AF-W - 470961.. .., .. . -,.:�� ___. :... �' . , ... . . .. ,.�.-. --- .
� . � ViII e �uf Fri.dle , Mi�.n.
� Y _
' BUTLDING PERMI'� ��°• i 9 S 0
,
, . ,
�Datet :+�'r�+�� . '�.�� �: �. . .
, �
Owner Builder ��:4'�:�ai�.�' •� . f . l'
j , ��� �� '�
Address • • f' • Address . �
, _
.. .........................
�
; `, � ,.° QCA�T[ON OF BUILI]ING
F' N'o. . s�,'�i:�.M� .t+� . Staee + '�'.'�: .� .�. .''�' . . . . Part of `I.flt _
� �.ot . � . BI q� .� . . .. Ad�iition or. Suh-Divisflan �� . . . . ..
v _ Corner LoL Inside Lot . SetbaCk 4��1.: r� Sideyard • .��',' .+��s . . . . . . .
� - - DESCRIPT[
' QN QF BUILDINIG
; To be: Used as; , _ : ;;
- � g � .•: Fk �
1 .
-
�`���r�.�-�...... Front .��... Deptki�+��., Hei hi a���'/ Sq• ........ Cu. Et. ........ ' ,,i
� .. Front Degfh .. Height St�, Ft, �, �
............. .... ....... „ ,
, . ... .r.,.... �''t.
; �YAe og: Consiruction :� , �.�.�;�: . . Es� Cost .�� � Ci.�. , p eted � . ' �
i ... ....
To he Com 1 �'' .I'�l'��
. . ,�_
� �.�°�,���� ���,iw'�' � '�%�*` �J`�1� ��
.
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, _
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j = � 4 �.,,�
I '
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In cor�ideration of the issuan�e to me . of a per�nit to construct the building . desc�ibed above, Y agree to do
� the proposed work in aecordance with the de�cription_ above .set forth and in compiiance with' all proVisions pf
� ordinances of the village of Fridley. , y
�. ' , _ . , _ ` < .
. ,: ,
....................................�.....,.
.......,,..
in considera#ion of the payment of a• fee. of $.',��,,,, ...,., permit is hereby granted to �:"� .. .
�'•'`�• ����� .. to �onstract the : building ar additioa ` as. described above. This p�rmit �� ��
the eupress condition t�iat the person to : whum it is granted and his �genis, emP�3'ees ati�d worI�nen, 3n ali . woFk .
done in; around and upon ssid builcling, or any pa�rt thereof, s1�a13 conform in a11 respecfs ta- the ordinaaces of
�"riidley, A�nnesota regarding location, construction, eltera.tion, maintenance, repair and mov3ng 'oP buildings with_
iri the viliage limits and this percnit m�y be revaked at any time upan violation of any of the 'Pravisi9ns of said
ordinances. , '':
R ' . , ' ` : <
•- - , ,, �-
' ,-��a�� �t�
. . -
�. : . .
_ , _
; NOTIGE: ' _ - _
7his permit does not ccver the constructlon, (nstalla,tiur� or alterat[gn fo� wirings,piumbing, gas heatin�,
sewer or water. Be sure ta see ti�Buliding Inspector for sepa� rat�pe�mi_ {�po��, �t��. ` �
s� ,�
,._._
�
SUBJECT •
City of Fridley 2 0 5 7�
AT THE TOP OF THE TWINS g U I L D I N G P E R M i T
�
; � CEIPT NO.
� i y�_�___ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. 3�,� y,�—
Li j �
---. A �'�'1,� CITY HALL FHIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BV
t �� � � 612-571-3450 910-F15 9/18/90 / /
J08 ADDRESS 5665 Jackson Street N.E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 7 5 Donnay's Lakevie�a Manor Addition SHEET
2 PROPERTV OWNER MAIL ADDRESS ZIP PHONE
Roy Peterson 5665 Jackson Street N.E,
3 CONTRACTOR MAIL ADDFESS ZIP PHONE LICENSE NO.
Ri.chax�d Hastinc�s Contr. 6331 Riverview Terrace N,E, 574��966
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS 21P PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION �❑ REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroo� Dwelling (23 �quaresZ 'Iiear Q�f
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REDUIRED FOfi ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. OCCUPANCY GROUP 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 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OFi ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCEO. • 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 I.AWS VAIUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT '$1 f�-SQ $a �JS
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- '
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $Z9.OQ Fire SC �l, �.rJ
PLAN CHECK fEE TOTAL FEE
�3�e /3
i�) SIGNATUREOGCONTRACTOi70RAUTHORI2EDAGENT �OATE� WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
��.t,.� /�d� � �' �'Ts '
SiGNATURE OF OWNER�IF OWNER ILDERi IDATEI BLDG INSP r1ATE
NE�1 [ ] Effective 8/16/90
ADL1N [ ] R-1 AND R-2
� [ ] Buildirig PeYmit Applicatioaz
c�ru�� Aaa�: ..S^6Gs ����-so� s�.
