inspector of Buildinga eha11, before issu3ng any pex'm3:t for the ereation of any building or structure, or i'or any addition t+o ang ex3.ating buildin� or atructure, or for any altera�ions cr.repe.ira to any e�eis't3ng buildin�oor structure, upon applica.tion therefor� require tbe p�.yment by � the appl3can�t for such permit of fees to �11e amouiit here3a beio�r set forth and 3n the manner herein proeided to-wit: 2.1. For any such permi.t for the erection of any fire-proof bu�lding,.other than a garage, warehouse, factory or grain elev�.tor, or for the erection of �y fireproa£ addit3on, for simi].ar occupancy, to e.ng exiating bui].d3ng �he�].7. be e.t the. rate of �1.40 for each one thousand cubic feet, or f"raction thereof, �.n euch ct�.bical contents. 2.2. For any such permit for the erection of any fireproof garage, ware- . housQ, factory or grain elevator; or for the erection of ang f3x'eproof addition, for similar occupancy, to any existing building shal7. be at the rate of �1.25 for each one thoueand cubic feet, classified as "ffreprooin by Section 502 of ths Minneapolis Build3ng Code. OH USES 2.3. For aqy such perrm�.t for the erection of any non-fireproof building other than a.gaxage� warehouee, factory or grain elevator, ar any non- f3reproof addition, for simi],:ar' occupancy, to any existing bu3ldin�. Permit �1.� for each one thousand cubic feet. GARAG �� 2.4• For any such pera►it for the erection of any non-fireproof gara.ge, warehouse, factory or grain eleeator, or for the erection of any non fireproof addition, for similax occupancy, to any existing building for each au�ch building or addition. Ninety'Cents for eaeh one tho�d cubic feet or fY�action thereof, in the cubical contents thereof with e. minimum of �4.fl0. - . For the pu�pOBe o£ computing fees for building permi�s the cubical contents of any building or addit3on to a uni�orm height throughout by multiply3.n� the ground area covered from a point aix.(6) inches below the floor line of the basement or cellar to �he average height of the upper aurface or f�o the a,verage height of the roof .svrface of the main gable oi a pitched roof, 2.5. For re�.irs or alterations to an existing atructure, the fee shall be at the rste of �3•00 for each Five Hundred Do11ar`„� ($5�•4��, or fraction thereof in the cost of all proposed work. 2,6. In no case ahall�the fee charged for any' permit ae set forth in sect3ora�2� be less tnan �4.oa. �� � r"� �' � �,"+�-'a►i :�%'� " �� ''� � w d � � � � � tS y p t,� : y ' 0 . � : m . M : O : a 9r7 . t� : � • � � N O �i � � a � y a `� � � � � � � o � o�o � N � o � O • O � . o . . bd : : � . . z � 9C �4 pC N r � O O O � � � � N O O y � � x � N � \ - � � � � d � � � z B � � � � � M � ������" �� ���`�� � � � � M '� Q' ,d � � o a ,� '° ' ryi a N : � � ; en Gl _°o ' � : �Q � , � . . O . � . . . . : � : : : : I I I I I I � �a �e �e �e � x l'.W N W f+ h+ � �I C�7� p C�7� O O O � En tsi �s v� tsa tn H O � 0 a x � r.. � N N c � D � r D —�1 T �/'� �I 2 m C r m * � �r a. p ~ � � Q' � o m � � �• �� .� � � � � � � � � � � °a � � 7� I �' Q `° � � � � � °' � � � '�' � a � bd � y � � t � � � � �' � .� � � w � � $' o �, I � N N 'J � � � WATER � URINALS earr+ ru� B/�S1P6 SINKS wnsr+ rw�n ORINK. FWNT. SFI�VRS. FLOOR DRAINS CJITCFI B/�SINS AUTO WI�SFIER GAS APPL GAS RANGE GAS OPENINGS a • z • �y in D A r p � � �� � � � .� � m b .'�, a� � y � � ���� � � � � 0 � � �• � y �° O R. �� � ��o N�, � � ���� � � � O � �O ��.. b � �� � ro � °� �� p��' o n a � ���A.° H 0����w � tiy a� �� ����: ��B � y �� w� �. � � � � � y � � 7'i r. �D � � ��� ; �.. G �d r'C A � M O �"� a Rx � M � � M � ►� va � � m � � 0 D � � � � ` �o '�' � � � � � � � �� O M � � � �a� � � � y a o A �. d V � V Q O � �'d � • �1'l N � i � ,. . 0 CHARLES R. WEAVER HERMAN L,TALLE VIROIL C.HERRICK ROBERT MUNNS JAMES D. GIBBS LAW OFFICES WEAVER, TALLE & HERRICK April 18, 1967 Mr. James N. Hensley Health Inspector Fridley City Hall b431 University A�+enue Northeast Fridley, R9innesota 55421 Dear Mr. Hensley: 316 EAST MAIN STREET ANOKA,MINNESOTA 55303 42I-5413 6231 UNIVERSITY AVENUE N.E. FRIDLEY, MINNESOTA 55421 5B0-3850 1 have received a telephone call from Mrs. Donald R. Molitor after her conversation with you about a eommunity well. She told me that you had indicated that the well was unsatisfactory for human consumption and had condemned the sa�►e. I suggest that you issue an order condemni�g the well and ordering it to be filled. If this seems reasonable to you, please proceed with the order and furnish me arith a copy. If you heve aMy questions, please give me a call. Sincerely. n �"� , � �� � , � d�W�JJh dirgil C. Herrick cc: Mrs. Donald R. Molitor 560 Northeast I ront4n Fridley, P4innesota 55432 s _ • cc c City� �:gr. , . � 4. � -- � `�irg il C . �I�rri�k � �` ' � pltun6#�g Insp, � ' � � _ 'i . . �t.ice: �ept, Pl�ss � � 1, date a�d ai.gn copq aad return ta J. .:�i ;�iens e�Tls�tuk pau, - - '. 32�252�^,��� - _ ���Z, � ,;��� . � " .� E o� ��' �� � -� � ti �� � y_ � w �1 a � ,�'� ' � �'F; ,� �' ,_�-�. � � . - , `fl���. �;�iV�y, ,� � � � ,: :�; . �i�'t� i��l��' �.. ,: . ,�grti, ��. i�a7 ;_.. �h �.... � j . . . .__. _ .h.� ' ._� ��i''�i��� i1�l�i �� ,.._ _ �': 'I`t1!: �'��,"D • ��lt�i.Q Rs �'A�,�.t�,' '�b� �A���riRt T3'Ei�'�if�# �t; .. �'�.dl�r, �i�e�c��a, ���� ` a� ?�iixQ��� I T t�A�'Y �t3�'��+1 Z : .: Y'4�3 1� �8� �i��`IF�� �'3��' T�E C�°-�I3'�.' �L �QCA"i'� �� 3�� �RCi�E��i �T. e F�;ia1�LEY « �1=#��l���fi# ! 3.� �:EA��.' �3�3��� : � . �E�:Ei� S I�i�fi ISA�tC�; . B�Y �54�;�t A�` A�T �1��N � i'� f�i ��=E�' `PI�3`�� . I+T�i�� X� �1 R+�D� ��R�IG� Ai1� A�1�'�.��`�A�LE Wi�� ��PP�'S�� Y��l` ��i���Y �3R��� :'�O 11�8l�.`.� Sl1�� ' ttii,�I�AI�t� H'!