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City of Fridley, Minn.. N•° 8655
BUILDING PERMIT
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Owaer: ��1'�� - _'�� Bu9lder �'� �
Address - Address
� CATION D G
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No. � � Stteet ` �rt oP Lot
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Lot _�__ Bl Addition or Sub-Divisi — �� �'
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Coraer Lot _ Ine�lde Lot '�� 3etback .�- �3�� Sideyard � G
3evver IIevatfon
Fotmdation IIevatlon
DESCRIPTIOW OF BUILDING
T vsea � �
�� Front ��� DeP� Hefght ,��� Sq. F't / � Ca. Ft� -
Front � Depth I�eight ����. Ft ���„�`"� Cu' Ft' � `� �
.
Type of etion F�t. Cost g�.R�-�- -���- _�'to Ue Completed
In cona�deratlon oP the f�uaace to me oP a peraiit to construct $building descrit�d ab agree to do
ths proposed work in accordance with the d�scrlp�ton above set F��,Aad in compliance pravisibns oP
ordinanoea of the dty oP Fridley. � P�:
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In co�fderatian of the Pa3+ment oP a fee of ' �� , P�rmit 9s hereby �aated to
to construct the bufldfng or addition aa described above. Thispe rmit is �ranted upon
We exPress conclition tl�at thepe�on to whom it ie greated and his agente, employees and worlmien, in all work
done in, around and upon eaid building, or an,q thereo� ahall cbnform in all respects to the ordinsnces oP
Fridley� Minnesota regardln�g locatton, conatru� alteration, maintenance, repair and moving of buildings
wlthir► the dty ]fmits and tbis pertnft may be revoked at any tlnae upan vlq�o�f aaq oY the provleions of eaid
orclinances. �., �, ,� „
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fin dalWioo Ia�aeEor tar aparafr �(M 1or NaW Nw.
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ADDRSSS
AP�.sLIC�TION FOR �UILDIAIG PERAi[T
CITY OF FRIDLEit, MIIVNESOT�
LOCATION
W ��.....,.,_��,�� Street �Part of LoC`��
. _LOT � � �C� .��ADDITI� R SUBDYVISION ��� � , . °��'2�' -
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Corner Lot�_Inside LQT Setback ��� —� Si�de�»'�ard�' ,/� -� � ,�� �
..SE�IER LI.EVATION FOUNDATiON ELEVRTEON ,
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Applicant attach to ti►is fo�n Two Certificates of Survey bf Lat and propoeed
_ l�uilding location drawn,on these Certificates.
DESCRIPTTON OF BUII.DIIITG
�—
Type of Coustructioa
To be cvmpleted
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sq. r�z .� .� (!� Cu. Ft . � // � �
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I�ront_� � Depth �' "��eight��/ �
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_�SQ. Ft•— ��� ��? Cu. Ft. �� �//�� %
� / ,�Tss t imated Cos t� �?�� �
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�'h� tu►ders3gned hereby makes applicat�.on for a permit for the work herein specified,
agreeing to do all work ia strict accordance with the City of Fridley Ordiaances
and ruling� of the Department of Buildinga, and hereby declares that all the facta
and repres�ataeions stated in this application are true and corte�t�. �
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(9chedule of
Costs can be found on Che Reverse S
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SEG�'ION 2. The Inspector of Buildiags ahall� before issuiag any permit for the
erection of any bullding or a�ructure, or for any addition to anq e�isting build-
ing or structure, or for aay alterationa or repairs to any exieting building or
structure, upon applicatian therefore, require the payment by the applicaat for
such permit of feea to the amount h�rein below set forth and ia the_mamaer hereia..
provided to-wit;
2.1. For anq such permit for the erectio�i of any fire-�proof build3n�,
other than a garage, warehouse, factory.or grain elevator, or for the erection
of any fire-proof addition, for similar occupancy, to any existiag building,
ehall be.at the rate of $1.40 for each one thousand cubic feet, or fraetion
thereof, ia euch cubical contents.
2.2. For any auch permit �or Che erection of any fire-proo£ garag�,
_- Warehouse, fac�tory.or grain elevator, or for the erection of any fise-proof _
addition, for similar occupancq, ta any existing building shall be at the rate
of $1.25 for each oae,thousaad cubic feet, classified as "f3reproof" by
Sectian 502 of the Minneapoli$ Buildin� Code.
$OUSLS . . . -_ . .
2.3. For any auch permit for tlie erection of any non•firepraof buildi�g,
other than a garage, warehouse, factorq or�grain elevator, or any non-fireproof
additionf for similar oacupaacy, to any existing building - permit $1.00 for each
one thousand cubic feeC.
GARAGES
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2.4_ For any such permit for the erection of anq nan-fireproof garage,
warehouse, factory or grain elevator, or for the erection of any non-£ireproof
addieion, for sim�tlar occupancy, to any exietin� building or for each auch
building or addition - ninetq cents �$0.90) for each one thousand cubic feet
or fraction-Che�ceof, in the cubical contents thereof with the minimuan of $4.00.
For the purpcse of camguting fees far building permita, the cubical eonteats
of any buiiding or addition to a uniform height throughout bq multiplying the
ground area covared frc5m a po3nt aix (6) inches below the floor line of the
basement or cellar to the average height of the upper surface or to the average
height of the roof eu,rfaee of the main gable of a pitched roof.
2� For regairs or alCeration� to an ex•i�ting strtscture, the fee shall
be at the rate of $3.00 per.each Fine Hundred Dollats ($SQ0.00) or fraction
thereof in the coat of all proposed work. �
2 6_ In no case shall the fae char�ed for any permit a� set forth in
Section 2 be iess than $4.00.
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ENGtNE�RING, �NC. .����'�
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�ce�ti�a�cate a� ssz�v+� �or � � � �v��,oPM�t��' co,
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� DENOTES IQON --'—"DENOTES DRa�t�AGE AND uTi�.►TY EaS�MEN7
LOT 26► B�.00M� 3� i1/IELODY MANOR 3R0 A�Dti10N
�OI(A COUFIT�
/ fra,eby eerfr�y fhot II»5 �s o h-ur � mrr��� reP+�sen�oi� o�'v suF+�cc� �'!� b�ewr���s �f fl,� e�o� cFsu:l�d ia�, ae�d
ef'H� luca�iron a�'alI truildm�s , flt�rean , mad d/ risr6dt erEV°ovriime�rh ,��'auy ,�rrm a- n said f�nd As survfyed 6y me �/+�5 —. d�
g! a.0 �9.f�4. Sl�'� ClRBAN ENf /NEEI?IAI� ./At'C. .
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Larry's Qaality Sanitation
17210 Driscoll St. N.W.
Anoka, MN. 55303
PLEASE NOTE
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Due to the never endin� rising costs of fuel, dumping� repair
and maintenance of equipment, we will be f orced to raise our rates
effective January 1, t979.