,
Legal Description: �d� 7 �L o c�' 5 pa �.vR y s Cr� k� v: � v,u ��v o/Z pd�.7 0
ownex xame & A�lress: �d y �� ��R s o,V �., #
Dontractor: li '� c� A� t� l,�A s?`r'nr�' s Z�1. # S' 7 Y-�C r'��'
��: b33/ ����CR,���� TE'�,
Attach to this application, a C7eYtificate of S'�uvey of the
lat, with the pr�ed �ction drawn a�n it to scale.
nF.SCRIPTI�T OIF II�Z�O�VH�Tr
L.NIIaG l�RF�i: Lerigth Width Height Sq. Ft.
C�iR�CE ARF�i: Tp��'+ Width Heic�t Sq. Ft.
D�K ARFA: Tp*� �+ idth Hgt/Gro�u�d Sq. Ft.
O'1R�R' o�� C� _ .
Corner Iot [] Inside L�t [] Ft. Yd Setb�ack Side Yard Setbacks
Z�pe of Construction: °T'�'� aFF d- (Z� �20o F �i„�t.ed Cost: $ �0��
Ap�rox. C�iletion Date: l b/� ���b
Proposed Driveway Width If N�w Opening Is Desired: Ft. $ $
Width + 6� See Back Page
D�+,TE: r�? �� APPLICAN''r: � Zp1. # S7 iF " iY�,�
�' 3 ° crrsr tr� a�Y
Permit Fee s a 9�6 Fee �7.e on Reverse Side
Fire S��-izge $ I. /�� .00i x�mit vaivation (i/ioth ��
state sumharge S •�� S.so/$l,000 valuation
SAC Q�arge $ $600 per SAC Unit
DrivewaY �'� $ Alt. np,o or Alt. °gn Above
Park Fee $ Fee Det,eramiried bY Engir�aerir�g
Sewer Main C�aYge $� Agra��oent Neoessarl' [] � N�YY []
� s �.��?.�
sr�rr�TTOxs:
j:�i1�����; c��� �4��+�� _«:i�+�_�� _
Zhe Criief Building Official shall, before issuing permits for the erectia�n of ariy
building or stnicture, or for atiy addition to ar►y existing buildirig or stnicture, or
for ariy alteration or re�a; r to any existing buildirig or structure, upon application
therefore, require the payment by the applicant for such �*�;t of fees to the amount
herein below set forth and in the manner herein provided to-wit:
� ZOr!'AL VAI�JE
$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
M �+�+�
$15 (Minisman Fee is $15 plus suzrharge)
$15 for first $500 plus $2 for each additional $100 or
fraction thereof, to azid includirig $2, 000
$45 for fixst $2,000 plus $9 for each additional $1,000
or fraction thexeof, to and including $25,000
$252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to and including $50,000
$414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and iuzcluding $100,000
$639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2039.50 for the fiYSt $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $3539.50 for the fizst $1,000,000 plus $2 for each additional
$1,000 or fraction thereof
DRIVEWPiY DEPRELSSION ESCRO�W
(Concrete C1irb Str+eets On1Y)
�lternate "A" : Removal arid replacement of curb ar�ci guttex only - Driveway width plus
6 feet times $13.50.
Alternate "B": Remaval and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
►'/�+� �� �+: � ��� • � • 1 u • •�
F�nnits for canstxuction will be issued a m�n�m►m+ of 24 hoa�s frcen the time of
applicaticn to allaw for propPx review of the prapor�ed structure and of the
aonstruction site.
A Certificate of Sur.vey of the lot, shcywing the location of the f�atian onoe it has
it has been oonstruct-.ed will be required before prooeeding with the framing.
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c;ty of Fr�a�ey
AT TME TOP Of TME TININS
i �
� ♦
� ; v _____ COMMUNITY OE�EIOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
� _ ,
� �"'\ � CITY NALL FRIDLE� 551�2
�""'� � �'� 612-571-3450
JOB ADDRESS �
5665 Jackson S r
1 LEGAL �OT NO. BLOCK TpACI
DESCR. 7 5 D
2 PROPERTY OWNEq MAIL ADpR�S$
Medtronics
3 CONTpACTOR MAIL ADDRESS
Swift House Movin 20845 Larkin
4 ARCHITECT OR OESIGNER MAI AODRESS
5 ENGINEER MAII ADDRESS
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION
8 DESCRIBE WORK
_ Move house at above address to ou
9 CHAN(3E OF USE FROM
STIPULATIONS
7
fJ[lr�
M 0 V I N G
B G PERMIT (
�BEP pEV OAT��4�99 PAGE OF
910-F15 �`,� / /
ZIP PNONE
_363-8521
ZIP PMONE
• . . .
.
�� ��
pOVEO Br
SEE ATTACHED
SFIEET
IICENSE NO
12227
LICENSE NO.