�` _ �AY �, 1��7, �� �"� C�:'Fx e�� ��a�,� ��L C�.U�E ���� �is��L � BE A8�►�, , " _ � �� ���� �it� +�i' i�idt�r 8�►��d ��' �r�ti�&; �, � . . �, �� _ �4 I _ W 0 . � 0 r � — __ . ` _ .. -- ,' nARRY S. MARKLEY, M.S., PRESIDENT MAX C. MARKLEY, Cn.E., PH.D., VICE PRESIDENT �� �� rS � No. f� Z'�e l�ar��ey I.a�oraior�es, In�. BOX 2043, COAAMERCE STA. MIf�1+VEAPOLIS 13, MINNESOTA ' . ME 3-5477 _, , �3 �t,j i • T� • --,....�__._: _:a _...._._... - i.: :' : _ � ii '€p. � � ` -�' � -�`�y _ .�.:L' `_C'.'. .:':'.`-. €..°, i. ';". f s. y1[e, find that the sample morked• -°�� ,�-- -�`�= �� I : ,,_ c';;�: _ _:. __.-.-o -- ' � -a ,... . ; ..., '. hos the following analysis: t-::u9..s� � la__ ._:d., :2 :��L`�'t;: ;d�'- �.�a� �i"3ci: ` � � o�i ::d:. � �1i�.i�.'.. �',r:�i _I."L� ��CS' y � t' �--'rU"� C•=:��i� V i_ '-9•:it .N n„�.:,� _ . �%'..-�.i':'..a ...�`-,..-` �. ^ � `—� ^- �c. i : t_-,. =�+'_,� '�.iA��'. . •( • - �`...._.. F'_'.rve'ti, c-� `i�� l�i�:J.:i�,.r ��i� 7• :7 � I i� A Y � � T _ � - {+ _ '� 1 ` • ' `�.�:.� eE: »f ��.tiS � ,) i".� f.. c:�h .. _.,....:q '� u 1.t.3. •-"L'�.^Lii�� ::�4'�k. �'�..�'{'..=f �. Vf° � U �Si _�.Y_...._ �:� �.'°:.Z;'.d.o� I rro�:.., � �, .s_..:.ie �.�KL i�6:'1' :?+.�_ i_).i.i: .�.�.+�:.� �Y'�_s. ',,~,, ~ � e.�t -.., ' w 1 .a3i �f �-_ �_4Gr 4:S � . I THE MARKLEY LABORATORIES By "� - - . , __ - - � , _ , _ -, -- - l � � f,�, � V" ' . � .. . � . . /�, � - � 1}� • ' � - j} . , . . . , ' .. . . � . �...,�..__ - - , . . . - ATTENT101J OF: ,(--_—.— _ �- _ • -�!�= t +=�_' -_ �'-_ _� �__;•= . City of Friclley .. !�1•J�l•�:1. TiR�1}���•l�l1•�=��i�i�i�i LEdin,a� Minneaota _ 55424_ _ , SUBJECT Health Problems Page 3... DATE May �. • 1967 � Q) Messy property and ducka ( I have given the complaint on the ducks to the Bldg. Insp. Dept.) at 1136 - 73� Avenue N.E. (Lot 3, Block 2, Central View This property is behind the Superior oil Station at 7315 T.H. #65 N.E. _ :� : - -` �^� ��r- ana Lot 20, �lock 2, Spring Lake Park Lakesiae) a�med by Milton Ouime�tte, 3846 Central Avenue N.E., Mpls., �an. . (11) Target property - dump3.ng, debris, etc. just off from T.H. #100 next to 688 T.H. �100 - Mrs. Hebert, across the unsurfaced street between Cheri '' 9 to Max Saliterman, and we have other correspondence on this in previous . �s�I , ny this prob�;em. Perhaps Target will icake care o� this too along with the � problem on r w en ey s ar eve op g s proper y or Street? Mr. Hoffa, 551 Hugo (Su. 4-7616) was in the office F'riday and I —_.__��1 . , _.. SIGNATURE Fr�.CZay� Mr. Molitor askecl that you call him at 788-9946 somet3.�ae bet-caeen REPLY: F A.M• c7.Yla 4 P.M. E30IR�2 P 011e S - . _�. Propc�r�y �.round dcaellin� is clean. �tes� is a� auto grave �rd. ��s . r. in or� � w� ZI-�iave t� o ta n�.rt agricti? ture --- ner�it. Ald c�.rs and trucl�� is zoaix� �robler�. -- . . o ._�c� a�oaae " - _ 11. �elieve thi� is bein� �a�cen e�r� o� by T�.r�et � _ --- -. . t ��Arking w�tl� ���s. �erri c�� o� t1�i� . DATE 5-20-�� SIGNATURE - J�� REPLIER'S COPY- RETAIN POR YOUR FILES CHARLES R. WEAVER HERMAN L,TALLE VIRGIL C. HERRICK ROBERT MUNNS JAMES D. GIBBS LAW OFFICES WEAVER, TALLE & HERRICK ti��y I S. I 967 Mr. James Hensley He�lth Inspector Fridley City H�II 6431 University Avenue Northe,st Fridley, P�innesot� 55421 Re : Condemnat i on of t^Je I I De�r Mr. Nensley: 316 EAST MAIN STREET ANOKA,MINNESOTA 55303 421-5413 6231 UNIVERSITY AVENUE N.E. FRIDLEY, M�NNESOTA 5542f 560-3850 Enclosed ple�se find , photostat of an �n�lysis of the w�ter in th�t well loc�ted �t 551 Hugo Street, Fridl�y, Minnesot�. As you know, this well was constructed for the joint use of several property owners. Some of the property owners h�ve objected to the condemnation order requring t-h�t the well be filled. From the inform�tion th.t I h�ve obt�ined, it would ,ppe�r th�t the construction of the well �nd its present condition is deficient, but that the wfiter meets pub I i c he� I th st,nd �rds. ( wonder if this condemnation order should not be in the �Iternative so as to require the welB construction to be brought up to , s�fe st �nd �rd or, i f th i s i s not done w i th i n a spec i f i ed t i me, the we I I i s to be filled. I would �pprecirte your thinking on this matter. Thrnk you very much. VCH:jjh � '� Sincere , � ��� Virgil . Herrick City Attorney . . �� la �/� C�� . � , -�� /�� � �l,%p� `"' � LAW OFFICE3 �WEAYER, TALLE & CHARLES R. WEAVER HERMAN L.TALLE VIRGIL C. HERRICK ROBERT MUNNS JAMES D. GIBBS �� r, i � �,�,.ti., .� '� �, .,�,> `���-� � � t� - June (, 196� Mr. J�,mes H. Hensley 5600 Benton Avenue South EdinA, Minnesota 55424 Dear Mr. Hensley: HERRICK 316 EAST MAIN STREET ANOKA,MINNESOTA 88303 421-5413 6231 UNIVERSITY AVENUE N.E. FRIDLEY, MINNESOTA 55421 560-3860 I acknowledge receipt of your letter of May 23, 1967, reg�rding the community well located at 551 Hugo Street, Fridley, Minnesot�. Thank you for the suggestions. I have sent copies of your letter to Mr. Hoff� and Mr. Molitor together aith a statement f rom me i nd i c,at i ng th�t e i ther the i mprovement s th�t you I i st be m�de within the thirty days or th�,t the well is to be discontinued �ond the shaft filled. VCH:jjh S i ncere y, � � �'`� � � � . � � � ;, �� �.����`'��. ���:.:/: 'j� .� � J" -�r` �-�/ri Z �' Virgil C. Herrick City Attorney 7 � !s_� ` �� _ � �� A c >. S'�At� C�� M�i�1V��TA +G�ihiTY C�� �t�1�i�A � � ORIGINAL�FIlED IN Tf91S 0&FICE 0� � �UN 9 1�57 ' __ ; _� f \'�, ;r. ,, e �+ �P°• .. �i�,�ohUva'� CZ�:3:''�i� _ � � Clertc ci Dictrzt Gc�sri f; . �n�E�� C��e�y, ��'ii��c�e�o�a t�,'��i'��T ��i�i' .-- By ���� ,�Q��i/��. �����T DVPuiit �� � �� ar , �'��w' ar � . i� ..eF /Xlll� �i f7���{j , � ' � , � ' , � , � , , . , �i�t�nt��r ' � ; , ` � , , : , ' � � . . . , . � , � � aR��R TC3 �1"1G1N% +�,U'S� ' vs. . , . . , . , � . . , � � " � '��IPG�RA�Y ���iRAl��ING �RT�ER C t�r o'E Frx d! ��, ,�c�s ,H� . �i�1ey ° ) : . ' . ` v� 8' `�,�' . �and i�r�Qtd �R. �iol��r�r_ �+i�'biNt � , , . � �/ ,,. , , . �,, � �o� �ne� �vi�r,� Ro.