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Rates will be as follon�s:
$5.00 pe,r month, for r,ervice at t he end of driveway. "
�5.50 per month� for service infront of garage.
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A no can litnit wri.11 apply to all these new rates. A no can
limit means you may have as many cans as you need for household
garbage. Household garbage consists of paper, bottles, tin cans
and ashes. Grass rvill only be hauled at tY�e end o f your drivewa,�r,
���ith a 10 bag limit per week enforced. All items suc as fo7.�ows
e�ill be picked-up for an extra charge, rocks, sod, concr-ete, buildin�
materials, appliances and furniture, by contacting the office at
44�-4090 ,durin� business hours. �
SE:dIOR CITIZENS PLEA�L NOTE ..
Effective January 1, 1979, we will a].so have a special rate for
you. For more information, please contact the office about this
special rate.
May I also take this opportunity to thank all my customers for
being able to serve you durin� my first year of business. A special
thanks goes to those customers and friends who had faith in me and
changed their service durin� my first months of business.
'
Please check policy desired and return with your remittance. All
accounts are payable within 30 days.
service at end of driveway
❑�5.00 per month� billed $15.00 quarterly (every 3 mos.) or
1� �57.0o yearly.
service in fror�t of garage-Cqn� �n1�
Q�5•50 per month' billed �16.� quarterly (every 3 mos.) or
(� �63.0o yeariyo
se vice in back yard- �An� un`� ,
6.00 p onth� billed �•18.•00 quarterly (every 3 mos.) or
69,0o ye 1y.
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I�te: Octob�r ?, 1980
Ti.me of Call : 12 : 40 p. m.
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Responding to Ca11: Chet Swanson got message from Lois.in Garage
Time Backup received: 12:50 p.m.
Ec{uipment at Site: Jetter
Crew Members: Chet Swanson
Addresses: 6740 Jackson and 6730 Jackson
Findings of Crew: A 2 1/2 f�t length of roots (4" diameter) impacted
., in both horizontal and vertica.l pipes on outside "drop"
of manhole at 68th F, Jackson
, Histo of the line alon Jackson: ' a
The li.ne was surcharged acked up) in 1965 (spring). It has been
cleaned twice, as a result of routine cleaning, since 1972, when we bought
the jetter. It received special attention on two other occa.sions when
fresh sand was noted by Chester Swanson in the manhole at Kennaston and
Jackson (it was televised and sealed then). It was cleaned. from Mississippi
Street to 68th in 1978 by Chet and Bruce because of a large root mass that
lodged in the lines after a backup on Mississippi Street. (4de cleaned it
all because we wanted to make sure it dich�'t loa��� �u�ywherc i�� thc 8"
lines) , The line has received careful attention because of the anwwit of
flow in it. The J�ior High School discl�arges a large amount of water in-.
to it at West Nbore Lake Drive.
The line is visually checked approximately every iuoiitll. It is not
included in the "high mainteiiance area" lists because of so few backup
problems with it. However, the "drop" manhole at 68th aaid Jdckson is
part of a group of "drop" manholes checked �nthly as a precaution. The
other drop manholes are at Lynde and Polk; Rice Creek Road just east of
Carrie Lane; 52nd apartments; and all those along 73rd Service Drive in
l�lody Manor.
Television records and routine cleaning records are available on the
line. The manhole at 68th and Jackson was last visua.liy checked by Chet
and Art on October 3, 1980.
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( .�!',... :: � v �� 9L�5`t'�v.•�`�.�i ,_-
Chester Swans n
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City of Fric�lcy
AT TME TOP Of TaE Tw�NS
�, j rv.•.N�� INTEk'CEPARIMEN7 RQQ�Si
� 1 ; P48LIC 1MORKS DIVISION
� � � GTY MA�� fR10lEr 53�32
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• s�:wLji s�l'OPPAGE
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SE41ER STOPPAGE �
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AUORESS 6740 Jaekson Stre�t N.L'. D�TE Uctot��•i� -, !.,, � ;
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CALL RECEIYED BY Public Works lk:l�aruu��iit AT 12:�IU (is;,',; ,,,'
CRE�I LOCATION 1+IHEN NOTIFIED !'ul�l i�. 6vurky ��:���clp;��
EQUIPM6fdT TAKEN�TO�SIiE J�ttcr �
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CAUSE OF STOPPAGE �1 accwnulatian of root5 that koto Rooter Con�panics hav�� �u� �
from house services and dropped into th�: City lii�t and flowecl down streau� to t�hti� �
and Jackson, gettin� cau�ht in the clrop n�r�iolr: �::iusiri� the �lug up. `� �
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TI�tE STOPPACE RELIEUED ���� P•m• � T i
DESCRIBE DAMAGE (IF APIY) '1'here was clothing on t}ie floor thraughout the baseiu�•�ii, }:���;
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many Christauas presents tor Christa��as of 198U. '1'herc was ;��proxui�ately J" uf �ti.�►; �
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throughout the entire basement. Water seeped iiito tlie bottar► of th�: cice� 1 r��c�::�� , !
sa�e meat.
Washer and drier were also ui hi�h water at niotors .(�:� �� � r� �� �;. �
ANY STATEME!`JTS MADE BY CRE�1 OR HOMEOWNER REGARDING DAh1AGE OR POSSII3LE CLAlt1 �
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REW Ar�O HOURS
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S�wer bacl:u� at b74U Jdcksori 51 rve�t t:uitt inu��J
The City crew c:arriecl out all tt�� thi,��;� 1��•a�► tl�e buse��u;��t that w� ����
water soakecl, :�ici th� haue owner triccl to p i�k thin�s out that was
or could be saved. The City hauled a small d�anp truck load of ruin�J
miscellanous clothin�, kid g�ues, sliues, s�iown�bile boats, articles
too ntst�eraus to mention to the clwup. I took abvut 6 plastic bags ��"
wet Clothing to t,he lawidromat to be cleaned and wa�h�d. Th�re were.
ma�ny personal �ssessions thdt wcre ��ui���ct tt�ut ►�cnt to t}te clwi�.
Ther� wa5 a set of �;nc:yclopeclias tlxat was: watc�r ckuu��;td, �lsc� ivaiiy
magazanes fmm the library that w�re ruinect. As tiwe goes, ther�
will i� t�re things to be evaluated for cl�r��a�e. t person;�lly hur�c:
the City and the i.nsurance ccwi�arzy will tak� a se:cot�d look at tliis
partiCUlar mishap and give the home ow�ier uru�h consicic:r�.tidn at ttii:=.
ti.me. •.
I just received a call from 674U J:��ksoii �i�i their freezer, wash�r
and tlrier had to be repaired by an a�pli�ui�� sh�pping s�rvice co.
They paid for the repairs.