LICENSE NO
O ALTERATIpN ❑ REPAIR �9 MOVE O REMOVE
TO
Jackson N to Carrie to Qui.ncy to 57th to 7th to 57th to TH 47 to 73rd E to
Cty 35 N
Current Water Bill of $51.61 due 8/25/99 plus final bill after meter readinga
Clean site of all debris including foundation and slab.
SEPARATE PERMITS ARE REOUIREO FOR ELECTiiICAL, PLUMBING. MEATING, TYPE OF CON$T.
VENTI�ATING OR AIR CONOITIONING-
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING
AUTMOR12ED IS NOT COMMENCED VYITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PER100 Of 120 OAYS A7
ANV TIME AF7Efi WOpK IS COMMENCED. NO OWLG. UNITS
I HEREBY CERTIFV TMA7 I MAVE 1iEAD ANO EXAMIN�O THIS APPLICA710N
AND KNOW TME SAME TO BE 7RUE AND CORRECT. ALl PROVISIONS OF LAWS VALUATION
ANO OFDINANCES GOVERNING THIS TYPE OF WpRK WI�L gE COMPLIED
WITH WHETHER SPECIFIEO HEREIN Oii NOT. TME GRANTtNG OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHOFI7V TO VIOIATE OR CANCEL THE pEf1MIT FEE
PROVISIONS OF ANY OTNER STA7E OR LOCAI LAW REGULATING CON-
STRUCTION OR TME PER ORMA E F CONSTRUCTION .�ZO.00
PLAN CNECK FEE
S�GN TUaE O CON'aA Oa AUTHONIZED AGENT 1DAfE� � EN 0 E
oTUAE O� OWNEp ��� OWNEp BW�DER� �D�fEi
ROUP �OCCUPANCVLOAD
SO.FT ICU FT
OiFSTpEET PARKING
STA�LS IGAFAGES
�
�
-J �
f�`iF
d,-
Effective 5/10/99
CITY OF FRIDLEY MOVING [] WRECKING [] PERMIT APPLICATION
6431 University Ave NE
Fridley MN 55432 �'��
572-3604 �� (��j"
Job Address: � � K�
Legal Description:
Owner & Address: �,����.�,�� � � Tel. #�(� ����c��
Contractor: �,cA,, �-�-��{��, �, r�,�P, �, �v� r Tel .,#,�L� 3�3 t�5`a�
Address : g��c�� ,�R,, �� ; ,,.` ,� L�,��.�.,�., ,,� � State License # � ( �,�� �
DESCRIPTION OF BIJII�DING
HOUSE: Length � Width �� Height (� Sq. Ft.
GARAGE:Length � Width � Height � Sq. Ft.
OTHER: Length Width Height Sq. Ft.
Estimated Cost $ ��'8� � Approx. Completion Date
�
IITILITIES City Water/Sewer Minnegasco N S P
NOTIFIED: 572-3529 [� 372-4720 [� 330-5500�
�� � i ��r�:�l���/%; �v
Water Bill Paid: Yes [ J or Collect [$ ��°n,�B ]
Cu. Ft.
Cu. Ft.
Cu. Ft.
`� / � �.
U S West
Business-603-6000
Home-244-1111 ]
Signature ��� � �
Moving Route:,]�G s � � 1 a s � �
� �' �4 �€ �a .�o � ��- � � � � �.�'
The undersigned hereby makes application f� a permit to wreck/move the building described above, agreeing to
do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State
Code which requires any water well on the property to be sealed by a State licensed water well driller, and
hereby declares that all facts and representations stated in this application are true and conect. ALL
DEMOLITON DEBRIS. INCLUDING FOUNDATION & SLAB. SHALL BE REMOVED FROM SITE.
� �/�� __�
� signature
Moving:
Wr�ng:
Principle Building into Fridley . . . . $300.00
Accessory Building into Fridley .... $ 42.00
Through or within the City .... ,_�6
Move a building out of City .. s:"� $ 20.00
For each 1 000 cubic feet or fract�on :- :--- �"
, --��"
For structures wluch would be impractical
to cube the fee shall be based on the
total cost of wrecking at the rate of
$6.00 for each $500.00 or fraction.
PERMIT FEE: STIPULATION5:
Minimum Fee: $20.00
Minimum Fee: $20.00
TO:
FROM:
DATE:
suaJECr:
MEMORANDUM
Mary Hintz
Jon H.,�aukaas� Assistant Public Works Director
.dt�
September 2, 1999
Properties Acquired for Right-of-Way
The following properties have been demolished and will no longer use water and sewer services:
5665 Quincy Street
5675 Quincy Street
5655 Jackson Street
5664 jackson Street
5665 Jackson Street
5674 Jackson Street
5675 Jackson Street
PW99-163
The properties were acquired for use as street right-of-way. They will no longer be residendal progerties.
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