�, �vfr� . i�rv,+� r�arr�s . , , , � � . ae�r unkr�owt�, , � . . , .. . � .� '.. � • D�f�ndta�t�*'; �� `� ' . , , , ,, � - , , , , , , � � � �. . �. ,.� ;. ���- ,. « .. � ;� : . . - T+t� T�t� A�QV�t1��� �D���ID�►rt`�z : .. r : . , � , �. , � � . . �� . � l�P�hi �+�in� I� �tt+�ch�! �c�m��t�# s�f :tfi� `pl�'ntQf�' ,c�r�d �i�+� �fF�slav�t of �a ;�plain�t�f ;�u�rti� ar�d ,v�i�ying th� �aid �C�c�e�pl�in�� a�d � fii�, rr�ct�fan �f �h�r A, �, � ,, � , , � . , �►�d, �at�y �'�r �t�� pfatntiff, .d�� ,s�wt�g �t� b�r+�, m�d� tficr� � ±�c��nay �tat� by r�n c� w1��ch �n�ury� wi11 �svfit ��d ���li� mou�,t w��! 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Fridley,,... James Ho. �°��nsl.eX..and...Donald...R,..... ..�4���?�.....a��...�h�...�...a..nd AAarY....Ro.�.�...�!.�.�...true...nqmes are unk�o�..yi� ..................... ..... ....... .... ........... ....... ..................................... ...................................................................................... ................. ..... .............Defe�da�sts iaa t)u a,Love �tled a�iosi in tha �um, oJ Two Huridr�d Fifty and no/100--------------------------- Doll,dra, la,�a�ul of tlee ; ............................................................................................................................ �n,o�1 __ ...... ... _.... . __ ... ' ��a st�, t� be � w� t,�e .atd.... C�.tY... �f. ..Fri.dl.s.�.....,,j�.m��....H.......H�ns.l�y....�ras�...�ns�ld...�. .......... ........ ' who`e true names are unknown, f�heir � ..MA.I1i.#G�1[.....�SI...,.�h�...��...s��. .Mot�l....�$,os..� .... ...........her.ra� exeauiora, admi�ietrc�tora or o,aai�ne� %r wh� � pa,ym,e�k uwall anat tncLb Go be mad�a, aoa joia�ttb and secr�all� bi�td ouraela�ea, a�+,d e�ah o f our h,eire. axeewtore �d a,dnuntatrcztora, 1Srm�lb bU �h�e P��^*• Seaud wtth our maZe d�d d,�t� th,�s ....................�th ...... . o J�ne .1� 67. � � _._... Tha oondit�on of this obliga,E�on ia �ueh, that where.as the nbot�e nam,ed Ylain.tiy� h,a.s dul� applied ror m Arri,� of Infunat�i,o�, m�{ainat aaul Defen�lmnts ��a th.ie cietioz, o,�;oordin� tm the at�atute d�. suo� f caea provld�d; . I � �1aw, �i�rrsfa�r¢, I f tha auid Pldir�aij� rhall p�y the said DefeadanGs a�oh da.naQa� ae t he►� i Temporary Restraining Order and Temporary (�junction austcc�sa bb redao�a o� adid Wri� i� tJze CaurO j�a,LLy deoides tha-t th.a s�aid Pla�itati� � 5. .. ...... noE � � entitled th�rato, tken b1�ala �1�. j�io�s aTta�ll bt �oid; oth�ertaiee to rear+ain t� �uLl ��r�e. Iin af.�st{mpttg �&erepi, We J�o,ve Jee�+eur� ast our ha,�td� dnd ieals �liir ... ....... ..._ ..8ti?.................. ... . � I Signed, 3ealad a� Ds11+�ed in P�e ot � "� � � _ , - - I � � .�-: -�..%.�.�::: .:. � . „�,.... .....:�c..�.. ....................................... ; / . � � I " � �-� y . . _� ..1� :.r� �.4J.L::..��.i:Ln... .......t` ... .................�... .. ...... . 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'� F�� �uv r�ul ... s�.� _... �v e�ae �� �ncrar�� v� ��t� a�1�� �ar� �v '��eu�g jugo�J.ioi �{ �naora aYae �n `� �'i�r.COx�p aao�ed �af� �Q o� �esmau� a�u o� .................................................................... ... ............................................................ .... ....... .. . . .. . .. . ......................................................................... ...... ....................... _................................ ................. . ............. .... ........ . . ... ............ .. ... _... ...... °fi�-I '3 �wl!W �v�dd�s /1'llvu°'e�d 'Rrreno� p;rn� lo� pitv uz�{?pn ............_.... ........ _........�•��la�...�����... ...._ . ................ .. . .... O �a'UL ALO`� � L7 BT .Q .P, ......v�Ori.r' _... /U "°!� ....._ .............. .. ......... 'tL ) � y�.�... .... !� C .... ..................... . . ... ....... ........... . .... .. . . 1 �� ........................................uidauuaH ,�� r�u�no,� 1 � t�?�Q�3lility�f �Q a�13�� , ,a _ ACKNO�UI.E�I�ER� 0�° �iJYiE�'Y a . D (�y Atioeteey in F'�et) ' • sTAT� oF` N9I R�N ESO�'e4 � COUNTY OF �EAt�IEPIN �� • p� ���a 8�h d.y of ,�tAII@ , 1S 67 , Befor� s�no� � notas� p��+11k �n and tor esld �;�„ Connty� personaU7 €+q�Ys�*� PEL� i 2ClC ,� .`�i11�lt1�.� P�o �e per�oaallg� �aos� and � bY �' '� tisat he is the Atturr�e�-lse-F�t af t8e EI��IR� FI�E � YA�IPIE Y1�T8. CA., n eor�soaetion ci Ousahao `��,.•�,, aaue duly eworn. �+1 eay+. ., _.��:_ p,;�->,�i;-� ��ka. ct�ea�ed. or�a�ise� ard eslstin� u�er as� �3 v�rEa� ���ws o! th�e �tste of Nebrae� P�a� t�e said i�att�meut ,�`�`^ Y=��':� aa b�i►alf oi ¢he �sid eor�renetion 6� �r�' ��� aR Dia�rr aard t�►at the �►Id � � ��a � 7�158 sa4d iaa4�nane� to be tdw 4ree a�t s� daed m�i ��. � ��.� — ---._.___... ='�• ;:,::,�� ��rz�es��f�a t�� �e� he i�s seit�rE*.y � aii� w� �f�+ut �tfi�ng the coapoYaCe �ai � aeid eoxporat�n. �,>'� . A��nea2�.!��9 v�a , � � . ;�;`.� �Y�� �U �, i have t��� ed9 � w�! s�fl�ed my �ff'r1eW �l a � ` ' ;��:: �'i E' � � g � , :�e �b3t � gerr � ab�a �fi�e�. i, r -., _:. r,.-.... \ -^, 5 � 9 � F r +�i' .W���Q'f� Q3��:• �qpaT �y'Ap�q�qsy�` _ fi � fi! [ 64fu3 tl 4� • . '.. �� r��� Nm�+ e���t. �u ;';' �_ _��� � �� • ---- ' . ��....__ . .�' ..� n,,:,'�. ,. ;� sa � � � l�t,�ry �bli�e ' 1 !�: - � 'y_, � 'Y - ;� � ' ���' ��t�:: r, � �,��: 1�_ te, ,�t• � �• �. . ::�;, :t' '-%(;�1,?� . �?;: f .� + 1 ' t;� .�f� efs'3 a�. � - . a..�- . �.;:. � irv.�. aY3��$d )!�9 1 k. t.1 i�; ��s��BC�+i a �i�••°+a`'"� ''� °A"`+�':aE'`e � L`#f34 lrwt?1 GY �i L°3dC^+� "'.cll� �O �B � � i� �7�l8 P.$EC41� �Tiit �8� � � !+3%i. � �. �w ; s.; ��. � }'? .+�1�� ,�i�''`,�.�; =�P:`.: :'°�'� ���`.`�'�+�� ���'i?