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sus�ecT PERMIT NO
City of Fridley 2 3 5
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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� `L _ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. � � ��
1 � �
� /��'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�'"""� � ��� 612-571-3450 910-F15 6/10/81 � �
JOB ADDRESS 7420 sacksor� 3treet N. E.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ZFi 3 Melody Manor 3rd Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Ciarence Grandy� 742Q Jaakson Street N.E, 786-4466
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Tim Olson C�onstruction Co. Route #4, Hox 46A, Cambridge, NIl�]' S5008 689-5067
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS Z�P PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 16' x 16' Addi.tion
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPERAiE PE��� T g REQUI�Ed ��� v�r���
HEATl�1�. ��.������ �1V� �:�. �
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Befo�e digging ��II loca! utilities
TE�EPMONE - ELECTRIC - GAS E�c:
REQUIREd BY l,AV1�
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. '
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
ANY TIME AFTER WORK IS COMMENCED. NO. DWIG. 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 WIIL BE COMPLIED $$�S�JO S'4.25
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GFiANTING 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- $S4. OO NONE
ST CTION OR THE PERFORMANCE OF CONSTRUCTION.
�� �,^ PLAN CHECK FEE TOTAL FEE
�,9��i a�!'lt,� � L✓,,�//Zr�--� �`/0 ° �% $13.50 $71.78
SIGNAT REOFCONTRAC ORORAUTHOHIZEDAGENT (DATEI �� WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
_ _ ` � � G
S�GNATUREOFOWNEAIIFOWNEABUILDERI IDATEI " BLDG �NSP �PTE
CITY OF �,,;IDLCY • •
APPLICl1'fI0'J FO�t l;ESIUt'i�lTl/1�_ BU1L[)It1G PCftt�iTTS
(tdc.�•�, Al �er��tions, lldditions, or Repairs)
� at�J(dE�t: �,t c����"1C� ��+�'Y��.I
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ADDRFSS : � Zi�Q �����`� �
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r�� ,vo: i� i� l�,— �1�� ��Ic�(�
[3UI tDER :� j ���1�. ' , _._...
nonncss: ��o � ���p� �rnh�,i� e
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TCL I�JO: � —' �CV I � -� � ��( — � ��
� Construction Location '
sxr��r.rio: sT��:T: °I`!�� �_��°% ���� �.
Lo��: . sr,ocx : I�UDITION : .
Coxner Lot: Insii3e Lot: SetbacY.: Sideyards:
Ap�licant at�ach to t�liis form two Certificates of: Surv�y o� lot and
prop��ed building tocation drawn on certificates to scale. �
DESCRIPTIOf� OF COF�STFUCTIOPI - �
� � B � .
I'ron�: � D�pth: Height:
Sc�a�e. Feet: �� Glibic Fcet: ,j� 0��
---r-- .
. k'rorit : Depth : Height:
Square• Fept: � C�zbic Teet:
25G � 3'�, �{3 = $3S8•� - 55�
Type of Coi�truction: _(���� ���1/�1�. Estimai:ed Cost: $ �
xb Be Cbr,�ple�ed: � m'! � �� .
` . _ Alt. A A7.t. B
Proposed Driveway Width I£ New Opening Is Desired: $' $
. , SEE 12x:VER;L SiDE OF SHEET
7�5ie undersigned he�:eby ma}:es applic�tion for a perntit fcr th� �.nrk� herei.n specified,
agr.ceing to c?o ,all. wor}; in s�:rict accardance �•�ith the City of I'ridley Ordinances 211C1
rulixigs oi i:lle Department af Buildings, and hereby declares that all tlie iacts and
ropresen�-�tions statcd :n this �.pplicatian are true and correct.
D.'�TF: SIGN2ITUF.'r; ;
Stiz�u��i;ions :
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• �3U) LJ)I1�1G i't_'<<111'f r[:t� :�(:II(�T)Ul_L-"� '� .
S1:C'!'x01� 7.. 7.'1�� 7:n�.:��cci:ar. of: 13ua.).c?.inrj :::1►r�].J., bctazr. i.:;::�ai.��q Z�ennits f-ar t:he crt:cL•�.on
t�f �iny l�t�:i.l.cl.i.n�� az :,t.d-uct:tire, or fa�� tin}� i1C1CI).t:)��Jl !:o aiiy cr..i�l:�.i�cJ T�tiilclinc3 c�z :�txucL•�zr_c,
. ci�' 1.'a�' c,r,y n1.t:c.��:�ZL-i�n or. r.e1riS.r.:, t:o •any c.:S..t:i»�l l�ui.t.di.�r.� or. sLr.ucturc, uj��n ar�J�Li.c:at.�.on
�tlicl:�:f.or.c, x:eel�i.i.r.c fJic l�tiymr.ut: }�� t]�e t�r�p].i.c:ant: �c�r. :;uch ��en�S.L• oi' fe.es L•o Ll�c arn�unL-
hrYu.i.n )�cl.a�•� sc:C for.th aiicl a.�i t;lic ��anrie�: hczci.n �,�:ov�.dc:cl to-�•::i.t: .
1J1:1d CUIdS`I']:UC'�I01� :�ing).e l.� amil.y llotae:; and Gar.�zcres, : y:� . 00/7., 00� cuLx� fec:t:. • .
PT.I:2•7 Cili:Cl:: ?.5 l�erce��t: ai bu�.�.c1i_n�J j�er.,nii: fce.
UliI:��EI'11]' llI:1'P.i:5S7UI•:: (CpncreL•q CUrU �i:rcets Only) '
' Altcrn�-�t.e n: Itc�noval aiid rej�l��xcamen� oi' concxe�e curb and
` c�uCter only; l�riveway e•riclth plus 6 feet• x$13. �0
11].ternatc T3: Removal and rep�.acemc;�t of concrete curb and
• gutter and inst��ll a 3 i'ooL t•�i.de approach c���i.h �'
� .� 6 x�;ch aepth; brivc�•�ay �•�idth �pl.us G feeL- x$15..75
- � . ��� i �on�n� tr;r-or���nTror
I`or the purl�se of co;nputi.ng i'ees far_ buildi_rig permi��s,. L-he cuk�icaJ. co;;tents oi any
buildi.ng or_ addi�ion, is dcL-cr:ni.ned by rnultip]_yir�g L-tze gr�und area covered f-ram a
poi.nt si�: (6) a.nches }�elo;�� the floor J_ine oi i:lZe base�neni: or the cellar to 'khc
average iicights ot thc �upper su�:face or to ihe average 2ieicPub of the roof �urf-ace
of �l:iie ,aain gabJ.e of a p�.tclied roo�. . �
Fox r_e�ai.rs or alterations to an existang si.rtiici:ure, the fee shall be at t�e xate
. of �3 . QO �,ier. each £ive hundred do�I.ars "($500. 00) er fracL-ion '�:1lereaf. in tlie cost
ai all proposed wor.Y.. _ •
In •no case sha�.l the fee cliargeci foz any pennit as set iorth i_n Secta.an 2 be less •
tiian $7.50 pl.us $.50 state suxcharqe. � • '
, . VERI F I CATIO� OF FOU;Sn111' I Otd
NOTE: Pennits �or consta.-ucti.on ���ill be issued a mznim� oi 24 haurs from ilie time
oi applica�i�n to al)_otv fox proper reviecv of the pro�.�sed si-sucturc and oi Uie
construction si.te. �
; �
A C�rtificate � of Suivey of the lot, sho�,7ing the locat�.on oi tiie foundation once it
has beeil coiis4nicted ��=i.11 be required bef.are pr.oceedin� s•rith thc ira�ning.