�Y� ��1��°lo a c�a�porat�e c� �r�a�ed t�r the lav�se of the Staee of ��� '� f•::�+:�>-? •��:� :� s� �,.+,� c�k �. ��saagey aff ��u Siate of IVebreaka doea hereby m�lce. conatL � A`�Z� 3 � �` ' ��,; �►'�o►r�,t.�.�,;���:, f> �.,�.�;, �:t,,:-�c�&, w�!, c�a1 a�ee�' d�lati-er E�s a�� aa 'r� �haDf ai aurety and aa iie se4 and deed: ,� _ �� .�.,� �:�'"��,T , � {,.--,"°"�,,.�r-...s��.,�.,�,._d�.,,�rs°<.,yprw�.�--i—.,:--�,:� . . �fj'��� '.iti�"� iisi viH.°.�:�e�:�t. a'�'�'-'-�' C;� .:..'s `3•. 4�03'i�'F.'�St K4�T !4� A � ,� . «a `i i - _ -. ,ro . . . . . ��� I . . � �'�iW1L.� �t�'a 1 ��g.j-. '' � • � = ^:. k'i ...� . :� , , _. _..� . ,-. . . .. . ► . . .'�- ':° a-� .: A[ croflitare _:, , . ¢n�,r �r r.��. �� . ��+ tr.� �om�any e3, FFU?F'!�TY .. ....�.�e. < � .-,. , . ......... Ufying bond t�i �t''.:2i7SA:79 i�:''� `� W'FC V y�'C; �.;9 sa►.i: ���' kbJAZ. OR I` ��i.80NAZ, � �OP�fi'1';' ..... .......... .... <. ..............^r.19 wben tiste �omPaa9 ^.c� qtlfll�Y)'L!!B �1UI1$ RiA%EML!M PENALTY t A j �100.GOO.OJ (�) $ 19.000.00 t�°a x°rre���cr ��r�.rc r�r-3c- ss+, o��:crai, n�-r n�T*� ...............�ccy.LTl?Tll�3 Pnprt�eB. �,nACgt��= or tas coilectore t^� S :.��t1.90 ii►y l'.�ii°11'i _�'.u"J�: .................... ...............E`rrT.UDI.Til e�n nanaltT. etrt. euysreednaa or Rttarai:_ee oP e, Ju�:,;^�en', �: daiend�uta reDlec7n or ln,junct:oa (DD S ?.P�O.O�J 1�y i,!'�C'�:°.+ ; F`,?tCLC'DING bends �shea tha P&�C:.31"i . Stace ia obilges � E i 8 S,OV200 (.� F�'.�I1,7 fiR Il1�TF'3�:%isi ymnided 4hera is aLtn.r�2A to tAla �ower of Attorc:eg, writtu:� :,�,tli��lcy in the P�rm ef an �rtient i�6a.tP� er Lclorrnaa, ol6� ed by fbe Chairmnn ai the S*.ard. Presldent, Vir,--F'reA; ]�r.t, FecretarT. Treaeurdr v►���xaedES+tfSerr,+t�;- ,�f t��e Es+st+lre F`1r3 send Nlws9ne Ins3vruho8 �C'.am�an9 mD:wtfl�lly auihuris,�n3 ![s aaa�cutlon. �el z� i�� f"::iE �� !�:t�F3.l?'v� !i vSI.T�PdCC �Q�ViF',Ai`d�' chsr�bs ew fuliy ru��l to CI6P. s.�me egtent ns if suc6 b.�ncis and ua- �s cb,4a��toev in the nasur� F4�erc�f M�exe aeg,ned by �n Fs�.-utive O�ice� of �'�ii IRL• �I�k: AI+ID MriRIIeIE TN1- � , a�:d�t!c�ied �ai �y �ae other �f eaNh etF�:urr, a�d herebp ra¢o5e3 a:►d con6ru� all that ies said Attorney�ej-in-f9ct � �a%��p�� 4Y��. 9'��'py�q�g /'` A: '�`�� l.Lfl l iH" ll..: 9 I G �is ��t ��f •�:cr�rq ass g�an^�e� �na�c�r an� �y aut�ori?�� of ,4lr2irle III. Section 3.1 of ehp r3y-Laws o� th� E.,'�7�1Rfc: Fl[3E A1�1D ii1Nl4��id'� �A.�' �=�i by Rear.h9tion of tiae 9aard af f)ieec��r• c!���� adopted ae follo�,ti,: ���.� ��R3� �9 u5' OthPi GE1i4^,��31iL�Tl? O� illC C:i�1i:i�.ClOR F:1.7�1 1TP C'�f.CUC►(� :fi ��7C ccrporate name Gf lhP �Y �`�te �ke'�ee�sa n� tt:e �I, :1rc�;i�,;nc. �ret,�ry. enp �es�t¢ZE �ctefarv, � reasurer, or asny dice-�r�idLmt, or by eac,6 e�t�r e�fl`ea�ts ea the �+-:�� e,¢ l�isaet�rs�as �u►�orize. i�ie �eu�a,an nE it:e Eboard. E'rsaiulea�t, �By� `'ic:: Preaic�.gt. �mcretaryr. any Aa- w�srt �ta�y, as fl�s �'aeae�ser me; aggr.+uet �'�itaereya in s��ct or �.�e�is wLo �hA�l ha�;e BI:IIIOPIty it+ i�eue bona�, pouuee, or un- i�a�'ha�:�*v�+i�c str�sr►r u� sl� Ccam�any. �-� crsr�c,rats sea! i� ssc8 s�ese�r� (o: i�+s validit�+ of un2� bands� Fvlicie•. ti�4��'eita�sn�s crr o�r ��Ulie� �f °�e cFS�ozaSits�." p� !! �� t%a�t t�2e alzcaye � a.d��i e��e-+� c�y. Im �''M�er� �J°�ae+�i. tlee ��1��£ fl�2E �4('�� !k� ' ae ca��s6d �la�,� �,�e:ks t� tr �►,^>,_�', Ey ats �a�c-$�rc�eeR . ea u i�Pre!o nfgiaed, du4y �::r.st�d by itd Aea:�tant �:• seter:a t� t4+'. ��q rf r"ru�us2, .�,etesa: �., . �. � • f� � � �� �d �� A3e�+.�at �crees�y 5�i A� C�''F i'.`Q'.�ai'aF:�.�iA �i��1f � !' t� �: ��.Jr'�L' ��: l = $ .. E,,'U�3`1�� Fl+i� AN9 ���;+E* il����.�k!!�"i�: t;��!�f'� �/°�,�,�,�'�-'� a� V icx��s.!si��E �'� �* ��'� � Ag �w.�re�a, �i.L1. ��, b.3�re �e �rc��nalty caaaa►e Ynle {'��tan. ro a�e �oov,mm. who bri�..g by me "��"°� ��.� ° � a�s;. i�s�2 "ss�i r�i��e aa i!r �aaAt� of f�ca�g�s. S�ate of PdeLeasi�a: t99�t he is the Vic�-Preaieleut of tlte � d � �"��k, � '�1'�A�lf�"� C'�+'V��#�, �„� co�ar€,t�ae �'escrs��txl in end w.�ecU eaecuted Che a�ve inatreiment; tbat ke� �.aF� 4��-` ��'i -ert?�?�.3�*�0 �ad a4ze se�D effis�d to ehe s�id ��tnamene i3 aucS� coa�rate seel; that it rvas eo afEiaed by order of ti� ��.� �_:� `��� - �r� ;:� e`-�" r_or�:�e�a�rs nred t��at !4e s��e3 �a,s naane t to � 9i�e order. fi- ^ � �y ri �tiscsac, +c r*� : °�� r . ' � x�'.��°. j �,• /. ' � %�` `� �'`Y, 3rd�g �3 i�veaT�-•. 14�> .. _ . �- . . _.. �r . � � �' 0 � �r f :� :. a e � • CHARLES R. WEAVER HERMAN L,TALLE VIROIL C. HERRICK ROBERT MUNNS JAMES D, GIBBS C LAW OFFICES WEAVER, TALLE & HERRICK June 29, 1967 3I8 EAST MAIN STREET ANOKA,MINNESOTA 55303 421-5413 6231 UNIVERSITY AVENUE N.E. FRIDLEY, MINNESOTA 554E1 660-3850 Mr. J�mes Hensley City Health (nspector C ity Ha I 1 Fridley, Minnesota De�r Mr. Nensley: Mr. Noffa w�s in to my office and wanted � st�tement from the C ity of Fri d I ey a s to what repa i rs hed to be m�de i n order to comply with the District Court order. I would appreciate it if you would furnish me with a memor�ndum st�ting what is necess�ry in order to bring this well up to public health standards. The Hoffas are anxious to complete the work so as to abide by the Court order a,nd would appreciate a statement from you at your earliest convenience. Th�nk you very much. Sincerel , - � . j ;�//. ` ,. �'"�' E"' . _ , - q ; � G �, Virgil C. Nerrick :jek �;_ .�.' ������ ��d 3��� �'_�. ���.�.��i7 €s�$�� ��� �et��'% �'���l�. �'i'$,�i:�.�p"y 'r�3.a�t��O't� :C �as g¢+.�. �� f f �t : In e,c��►rc��n�� �a�.r.� �=�i�n��o�� ���a��n� �� �e�1.��i �.+���i��i��a ���. ����, ��C �,� r�c�e��� �� ��� �u��£� � t�,i� �s��rd� ��-:� �aiL�a�s�a� i.re�c������.o�e ��,��� ��+� .�.�aax���� ��reet w��.1: . �;� � ��.��r�� ��� �3,�s��u� �ist�ace� "b�e�caeen ��� ��Sl a�d an�► �ae���nt�.L �1.L���ton �t��� �s ���.