�RTIFIGJITE OF OC�l1PAf��C�' ' '
' 7►p�licatic�n for a Cer�ificatc oi Occupancy shall L�e mad�� ten (10) days prior t.o the
use G3:' OCCU��I2Cj� oi• any st��ucture for �ahich a L�uildiiig �err,►it l.as bcen i.ssued; ci21Ci
sc�id struct:u�-e s2�all_ iiot i�e used or occupied L:tiL-il � Ceri�i_f:ic�te o.f C�ccul�ancy has
bcen xssucd.
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sue�ecr PER O.
City of Fridley 16318.
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
r
� � R .
� ' COMMUNITY DEVELOPMENT DIV. �p
� `ti: ------� �4 � �
r j � PROTECTIVE INSPECTION SEC.
1 ; �
l_--- A �����,,� CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV
i �� 612-571-3450 910-F15
8J3/81 � /
JOB ADDRESS �420 Jackson Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2Fj. 3 Melody Manor 3rc1 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Clarence Grandy 7420 Jackson Street N.E.
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
R:i.chard Ha.stings 6331 Riversri�ret- Terrace N.E.. 57�4^9966
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADORESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Residentia.l
7 CLASS OF WORK
❑ NEW O ADDITIOPI O� ALTERATION ❑ REPAIR ❑ MOVE � REMOVE
8 DESCRIBE WORK
Reside dFrelli.n
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. �i],�.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OH IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FQR A PERIOD OF 120 DAYS AT
ANY TIME AFTER 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 $`rji OOO �$ $`2. r'JO
WITH WHETHEF SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OFi CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $SO.r'JO
.(,AGV 'V PLAN CHECK FEE TOTAL FEE
,,�, r $ 53. 00
% SIGNATUREOFC' TRACT R fiAUTMORIZEDAGE IDATEI� '� WHEN PROPERL VALIDATED THIS IS Y�R� RMIT
�
SIGNATUREOFOWNERIIFOWNERBUILDERI IDATEI BLOG INSP � TE
CITY OF FRIDLCY Effective Aug. 1, 1981
APPLIC/ITI�'d FOf� RCSIDL"tdTl/lL QUILDIf1G PE�ti�iITS
(Ne►•�, Alter��tions, Additions, or Repairs)
�� � �
011I�ER: C��,�'��- � �
ADDRESS: � �:
TEL N0:
� ¢�'� �
[3UI LOER : ����`�.` "�
ADDRESS: � a �� l� � .%��
TEL t�d0: �7 y- �' �° � � -
Construction Location
• STJtITT NO: (� STFtEET: Q�
—���-
LOT: � SLOCK: �
Corner Lot: Insicle Lot:
� T rv �
ADDITION : � � �..�.�. � �
SetbacY.: Sideyards :
Ap�licant attach to this fozm two Certificates of S�rvey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOid OF CO���STRUCTIOPd
`�- S � �� Front: Depth: Height:
Square.Feet: Qibic Fcet:
Front:
Depth: Height:
Square� Feet: Cubic I'eet:
�
Type of Construction : (_�dt' . Estimated Cost: $ � �' � � '
Rb Be Oos�pleted: �'� � b J�)
Alt. A Alt. 8
Proposed Driveway Width If New Opening Is Desired: $� $
, SE� REVERSE SIDE OF SHEET
R�ie undersigned hereby make� application for a permit for the �:vrk� herein specified,
agreeing to c3o .all work ir� strict accordance ��ith the City of I'ridley Ordinances �id
ruling� of the Department of 73uilc3inqs, and hereby declares that all the facts and
representations stated in this application are true and correct.
D.7�''�: � � % SIGt�,nZ'L1I2E :
Stipulations:
�S��SZ�
� .��
'�S�.c�� .��
BUILDI•NG PERNlIT F�EE SCHEDULE
The Inspector of buildings shall, before issuing permits for the
erection of any building or structure, or for any addition to any
bxisting buildinq or structure, or for any alteration or repairs
to any existing buildinq or structure, upon application therefore,
require the payment by the applicant for such permit of fees to the
amount herein below set forth and i.n the manner herein provided to-wit:
TO�AL VALUATION
$1.00 � $500.00
$501 t� $2,000
$2,001 t� $25,000
$25,001 to $50,000
$50,001 to $100,000
FEES
$10.00 Minuauan Fee $15.00 plus surcharge
$10.00 for the first $500 plus $1.50 for each
additional $100 or fraction ther�f, to and
including $2,000
$32.50 for the fixst $2,000 plus $6.00 for each
additional $�,000 or fraction thereof, to and
including $25,000
$170.50 for the first $25,000 plus $4.50 for
each additional $1,000 or fraction thereof, to
and including $50,000
$283.00 for the fi.rst $50,000 plus $3.00 for
each additional $1,000 or fraction thereof, to
and including $100,000
$100,001 a�d up $443.00 for the first $100,000 plus $2.50 for
each. additional $1,000 or fraction th+ereof
PLAN Ci�CK: 25 percent of building pezmit fee
DRIVF�TAY DEPRESSION ESCROW: Concrete Qirb Streets Only
Alternate "A": Removeal and replaceinent of curb and gutter only
Drive�aay width plus 6 feet x$13.50
Alternate "B": Renoval and replacement of curb and gutter and install a 3 foot
wide approach with 6 inch depth
Driveway width plus 6 f eet x$15. 75
VERIFICATION OF FOUNIIATI�ON
Permits for construction will be issued a mini.mum of 24 hours frwa the time of
application to allow for proper review of the proposed structure and s�f the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with.the framing.
°r � - r
sue�ecr PE
c�ty of Fridley � 171 A 5
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
� � REC .
� �� ___�� COMMUNITY DEVELOPMENT DIV. � ���
r � � PROTECTIVE INSPECTION SEC.
1 . ,
I
� � /�"1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�""� � ��' 612-571-3450 910-F15 5/17/83 / /
JOB ADDRESS
7420 Jackson 5treet N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 26 3 Melody Manor 3rd SHEET
2 PROPERTYOWNER MAI�ADORESS ZIP PHONE
Clarence L. Gran 7420 Jackson Street N.E. 786-4466
3 CONTRACTOH MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING ,
Rf:S].C�eIl't].8.�.