� �e��r L�, �erati+� ����, ���car�a��� �i�l�, �e��3.r� �i� c�r c�s��r��.. �e �i.s�i�ss� �i�t���� °��x�t a �*�Li +�� � La+c+�t�c� �r�:� �t�� �baw� i�3���c3 iC�s �,� �� ��„ �� C�b��fir� � �c���.��d ��t+�*��nt �r�� �h� t��il �o�atr��a� �� �� ��+� ����� �� �+� s���..'��, d�� 4� ��� ����., �a�s �'�� c���e� be�t'��� f���a�'�€�� �d ��i�+ �9'���'��� f+��^�i.'�i�� ��i�� ��� ���i.�� ������� ��,re�u�°�� �uea �a �cl��� ��d�n, r�s�.ft, rofit�,� ��c� �1��, �►��t� �.i�a �e�r�i�y► ��� �*ei��t a:� r��il �t�i+�?��te�� �� tl�� t��a1l ������ ��° �����.�� +��.�� ���3�,�,. 3 � �� c�� � �� � b� �����c� a �fs��,� � fl 1 �+� ��t�v+� t�� �rc�ur�+� ��rr�zc� �aae� �. re3�far�a� �r���et� �1��� �4� � �c�, �v��:% ���s��i��el� �. � � c� � � �t � �, �.�sr�� 3 �4�� g+�r f�� a��,q �'r�►� �e ����, �t �e �i�t+�1Z� �� ���� .�i1 �e��'a�e �d ��a��� e�at�r �il.�. � �wa�► �'a�� �h,+� �a�i�g� �� �u� �ta�d �� ��� �w��.i �a��a9� ,��in�c �us� k�e ����.xe� ��1�� a ��a�i�►�y ��s��� a��.�,� � �+r �.'�� ���� �tu�t � ��e��� a� � �att� �hi�. ���s �+��3 �tm�'�ce dr��a,g�. ���� t�a� a�+�� ��v+� F�� �����,���d,. t�$ w�ll �u� t i� de������A�.t�i���. s`�i� �T��t�'���3.+a� c�tp i� eax�'i�� �ut �g �€��it� �r+�.3.r��r3a .����rr�►► �l��el� �� ��a� rati�►� �� ��e �C b3.e�+��i tc� ��� ,��Il�n�-- ��' •��a.���r a.�t� � �s�� e��' ��� �,e�� ����� � �vt�t� t�. ���y +�� .a�'.1'. �'�.�."1d' '�i���� '' �,'�s?� „ � +�' ���%��;% � - . t 1 P ��i �,���h �3�*��a t��� ����� �� �t�e ����r.� ca�� ��.� �u���.t�e +�� �;�r �=o� 'A'��. °�! � C''.f3�'?�+�`�4� ��'s�t1Zt� � �.I�f � �.R'� �ii� �,t�l� i'�!g �l�7flt1� �,� �'3�3U�8 �, �����e�:Sl� ��'-r �€�� �•����e� ����1+� t�: �:��e�' �r�� � w��l +�nt�� ��e �t�1����� �c��� d�����a�ar�. � c��*&a�� '�����r�.o%�� �.�+�1 �, +���m�.eai �s�� n��p� i�al ��a��.���e��a ��� ��� s����� �u.�� �, ��. I� �r�� ��r�r ��y ���$�i��. �r d��f�i�i.��.+�� s�it�a ��e� gbove ac�q������� � ��.���� ����. ��+�e �+� ���att �. �t+�r� tt�ti� y?�e� , .3�i�� ��. �en�l�y� ���t +�� �3�1�y �� �� �ea1�1� �e:._ �n,.' l� �C : �`�,� �� �.� �l���.+t`� �°tl��Z� �������� �iC�t �-��� �f�3t:G ATTENTION OF: ___.�._ .__._.. _____.,._ __ ______.. _. .__.__.___�____�. �_._.____ ___..___ _____.�-.___� JAMES HENSI,EY, HEALTH INSPECTOR TO----------- --____ ___v_________ _ SUBJECT COMPLAINTS DATE APRIL 24, 1968 MR. DONALD MOLITOR called about the community we11 at 560 Ironton Street. He said that the Court gave Mr. Hoffa 60 days to get it in shape, and he has done nothing. --� ___---------_—__------------- ------- ------- --- ---�_"_�—__ in Mr. Molitor said he believed it was/worse shape now than it was before. b F 2. A woma.n called to complain_about rats in the back �ard__at the home they are renting at 100 Riversdd�e Way� owned_by Marlon_Barclar�_ 804 N E. 26th St. She said there � ----- _______ �� ��� _was o1d lumber _pil�d_._in the ara e__ but an arba e_ had been cleaned u_� She said �. _ _.__.__ S_.___g � _ _.____�_S_� _�_ _ _ __. ___.� __.._ _ P __ ___.______._ __ ___. if y_ou_would stop,_she would_appreciate any informatioq on poisons etc. __-- __ _ __ __ _ � _ __ _ ___ _ _ _ _ ___ _ _____ ___ ___ ___ __ __ _______ _____.__ ____ _ __ __ _. �: ` SIGNATURE na° '� m1s CITY MANAGER'S OFFICE REPLY: � __._ _ _._ _ _ __ __._ __ _.__ _ __. __ . _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ __. _ _ _ .__ ___ __ _ _ _ _ _ __ _ _ _.___ __._ DATE SIGNATURE REPLIER'S COPY — RETAiN FOR YOUR FILES � �. _.� � _ � � r - ; , � - - i =- -- - � --- . - - -- i ,_ . - , - -_ - . � - -- _ . , _-,- - - __ ; .__ : - ---- �--- - � � � . _ f � " � � :�--- - ' ���- ���, �.�'�' __ ;,. - _ � - � - _ i -_ — i - -- � _ _ �� ��� ���1'a�3�: i � ����� ���# �.+��.��i - ��1�#��'���G . - __ _: _ ;, - ���" �s �����3�� _ - _ , '�� ��'� ���.� � L��"�i►��� ���i� �,����� '�t� ����'�;'� ���.s I - � �'Q�3��L3'�� �i� �� r�` , ;��'����f "��_ _ � ��# '�+�� ���`� '�� ����� �� �i�d�� �r ������ �a� ����� � i� � ��� �� � �i� :�������►� �� �r- ��� �t� ��# '1���� �t��t�I���d �` ��� ����� ; ���1�� ���. ��,s:'�e�i��� � ��� ������a �� i����i��� ���� t� �� ��r��� ��t���. � ���� ��` �'��� ��� ��� ��� ������� �� ��i.�� ����� - - I� ' � �� ��� ������� �'� �� ���'��-� � �` cs��3.�� . 5'b�����= - �. , � ���+����.�� . _ - . - _ �.��t _ � � � _ _ _ � � �'�' �':,� ��� � - ����.e� ���:� ������� ' �� - � - � � ���� ���� . - ; - _= ���� ������: �- v_ - sus�ecr PERMIT NO City of Fridley 18 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � ECEIPT NO. � ;____ COMMUNITY DEVELOPMENT DIV. ������ L � PROTECTIVE INSPECTION SEC. r , , � . , � � /'��1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVEO BV �----� • •,� 612-580-3450 910-F15 9/12/73 / / JOB ADDRESS 560 Ironton Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 45-48 G Rivarview Heights SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Merlin Brunkow 560 Ironton Street N.E. 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW [� ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Build 15x24 Ad.dition to ma.tch existing structure. 9 CHANGE QF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. 00�. fr�le THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 3GO %� ZOO ANY TIME AFTEA WORK IS COMMENCED. NO. DW�G. UNITS OPFSTREET 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 �Q,�OOO ��.5% WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �14,.00 STRUCTION OR THE PERFORMANCE OF CONSTAUCTION. PLAN CHECK FEE TOTAL FEE $16.57 � S,1Gn!.TU CoNi ACTOA�o UTHORiZED�GENT (DATEI N PROPERLY VALID ED HIS Y UR PERMIT _^ � 1 � �c S{GNATU OF O ER 1 OW BUILDERI 1 ATEI P '. �� aPpI,ICATION FOR RLSIllENTIAL, ALTEItaTr.C1;V, OR �llUl'I'ION l3UII�DING PERMIT C1"1'�' OF 1-1:lULk:k', �11NNFS0'T.A % � ' � �� � ��y , �� L � �' �� L� � � 'i�' -• � :�..►�u `� `��' NO;. STREET: T�O� ; `�`� ��A BLOCK : ADDITION : CORN�� LO�: INSiDE I,OT: SETBACK: SIDEYAFD: pp�lican� attach to this iorm Ztao Certificates of Survey of Lot and proposed buildisig locafiion drawn on Cheae Certificates. �ESGRIPTI�N OF BUILDING To Be U�ed As; j�'__a��-L.�''� Front : �� Depth : ' °� Heigh� : � Square Feet: .�2� Cubic Feet: � a�� Front: Depth: Height: Square Feet; Cubic Feet: �►p� o� C�nstruction: ,W�,;��1 ��1,1�iNl�( Estimated Cost: $ ���%?,�' �a Be Completed: �%lDl,��. ?� ,/� / � ►� � The undexsigned hexeby ma.kes applicatinn for a permit fox the work herein t�peci.fied, agxeeing to do all work in stiic� accoxdance with the City of Fxidley Ordinances and rulings of thc� llepartment of Buildings, and hereby deelaxes that ��11 th�. facts and xepresentations stated in this application a�e true and c.,rr��c t. BATE : (See Reverse Side FoY � `P �y�� ,� � -� � �� Sv �-_ � � 5� 7 P S IGNAT'URE • Additional Informa.tion.) �e (- -� -� �� � � � ,� � BUI LDING 1'�IL�9J'I' 1��:F: SClll:llUl_k: S�QTZON 2. The Lnspectur .�f Btiii.ldin�s shall, before issuing pextnits f:or Che exeCtion of sny 6uiiding or struct�irc�, c>r Fox� an�� addition to :iny existing building ax structurc_, or for ..�Tiy ,+ l terat i.on or rc;pairs to any c_�:isting lauil.din� or structure, upon applivati�n therelor�, requirc the payment by the applicanL fox such permit of fees tc r.h�� :�muune hexein below set forth and in �l�e manner herein provided to-�-lit: UNTFQRM BUILDING CODE: Type 1, 2& 4-� �2.15 for each onc: thousand cubic �eet, ax fraction ttie.rc:of, in such cubical contents. T�•p� 3& 5- $1.85 for eaah one thousancl cubic feet. :�llJ)ITIONAL I�PORI�IATION Foz the purpose of computing fees fo� building permits, the cubical contents of any building or .zddition, is determined by multiplying the ground area oOV��C�d fxom a point six (6) inches below the floox line of the basement �x tbE� Ce11ax� tQ tl��� average IieiKlits uf Che upper surface ox to the average � h�i�ht a� ths roof surface of the main gable of a pitched roo�. Fox x�pairs ox aJ.kexations to an existing structure, the fee sha11 be at the x'a�e o� $�.00 per eac� five hundred dollars ($500.Op) ox fraction thexeof in the �o�t of all pxoposed work. Trt aa case shall the fee charged for any permit as set forth in Section 2 be 1��e than $S,Op. VERIFICATION OI' FOUNDATION NQT�i Petmits tor construction will be issued a minimum of 24 hours from th� t�ae o� application, to allow for proper review of the proposed structure arnd pt �h� co�stxuction site, A Certified Suxvey of the lot, showing the location of the foundation, once iC has been eonstxucted, will be required before proceedin� with the framing. �'L'RTIFICATE UI� OCCUPANCY Appli,catipn for a Certiiicate o� �ccupancy s}iall be ma,de ten (10) days prior to the u�e or occupancy of any structure for which a building permit has beeri �.e8tt�sd; �nd s�lid structure shall not be used or occupied until a Certificate of Accup�,ncy has been isaued. �� w ` ,�w � �,. SUBJECT PERMIT NO. City of Fridley �.� � o� 7 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � � � IPT N � • COMMUNITY DEVELOPMENT DIV. ' j L ��—�� , r � � PROTECTIVE INSPECTION SEC. <��� � � � �6.7 .� i i.---� �"'1 •� CITY HALL FRIDLE� 55432 NUMBER REV DATE vnGE Oc vPaOVED Br i ' � 612-571-3450 9�0-F15 / / JOB ADDRESS 1 IEGAI LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oESCR. 45-46-47-4 g RIVERVIEW HEIGHTS SHEET 2 PROPERTY OWNER MAIL ADDRESS IIP PHONE DAVID KLOBOW 560 IRONTON ST FRIDLEY MN 55432 783-9078 3 CON7RACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. same 4 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 � REPAIFi ❑ MOVE O REMOVE 8 DESCRIBE WORK SIDING 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOIO IF WOHK OR CONSTRUCTION ZONING SO. FT CU. FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OF WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. 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 yALUATION SUHTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED 300.00 .SO WITH WFiETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEFiM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 2]..00 FIRE SC .SO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECKFEE TOTALFEE f .�� �� �—/ �' -'(.S— 22. 00 S�GNATUAE OF CONiRACTOA OR AUTHORIZED AGENT iDATEi HEN PpOPERLY LIDATED THIS IS YOUR PERM17 G�./�/� /`� . �` �O � � � � � � � � SiG TUREO:OWNEAU:OWNEABUiLDEFi �DATE� � BLD �NSP paiE ��� � � Cffective 8/ 1/95 ADDN ( ] CITY OF FRIDLEY � �� ALTER [] SINGLE FAMILY AA1D DUPLEXES R-1 AND R-2 ��� Build.ing Permit Application Construction Address: ,� � O �/Zo �uTo � S�-- .LJ � - Lega1 Description: — Owner Name & Address: �% f/i ��OC� O c,cJ Tel. #� 9 3°- � o°7 � Contractor: 1 _ �-� _ MN LICENSE # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction dra.wn on it to scale. Tel. # DESCRIPTION OF IMPROVEMENT I,I�TNG AREA: � � Length Width Height Sq. � Ft. GARAGE AREA: Length Width Height Sq. Ft. DECg AREA: Length Width Hgt/Ground Sq. Ft. OTHER: S f� f N�' - Coraer Lot [] Inside L.ot [] Ft. Yd Setback Side Yard Setbacks ,� �_ Type of Construction: Estimat� Cost: $� o o� _,,� ; Approx. Completion Date: . � ( Cost on Back ) -- -- Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _� DATE: APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: s I, �' � < �'� $ �i� $ $ $ $ $ $ $ �, � CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/1()th%) $.50/$1,000 Valuation $850 per SAC Unit $S.� (State Licensed Residential Contra.ctors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreemeirt Necessary [ l Not Necessary [ l �iTILDINCr PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or siructure, upon application therefore, re�uire 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,(�1 to $25,� $25,�1 to $50,000 $50,�1 to $100,U00 $1(�,�1 to $S�,OUO $5(10,001 to $1,000,� $1,0�,�1 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $S� plus $2.75 for each additional $1� or fraction thereof, to and including $2,OD0 $62. 