7 CLASS OF WORK
❑ NEW ❑ ADDITION [� ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroo�' Structure
8 CHANGE QF USE FROM TO
STI PU LATION S
Roof can be 2nd layer but not 3rd. Install galvanized valleys.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
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
ANY TIME AFTER 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 IAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $650 S•5O
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- y�`1S.00
STRUCTION OR THE PERFORMANCE Of CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
$15. 50
SIGNATUREOFCONTRACT HORAUTHORIZEDAGENT � (DATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
�°/7—�3 � � � �.�
SIGNATUREOFO NE IIFOWNERBUILDER IDATEI BLDG INSP �t.
9 -
CITY OF FRIDLCI( �ffective �►ug. 1, 1961
AI'PL�CATIal FO(t RtS1DtNT1/1� 6Ul101ilG PZRi9ITS
(Hc„r. Alterations. Additions. or Rcpairs)
ONt�ER:
ADDP.ESS: � _
TEL M0: • � �C — �s�� .
• — —
BUILDER: ' •
ADDRLSS: �
TEL N0:
. Construction Location
�
. srn�r uo: '�a-o crn�r: �J�/cs o� ��� N� �,
LOT: G2 �' sIACx: ^_ � _ ADniTIOI�I a ��/ �� � � ��a���
Coznez Lot: �_ Inciae Lot: `_ i�tb�c}a ______r Sid�yarbs:
11p�l�car�t attacA to tl�is fozm is+o Gertificates oi S1�zvey of lot �nd
pzoposed buildir�g locataon dravn on certificates to scale.
OESCRIPTIOit OF C01•�STP,UCT10q
� � Front:
6quare Faett
�P�= Height:
Cubic Feetr
, Front: Depth: N eight:
6quare Fe�t: Oubf c I'eet:
�� ��- � .
7�►Pe Oi CbTabLTUCLfor1 i ESLi�►atQd COSLe :� S�G --a
7b Be O�r.�p2cted:
711t. A A1 t. B
pzoposed Drive,+ay i�idt?� If Nev Openir�g Is Desfred: _' :�
___-_____.� �_
, . .. SEZ Rs,VER;E S7DE OF SHt�T
• . • _ .
��e undersigned Aezeby �na1;e� applie�tion foz a pencit icz the ��ozk herein specified, ,
egreeir� to d� ,all vork it, 6trict eccordsnce Mith the Gity of Ftidle�� Ozdi»ances a»d
tvlin�s of the Del�►�sbnc�t of Duiidingc, and ?��eby dec�azes t?►r►t all t]ie fact� and
tepre6crt�tfens stated 3s� t?�is application ase true and cosrect.
narE: �"Yt / 9�.3 sica�nzv�:
Stipulations:
� �S . C�C�
��
� /.S ��
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SUILDING pERyIT !EE SCHEDDLE
!he Inspectoz oi Dnildinqc s?�all, befoze issuiag pezmits ioz tAe
•r�ction ot �ny builainq oz attvctnre, or ios �ny addition to any
•xi�tiAq pnildiAq os stryctnst, or tor aay altezation or t�paiss
to •ny •sistinq �niidinq ot atznctuze, opoa applieation tl�ezetoze,
s�qui:t the payaent �y tAe applicant toz sue?� permit o! t��s to the
��ouat a�reia Delor set iozth and in the sanaez ?�ezeir� pzovided to-vits
7'0?�I. Vl1Ii7l1TI�1
�1.00 !a SS00.00
=SO1 m i2•000
t2. ooi ea s2s, o00
f25,OG1 to SSO•000
!'E£S
i10.00 Mini�uim Fee 515.00 plus surc?azge
� =10.00 !or the lir�t iS00 plus 51.50 toz each
additional i100 oz izaction thezeof, to ar�d
including :2,000 -
i32.S0 toz the iirct S2•000 plus 56.00 foz each
addi tional S1.000 oz iraction t?�e�eof, tc and
l.nelueling f25,000
:170.50 foz the iizst S25,000 plus Sa.SO for
eaeA additional 51,000 or traction thes eot, to
a»d including =50,00�
i50, 001 ta il�, p00 i?63.00 toz the iirst t5�, 000 plus S3. 00 ioz
each •dditional s1,000 oz tr�cti�n t],ezeof, to
ar�a includar�g S100, 000
:100.001 ard np ia43.00 toz the fizst 5100, 000 plus S2. SO ior
•ach •dditional 51.000 oz iraetion thezeof
PI�W G�C7C: 25 pezce�t of puiiding permit fee
DRIvD�AY D�EPRESSION ESQtOf+t: Conczete Q�zb 5tseeta �ly
lllteznate 'A": Reso�v�al ar,d zeplaceme�t of cvrb and guttez only
Oriveway vidth plus 6 feet t S13.S0
111ternate `B': Renoval ar�d replsceAer►t of cuzb and guttez and install a 3 foot
vide approach vitA 6 inch depth
Crivevay vidth plus 6 feet Y:1S.75
VERIFICATION OF FOUNDATION
Pera►ita to= conStsvctian vill De issued a minin►�n of 24 houzs frao tr,e time of
applica tien to allov toz proper seviev oi Lhe propose8 structure and of the
constru ction site.
1► Gertiticate of �n►ey of the lot, sAovinq the location of the loundation once it
bas been oonstsvcted vill be zequired before proceed_ ir� vith the frani,r��.
��
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C� ■ i V ■
FR1DL�.Y
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E.. FRIDLEY. MINNESOTA 55432 • PHONE (812) 571-3450
April 9, 7984
Mr. Clarence Grandy
7u20 Jackson Street N.E.
Fridley� NAT 55432
Re: Concrete Obstruction In The Gutter
Dear Mr. Grandy:
It has been confirmed by recent inspeetions that you have placed concrete in
the gutter immediately in front of your driveWay. This practice obstructs the
Water floW in the gutter and can cause damage to City vehicles when clearing
snox from the streets.
Therefore the City must require that any material be removed from the gutter.
To insure that all the concrete is removed and that there is no damage to the
curb� a City street maintenance creW will be removing the concrete.
Any initial costs Will be absorbed by the City, but if at a later date� it is
found that a neW obstruction exists, any neW removal expenses xill be the
property owner's responsibility.
If you feel that a problem exists When trying to enter your driveWay from the
street� please contact the City Engineering Department about aceeptable
solutions, e.g. construeting a neW driveWay depression. Tt should be noted
that on�v the City or its authorized con�r�ctor ean do eurb and autter cement
]e19�k.�
The City is confident in qour cooperation on this matter and again, if any
questions or problems arise, please feel free to call on me at 571-3450.
Sincerely,
STEVEN J. OLSON, R.S.
Environmental Officer
S10/mh
CC: Mr. Ralph Voll�an
Supt. of Public ilorks
✓ � CITY OF FRIDLEY
�-� �
: py�;J�a 6131 UNIVERSITY AYENUE N.E., FRIOLEY, MINNESOTA 65132
'�. �y TELEPHONE ( 612►571-3150
A,�
�� `�� ;'" October 26. 1983 _
�'�;-:::;;:,�;��'
�} �._=n.�.`je.�
�'!!',4•. , - .
'�`�'''4°:
�,
�_ ..�--;;.
;. -•., Mr. Clarence Grandy
: y' 7420 Jackson Street 1�. E.
, Fridley � 1�1 55�32
Re: Concrete Obstruction In The Gutter
Dear l4r. Grandy:
IL has been confirmed by recent inspections that you have placed concrete
in the gutter immediately in front of your driveway. This practice
obstructs the water f1oW in the gutter and can cause damage to City
vehicles when clearing snox from the atreets.
Therefore the City must require that any material be removed from the
gutter. To insure that all the concrete is removed and that there is no
damage to the curb, a City street maintenance crew will be removing the
concrete within the aext week.
Any initial costs will be absorbed by the City, but if at a later date,
it is found that a new obstruction exists, any nex removal expenses will
be the property owner's responsibility. �
If you feel that a problem exists whea trying to enter your driveWay from
Lhe street� please contact the City Engineeriag Department about
acceptable solutiona, e.g. constructing a new driveway depression. �,
should be noted that only �he Citv or its authorized contraetor ean do
surb and autter cement rrork. -
The City is confident ia your cooperation on this matter and agaia� if
any questions or problems arise, please feel free to call on me at
571-3450.
Sincerely�
���
STEVEN J. OLSON� R.S.
Environmental Officer
STO/mh
�
. sue�ecr PERM
City of Fridley o 18414
AT THE TOP OF THE TWINS g U i L D I N G P E R M I T
r
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV. � D � /�
� ; V � '
r � � � PRO7ECTIVE INSPECTION SEC.
1 ` i
� �'��� � CITY HALI FRIDLE� SB43Z NUMBER REV. DATE PAGE Of APPROVED BY
�""'� � ,'� 612-571-3450 9t0-F15 5/6/86 � �
JOB ADDRESS 7420 3ackson wtreet N. E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ZFi 3 Melody Manor 3rd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Rflbert Parupsky 7420 Jackson Street N.E. 786-3933
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Samne
4 R�ICHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS Z�P PHONE LICLNSENO.
8 USE OF BUILDING
RL'S1C�Pril'tl�
7 CLASS OF WOHK
❑ NEW ❑ ADDITION � ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOFK
Construct a 16" x 18' Deck
9 CHANGEQFUSEFROM TO
STIPULATIONS
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTHUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WOHK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE AEAD AND EXAMINED THIS APPLICATION 1 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 WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $�-►800 S•9�
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 529. 5O
PLAN CHECK,AEE TOTAL FEE
�. : -
$ 7.38 $3�.78
SIGN�F N'R t ORAUTNORIZED GENT IDATEI WHEN PROPER VALIDATED THIS IS YOUR PERMIT
, �C � � � �l
SiGNATUREOFOWNERtIFOWNER UILDE DATEI BLD INSP �AT
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p� [] City of Fridley Effective 4/1/86
ADDN. I✓l R-1 AND R-2
pLTER. [ 7 Building Permit Application
Construction Address: ��T � a J� G���/� �%
Legal Description
�
Owner Name & Address : `�� �/ � ✓ Tel . ,� �� ` �
Contractor: �1%i 1G�,50/✓ G�jV, �p/t/�'L- Tel. �
Address•
LIVING AREA:
GARAGE AREA:
DECR AREA:
OTHER:
Corner Lot [ ]
Attach to this a,pplication, 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 Width Height Sq. Ft.
Length �_ Width � Hgt/Ground Sq. Ft.
Type of Construction:
Approx. Completion Date:
� ��� � � � � y
t [ ] Ft. Yd. Setbaek
Side Yard �etback
Estimated Cost: $ � � �+
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: APPLICANT: Tel. �
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY QSE ONLY
$ s� Fee Schedule on Reverse Side
$ �,�� 25� of Building Permit Fee
$ � � V $.50/$1,000 Valuation
$ $475 per SAC Unit
$ Fee Determined by Engineering
$
�,�� Agreement Necessary [ ] Not Necessary [ ]
$
��z
n
� � ��
�.��� �0►Uu
� -� ,� �� � 1 �t��
a���
BIIII.DING 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 strueture, or
for any alteration or repair to any existing building or structure, upon applicatio n
therefore, require the payment by the applieant for sueh permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
Total Valuation
$1.00 to $500.00
$501.00 to $2,000.00
$2,001.00 to $25,000.00
$25,001.00 to $50�000.00
$50,001.00 to $100�000.00
$100,001.00 and up
Fees
$10.00 (Minimum Fee is $15.00)
$10.00 for the first $500 plus $1.50 for each
additional $100 or fraction thereof, to and including
$2,000.
�32•50 for the first $2,000 plus $6.00 for each
additional $1,000 or fraction thereof, to and
ineluding $25,000.
$170.50 for the first $25,000 plus $4.50 for eaeh
additional $1�000 or fraction thereof, to and
ineluding $50,000.
�283.00 for the first $50,000 plus $3.00 for each
additional $1,000 or fraetion thereof� to and
including $100,000.
$433•00 for the first $100,000 plus $2.50 for eaeh
additional $1,000 or fraction thereof.
DRIVEHAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus
6 feet times $13.50
Aiternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach With 6 ineh depth - Driveway width plus 6 feet times $15.75
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 2�1 hours from the time of
application to allow for proper review of the proposed strueture and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been eonstructed will be required before proeeeding with the framing.
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F, ., � '
li
sue.,etT , ERMIT N .
City of Fridley 2 8 2 41
AT THE TOP OF THE TWINS g� I L D I N G P E R M I T
r �
' �' {�1"il�°,�� T NO.
� ` ITY DEYELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. ����
� . i {Cl (! U
i---- A;�'��,•� CITY MALL fRIOLE� SSI$Y NUMBEN pEV DATE PAGE OF AVPROYED BY
� '� 612-57�-3a5o s�aF�s
10/14/98 � �
JOB ADOHESS
7420 Jackson Street NE
t LEGAL �07 NO. BLOCK TRACT OR AODITION SEE ATTACHED
DESCii. 2C 3 Melod Manor 3rd Addition SHEET
2 PROPEfiTY OWNER MAIL AOOR�S$ 21P PNONE
Robert Paru sk 786-3933
3 CONTRACTOR MAII ADORESS Z�P PMONE IICENSE NO
Seal Guard S stems 9199 Central Ave NE
4 ARCNITECT OR DESIGNER MAIL AODRESS ZIP PFIONE LICENSE NO.
5 ENGINEER MAII ADORESS IIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
� c�nss oF woRK � REPAIR p MOVE O REMOVE
❑ NEW O ADDITION ❑ ALTERATION
8 �ESCRIBE WOfiK
Repair siding and trim - storm dama e
9 CHANQE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before covering.
SEPARATE PEFiMITS ARE REOUIREO FOR ELECTAICAL, PIUMBING. MEATING. TYPE OF CONST. OCCUPANCV GROUP OCCUPANCr LOAD
VENTILATING OR AIR CONOITIONING
THIS PEFiMIT BECOMES NULL AND VOIO IF WQRK OR CONSTRUCTIO�I tONING SO. FT CU FT.