25 for first $2,� plus $12.50 for each additional $1,t100 or fraction thereof, to and including $25,OQ0 $349.75 for first $25,000 plus $9.00 for each additionat $1,0� or fraction ther�f, to and including $50,(�0 $574.75 for first $50,(�0 plus $6.25 for each additional $1,0� or fraction ther�f, to and including $100,� $$87.25 for fYrst $100,0� plus $S.� for each additionai $l,� or fraction thereof, to and including $5�,00() $2887.25 for the fust $500,0� plus $4.25 for each additional $1, 000 or fraction thereof, to and including $1, 000,000 $5012.25 for the first $1,000,� plus $2.75 for each additional $1,� or fraction thereof DRIV�WAY DEPRESSION ESCROW (Concrete C�b StreeLs Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway w�dth plus 6 feet times $13.�. Altemate "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 $15.75 . VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the conslruction site. A Certifica,te of Survey of the lot, showiag the location of tlae foundation once it has it has been conshucted will be required before proce,eding with the framing. � D m n 3 0 m � � � w � 7 � �� o � 3 � Q � O �D �$ cn cmi -u Q. � � � m � � �� � m g � � c .« �/YI rn Z � -O m � O Z m � N � 1 �� �� m� � m v < a � � � , C � � �v Zrn �: m� � Ci O � � m s � � D rt' � � 0 z O z '17 7 w � � � fI� 2 fD '-_I Q � . i � � ��i W �� N � T71 'ui z• a� r �„ nm mn z:� ITl z n �L � IV � �, 3 a 3 -�i. 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BLOCK TRACT OR AODITION SEE ATTACMED DESCR. L�S-48 G Riverview fleights SHEET 2 PROPERTY OWNER MAIL ADDRES$ ZIP PNONE Reith Scheil 560 Irottton Street NE 717-3082 3 CONTRACTOR MAIL ADORESS 21P PHONE LICENSE NO. Greg Wills Exteriors 4246 Royce St NE, Mpls., MN 55421 788-0529 20037840 d AqCHITECT OR DESIGNER MAIL AODRESS 21P PNONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION C� REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reside House & Garage 9 CHANOE OF USE FROM TO STIPULATIONS Install building wrap and have inspection of same unless manufacturer' specifications state it is not required. TYPE OF CONST. OCCUPANCY GROWP OCCUPANCV LOAD SEPARATE PERMITS ARE FEOUIRED FOfi EIECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULI AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, Ofi IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOF A PERIOD OF 120 DAVS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTFiEET PARKING I HEREBY CERTIFV TNAT I HAVE READ ANO EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW TNE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS yp�UATION SURTAX AND ORDINANCES GOVERNING THIS TYPE Of WORK WILL BE COMPLIED $2 23O �1.12 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT � DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pEFM1T fEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $74.75 Fire SC �L.23 STRUCTION OR THE PEFFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TpTAI FEE License SC $5.00 $83.10 SIGNATURE CON'RACTOpORAU�MOA�Z DAGENT IDATEI HEN PROPERLY V IDATED THIS IS VOUR PERMtT ? c / �f� SiGNATURE OF OWNEA �if OWNER BUILOER� �DATE� BLOG �NSp � r�arE �e'- _ NEW ADDN ALTER Ll �� �� CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUII.,DING PERMIT APPL.ICATION � ConstructionAddress: � (�� ��� �f�..� � � Legal Description: Owner Name & Address: Contractor: Address: � P� Effective 1/1/97 Tel. # �1'% � �t' �'2— � MN LICENSE # LIVING AREA: GARAGE AREA: DECK AREA: 01'HER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPItOVEMENT Length Width Height . Length Width Height Length VVidth Hgt/Ground ,d// Il�la � . Construction Type: ` Driveway Curb Cut Width Needed: Ft. + 6 Ft = Tel. # ��,� � ��' � � Sq. Ft. Sq. Ft. Sq. Ft. Estimated Cost: $ � (Fee Schedule on Back) Ft x $ _ $ h. � � % � ` •► ' �� i � � � ✓�� -17.�� �� , � . , i � Pernut Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge �r.yr:�� STIPULATIONS : $ � � � � .�-�3 $ i./� $ $ �- � $ $ $ $ � �./� C�TY U5E ONLY 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 Detemvned by Engineering Agreement Necessary [ ] Not Necessary [ ] BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or stiucture, upon application therefore, require the payment by the applicant far such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: � TOTAL VALUE $1 to $500 $SO1 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50, 001 to $100, 000 $100, 001 to $500, 000 $SOQ,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $S(?0 plus $2.75 for each additional $100 or fraction thereof, to and including $2,OOU $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 additiona.l $1,OU0 or fraction thereof, to and includ.ing $50,000 $574.75 for first $50,�0 plus $6.25 for each additional $1,000 or frac�ion thereof, to and including $1Q0;000 $887.25 for fust $1�,000 plus $5.00 for each additional . $1,1�0 or fiaction 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 $1,0(?0,� $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 constructed �.��i!1 he required before proceedinR with the framinR. .� _ R ..� $ll11C�.lrig Inspections 763-572-3604 DA���-a T-o 5-- srrE P.nD�ss .p'�o 0 THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMTf A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERNIIT TYPE TYPE OF WORK: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS �'�'J 'al O OWNER �CONTRACTOR NAIvIE• c '� � �°I �is I � �Dt�ss: �" � �� owi� PHONE: � � � 7� a — 3� �Z NAME: T�IYIN W � � STATE LICENSE � � �� ADDRESS: PHONE � � SINGLE FAMII.Y/NEW COT1S L7 TWG FAivIILYiNEW CON3TRUC'i IGN ❑ ADDITION O G�RAGFJSF� ❑ gpSEIv�N'I' FINISH C9'�OOF ❑ D�{ O SIDING O SWD�M�IWG PO p N�ry O ADDITION n Men.rrRntANrFJREPAIIt ❑ REMODELMG DESCRIBE WORK BEING SIZE OF IlvIPROVEMENT �� ❑ DRA1N TILE ❑ OTE�R Permit Received By: Date Rec'd: /��'�� �.