AUTHORIZED IS NOT COMMENCED V�1ITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONEO FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCEO NO. DWLG. UNITS OfFSTqEET PARK�NG
I HEREBY CERTIFV iNAT I HAYE REAO AND EXAMIN�� TMIS APP(,ICA710N STALIS GARAGES
ANO KNOW TME SAME TO BE TFIUE AND COARECT. ALL PROVISIONS OF �AW$ yALUATION SURTAX
AND ORDINANCES GOVERNING TMIS TYPE OF WpRK WILL QE COMPUED
WITM WME7HER SPECIf1ED HEREIN OR NOT. TME GRANTING OF A pERM1T 6435 3. ZZ
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL TME pEpMIT FEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON•
STRUCTION OR TNE PERfORMANCE OF CONSTRUCTION ].2 . 75 Fire .S 6. �i3
PLAN CMECK FEE OTA� FE
S�GNATU�7EOFCON'AACTOpON4UTNOA�ZEDOGENT ID�fE� n �
PR PE OATED IS VOU PEAMIT
_ LI�. .
S�GN4TUAE O� OWNEp��F OWNEpBWIDEFl� iOAfEi . � � BLDG � 5� ' qiTE
a a/� �� � j
ADDN ., - �-CI1'1�,=0F FRIDLEY � - _ _ �:y.
ALTER SIl�TGLE FA1V�.Y AND DiTPLEXES R-1 AND R 2
- BUII.DING PERMTT APPLICATION
co�cuctionAddre�s: ' �
Leg�l Description: �
Owner Name & Address:
Co�mcactor: eQ �
Aaa�: 9 I qq C.en�
• �ve uityts
- �� r
����' �g�
Atrach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale. �
DESCRII'TION OF IMPRO��
�l�i� _ �REAs - - Length - – -�idth - �iei.�ht ---- — �q. F� —
GA�AGE AREA: Length Width Height � Sq. Ft�,
DE�B AREA: Length Width HgtlGround Sq. Ft. �
OTT�EER:
Cons�uction Type: Estimated Cost: $� � , �(� -
(Fee Schedule on Back) �
Driv�way Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ –$
DA1'�: l ��� a� APPLICANT: � Tel. #� (.' V
��
Permat Fee
Fire Surcharge
State Surcharge
SAC Charge
Lice�se Surcharge
Driv�way Escrow
Erosion Control
Park Fee
SeweP Main Charge
TOTAL
STIP�JLAT�ONS: �
CITY USE ONLY
$ ��/i .1
"I , 5 Fee Schedule on Reverse Side
$ �P . � �J .001 of Penmit Valuation (1/IOth%)
$ �� �� $.50/$1,000 Valuation
$ $1000 per SAC Unit
$ � � �b $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ I�"I '��
BUII.DING PER1VITr �FEE SCHEDULE '�' � �
The Clrief Building Official shall, before issuing permits for the erection of a�► building or sorucwre, or for
a�► addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, r�quire 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
$SOl to $2,000
$2,001 to �25,000
$25,001 to $50,000
$50, QO 1 to $100, 000
$100,001 to $500,000
�500,001 to $1,000,000
$1,000,001 and up
�� :.
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, w and including $2,OOQ �
$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,�0 plus $y.W i�r each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,0� plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,0�
$887.25 for first $1�,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus 54.2� for each addiuonal
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,�0,000 plus $2.75 for each additional
$1,000 or fracrion thereof
DRI`TEWAY DEPRESSION ESCROW
(Concrete G�rb Streets Only)
�lternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $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
will be required before proceeding with the framing.
�
SuB�ECi
City of Fridley
AT THE TOP OF TME TVYINS g U i L D I N G P E R M I T
i �
� �
� ; v __��� COMMUNITV OEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1 . �
i--_-��� "' ��� CITY MALL FRIOLE� SS132 NUMeEa REV O�TE
L 612-571-34b0 910-F15 4/29/99
JOB AODRESS 7420 Jackson Street NE
t LEGAI LOT NO. BLOCK TRACT OF ADDITION
DESCF. Z( 3 Melody Manor 3rd Addition
2 PqOPEfiTY OWNER MAIL ADORES$ 21P
Robert Parupsky 7420 Jackson Street NE
3 CONTqACTOR MAIL ADDRESS ZIP
Budget Exteriors 8017 Nicollet Ave S, Mpls., mN 55420
4 AqCNITECT OR OESIGNER MAIL AODRESS ZIP
S ENGINEER MAII ADDRESS ZIP
8 USE OF BUILOING
Residential
7 CLASS OF WORK
O NEW
e oescR�ee woaK
Reroof House & Gar
9 CHAN(iE OF USE FROM
�
P 1T NO.
29348
RECEIPT NO.
� �
OF A PROVEO B�
�
SEE ATTACNED
SNEET
786-3933
PHONE �ICENSE NO
887-1613 6564
PMONE LICENSE NO.
PMONE LICENSE NO
O ADOITION ❑ ALTERATION (� REPAIR ❑ MOVE � REMOVE
9 Sq) Tear-off; Reside House
TO
STIPULATIONS
Und�Yla.�ent must comply with the State Building Code. Call for
building wrap inspection before covering.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm9 Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMITS ARE REOUIRED FOFi EIECTRICAL, PLUMBING, HEATING, TYPE OF CONST
VENTILATING OR AIF CONOITIONING
tHIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING
AUTNORIZED IS NOT COMMENCED WITHIN 60 OAYS, OR If CONSTqUCTION
OR WORK IS SUSPENDED OR ABANDONED fOR A PERIOO OF 120 DAYS AT
ANY TIME AF7ER WOqK IS COMMENCED NO DWLG. UN
I MEREBV CERTIFV THAT I NAVE READ AND EXAMINEO THIS APPLICATION 1
ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yq�UATION
AND ORDINANCES GOVERNING TNIS TVPE OF WORK WILL BE COMPLIED
SQ.
STALLS
WITH WHETMER SPECIFIED MEREIN Ofi NOT. TME GRANTING OF A pERM1T �5,685
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLA7E OR CANCEL THE pEqMITfEE
PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGUTATING CON- @
STRUCTION OR 7 E PERfORMANCE OF CONSTRUCTION y�11Z.2S
PLAN CMECK FEE
��? 1 � Lic e C $
S� A AE OF ON'RACTOA Op AUTHOai2ED AGEN� IOATE� . ..... ���� .
��� OWNEii BuLLDEfi� IDATEi
OCCUPANCV
CU FT.
ET PARKING
IGARAGES
$2.84
SAC CMAR E
Fire $5.69
TOT F E
_ 25.78�
�n�g i��M�7
� �
4
NEW [ ]
ADDN [ ]
ALTER [ ]
ConstructionAddress: i
Ixgal DescriFtian:
Owner Name & Address:
Contractor: ,
Address: .X l�l 7 %%l I�,
CTTY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUII.DING PERNIIT APPLICATION
�
Effecdve 111/99
J��h� -� ,�/
���' ��7�. 75�
a3�� �
� �°
�� Tel. # 7 � � � �y��.�
MN LICENSE # �� .
Tel.� ��7" � ��j
Attach to this application, a Certificate of Survey of Lhe
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
LIVII�TG AREA: Length Width Height
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
OTHER: �� °`�
Sq. Ft. _
Sq. Ft. _
Sq. Ft. _
d`
�. . s �
Construction Type: ° � Estimated Cost: $ l� , �
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT: �..��(1 `-�.-�J\ C�,� �1 c% Tel. � ,�� 7 ��� .�
��2 Z � CITY USE ONLY
$ � Fee Schedule on Reverse Side
$ ���1 .001 of Permit Valuation (1/lOth%)
$ �2. $.50/$1,000 Valuation
$ $1050 per SAC Unit �
$ i � $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
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1
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BUII.DING PERMITj 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 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 $25,000
$25,001 to $50,000
$50,001 to $1Q0,000
$100, 001 to $500, 000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 e:
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,OOU
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction 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 $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Stree±s Only)
Alternate "A": Removal and replacement of curb and gutter orily - Driveway width plus 6 feet times $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 FOUl�'DATION
Permits for construction will be issued a minunum 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
will be required before proceeding with the framing.
� ,. R
Building
Inspections
763-572-3604
DATE '� /
SITE ADDRESS
1'HIS APPLICANT IS:
PROPERTY
o��,
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WTfH
APPLICATION
PERNIIT TYPE
TYPE OF WORK:
PLUMBING
RESIDENT'IAL APPLICATION
CITY OF FRIDLEY
: • ■ • •�
��% L�/�/,1���
�..����
%,/�"//�i/l,1/�i
Permit No.: pf CJCJa �
Received By:
Date Rec'd:
> � ' G�/Y7
STATE LICENSE # EXP DATE
ADDRESS: CITY STATE ZIP
• •I�.(�7�1y
�SINGLE FAMILY
❑ NEW
FAX
❑ TWO FAMII,Y ❑ TOWNHOUSE
�;&EPLACEMENT
%9 % /.
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installarion or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. Labor cost between $300 to $5� = cost of labor x.OS =
FOR PROJECTS WI�RE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FlXTURES; (INDICATE TOTAL
NUMBER OF EACH BELOVi�
BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING
BATHTLTB GAS PIPING (n�� cmuC�vsE) SWIMMING POOL WATER SOFTNER ($35)
CLOTHES WASI-IER KTfCHEN SINK WATER CLOSET BACKFLOW PREV. ($15)
_ DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR Il2RIGATION
_ WATER METER _ OTHER
Permit Fee
TOTAL DUE
$ _ f� G� Number of fixtures @ $10.00 � x $10.00 = $
.50 Number of fixtures @ $15.00 x $15.00 = $
$ / Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Tota1= $
THIS IS AN APPLICATION FOR A PERNIIT-NOT VALID LR�TIL PROCESSED
I hereby apply for a building permit and I aclaiowledge 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 pl' ation or a germit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the of o ich re ire eview and approva������ �T�/l�✓���� ��� �
SIGNATURE OF APPL PRINT DATE �/ �
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
Bui�ding
�r��pections
763-572-3604
763-502-4977 FAX
DATE i 1/ l,�
SITE .ADDRESS
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSURANCE
PROPERTY TYPE
PERMIT TYPE
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 1-1-09
YOUR E-MAIL
OWNER ❑CONTRACTOR
STATE LICENSE # EXP DATE
ADDRESS: CITY
ivrv� FAX
SINGLE FAMILY/NEW CONSTRUCTION S1ZE
TWO FAMILY/NEW CONSTRUCTION STORIES
❑ BASEMENT FINISH
0 DECK
TYPE OF WORK: ❑ NEW HOME CONSTRUCTION
_ �MAINTENANCF./REPAIR
DESCRIBE WORK BEING
SIZE OF IMPROVEMENT
ROOFIlVG
NLIMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
0 ROOF ❑ DRAIN TILE
❑ SIDING �OTHER
❑ SWIMM[NG POOL
O ADDITION
O REMODELING
0 HOUSE ONLY
� HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
Permit No.: t�o '�i �
Received By l�
Dat���A P1Y ' 9
A
s �i f�
lii
STATE ZIP
FI'
BASEMENT REMODELING SUBMIT•
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
OSoffit ADDITIONS. & PORCHFS SUBMIT•
� Trim 1• Site PIanJSurvey showing the existing structures
❑ Fascia and proposed project.
2 T ts f
wo se o construction plans
WINDOWS 3. Energy Calculations
IN EXIS1'ING OPENINGS ❑Yes �No L�ATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OEWIlVDOW TO BE AiSTALLED NUIVIBER OF WINDOWS
ALL FEES ARE BASED ON VALUATTON, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
rernut ree
Plan Review
Fire Surcharge
Surcharge
License Surchazge
SAC Charge
� Curb Cut Escrow
Erosion Control
Park Fee
Sewer 1Vlain Charge
Total Due
$ See Back Page for Fee Schedule
$ 65°/-0 of Building Permit Fee
$ .001 times the total job valuation
$ .0005 x Permit Valuation Minimum $.50
$ $5.00 (State Licensed Residential Contractors)
$ $2000 per SAC Unit (Plans to MWCC for determination)e a
_$ 5Ll�. -- �ft+6ft=,�1?Z�ftX$2a=$ .s�z �
$ $450 Conservation Plan Review ��
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ `— Make c6ecks payable to: Citv of Fridlev Attach .r,ti
THIS IS AN APPLICATION FOR A PERMI'f-NOT VALID UNTIL PROCESSED
Z lo
22
�
5 �-
�� —
I 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
pemut but only an applicatio for a permit work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case w k whi uires revie d approval of s.
SIGNATURE OF APPLIC PRMT NAMi��. OY )/ AT S% � O�
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Page 2- Building Residential Application
�
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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 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 FEES
$1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $100 or fraction, to and
includin $2,000
$2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fracrion, to and
includin $$25,000
$25,001 to $50,000 $391.25 for 1�` $25,000 plus $10.10 for each additional $1,000 or fraction,
to and including $50,000
$50,001 to $100,000 $643.75 for lg` $50,000 plus $7 for each additional $1,000 or fraction to and
includin $100,000
$100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fraction to
and includin $500,000
$500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or
fraction to and includin $1,000,000
$1,000,001 and up . $5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional $1,000 or
� fraction
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 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 Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
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