� WID'1'H HEIGHT � STATE ZIP, F� ROOFItvC: " `."""'" ".._ _ �pSgMEN'f ItEMODELING SUBNAT• TTUMBER OF SQUARES �� � HOUSE & GARAGE 1. Existing Flaor Plan GARAGES ❑ A7'I'ACfiEU GARAGE 2, propo�;d floor plen PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUC7'ION INCLUDING DECKS, SmIIVG ,e nniTiONS & PORCHES SUBMIT• O Vinyl ❑Soffit 1. Site Plan/Survey showing the existing swctures O Aluminum ❑ Trim O Other � Fascia ana Pr°p°sed Pr°�ect' 2. Two sets of consWction plens WAVDOWS 3. Energy Calculetionc IN EXISTING OPENMGS ❑Yes ONo IACATION OF WINDOWS OR FOR NEW OPEMNGS-UESCRIBE S1ZE OF OPENING CHANGES & TYPE OF WINDOW TO BE MSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) T�T��. J�S �ALUATdON � 4��� 4C�LtP.�NCX TYPE Permit Fee Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Chazge Tnra� nue $ _ $ / i v `�— $ ,� 2 $ �'� -- $ $ $ See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) times the total job valuation — Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AId APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclrnowledge that the information above is complete and accwate; that the work will be in conformance with the ordinances and cod of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application f a pe rt and rk is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work w' s r ' and approval of plans. � ���� SIGNATURE OF APPLICANf PRINT NAME �� ��''f1�bATE l Z� 2?�� Page 2- Building Residential Application BUILDING PERNIIT FEE SCHEDULE The Chiei Building O�cial sha11, before issuing pemvts 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 pemut of fees to the amount herein below set forth and in the manner herein provided to-wit: . VERIFICATION OF FOUNDATION Permits for construction will be issued a minunum of 24 hours from the ti.me of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv - - - - -- — -- - - --- City of ��i�ley ° - — -- - - Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 Building MECHANICAL Permit No . Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: �- 763-502-4977 FAX EFFECTIVE 2-19-09 DATE I��� O% l YOUR E-MAIL ADDRESS q�trf�C �!CG ��q►C 1� . NP� SITE ADDRESS S6o .L�hv1 VI ST TH1S APPUCANT IS: [�OWNER ❑CONTRACTOR PROPERTY NAME: C7A'NC I°J�K vG / OWNER/ ADDRESS: �60 rro�� S7 CITY '� �' Ooc, STATE,�1/�IP �J�.� TENANT pHONE: ��s7 %�� 7SS� CONTRACTOR C ANY NAME: SUBMIT A COPY OF CONTACT PE YOUR STATE STATE LiCENSE # LICENSE WiTH ADDRESS: CITY STATE_ZIP APPLICATION PHONE FAX PERMIT TYPE �SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � NEw � REPLACEMENT � ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK � � b ��� �� � �a FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT W'HERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOV►� Equipment Installed MFG: MODEL: SIZFJBTLT MFG: MODEL: SIZEBTU MFG: MODEL: SiZFJBN A/C $25.00 FIREPLACE (GAS) $i5.00 _GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $IS FiREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.(TO BOILER $35.00 FURNACE $35.00 _GAS [JNIT HTR $10.00 CHIMNEY LP,VER �10.00 GAS DRYER $10.00 POOL HEATER $35.00 �DUC'i WORK S 10.00 iIGAS PIPING $10.00 �VENTILATOR $15.00 Number of fixtures @$ l 0.00 � x� 1 QAO =$ � Number of fixtures @$15.00 � x$ I5.00 =$ �� Number of fixtures @ $25A0 x $25.Q0 = $ Number of fixtures �a $35.00 x $35.00 = $ State Surcharge = $ .54 NIINIMUM FEE $35.50 Tota1= $ 3S• � THIS IS AN APPLiCAT10N FOR A PERMIT-NOT VALID UNTiL PROCESSED T hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that i understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with tl�e approved plan in the case of o k which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME 1� � DATE ��IID � PLEASE NOTE: SEPARATE PERMITS ARE RE UIRED FOR BULLDING, ELECTRI AL AA1D MECHANIGAL WORK City of �+'ridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building PLUMBING Permit No.: iX`�-��.5 C� Inspections RESIDENTIAL APPLICATION Received By: �� 763-572-3604 CITY OF FRIDLEY Date Rec'd: �-C�1 763-502-4977 FAX EFFECT[VE Z-19-09 DATE D� % 't YOUR E-MAIL ADDRESS NY l� (C.4°� �R� YfV° SITE ADDRESS rSQ� ..Ly�l y TH1S APPLICAN'C 1S: �OWNER ❑CONTRACTOR PROPERTY NAME: ArK /"� ,/p OWNER/ ADDRESS: �� f./oy7'� CiTY /rI � lB STA'fF/�ZiP �?� TENANT pHONE: 6I� • %�� . �F.3S� CONTRACTOR N SUBMIT A COPY OF YOUR STATE STATE LICENS DATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: CITY STATE ZiP INSURANCE FAX PERMIT TYPE QS�NGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � NEW G�I2EPLACEMENT DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. BATH SINK/LAV FLOOR DR SHOWER ✓WATER PIP[NG BATHTUB GAS P[P[N IC) SWIMMING POOL WATER SOFTNER ($35) CLOTHES WASHER ,/ K[TCHEN SINK WATER CLOSET BACKFLOW PREV. ($15) �/ DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRiGATTON WATER METER OTHER Number of fi�ctures @$10.00 3 x$10.00 =$ 30 Number of futtures @$15.00 x$ t 5.0{i =$ Number of fixtures @ $35.00 x $35.00 = $ 5tate Surcharge $ .50 � • (MINIMUM $35.50 Total = $ 5.5� THiS IS AN APPLICATION FOR A PERMIT-NOT VALiD UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in co�lformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that T understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the of all work which requires review and approval of plans. SIGNATURE OF APPLICA PRiNT NAME (�CiA�C� ��-Ae`✓1Gy DATE I(1/b�O� PLEASE NOTE: SEPARATE PERMIT5 ARE RE UIRED FOR BUILDING, ELECTRICAL AAtD MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977