AF - 47478City of Fridlep, Minn.
6431 Universit�y Ave. N. E., Mii�neapolis, Minn. 55432
BUILDING PERMIT
�te; —_FQbruary 21, 1973
0 Meara '
p�; XX�[ & Cave Bldrs . 8���
�_ 167 Wi nA,x or -ourt Address
Same
12040 ;
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�790 LOCATION OF BUILDING
�a �^ Jefferson Street N.E, p� of Lot
Lot 3 & �6. o o -- `
Lo't 81oc1c 1 . Addition or Sub-Divisioa __._ Adams Street Addn.
Co�mer Lot Inside I.ot x Setback � 35' Si�eyard ___.. & 10
BeWer F�evat%t Fuunda.tion Elevation
DESCRIPTION OF BUILDING
To be vsea as:
Dwelling Front 26 Depth 36 Height _?� Sq. Fk _.._._____ Cu. Ft __
Garage _. F`raat 20 �p� 22 Height 1� Sq. F't. __ (�t. F't. _._..
q•y� ���n wood fsame �� �t 32, 900 _ To be Completed May 1973
Provide verification survey
Provide Hard Surface Drive
Sac Charge 275.00 paid
SEPERATE PERMii'S REQUtRED FOR WIRiNG,
HEI�I;tNG, PLtlMEit�tG AND SIGNS.
Sewer Location Water Location _
141 S. of M.H. (Inv. 864.52) 9.2r S. of Sewer Service
Wye Elev. 865.08
Top of Footing 868.08 Split not registered at County-laterals o/k/
In �o�sideration of the issuance to me o! a permit to c�struct tbe buildmg described above, I agree to do
the proposed work in accordance with the descrlption above set f and in mpli with ail provisions at
Qt+�3nances o! the city of �idley. �
Ia co�sideration of the payment of a fee of $ 48 . 00 ; permit is hereby granted t��L�. ��ve Bldrs .
to constnxct the building or addition as d�cribed above. This permit is granted upoai
tbe express condition that the person to whom it is granted and his agenis, employees and workmen, in ali work
$one in, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances u�
Frtdley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildiII�
W1�� city limits and this permit may be revoked at any time upon violation of any of the provisions of said
NOTICE:
Thlc p�rnut do�s aot eovK th� consfruetion, instaiiNion fo� wirin�, plumbing, gas hsaNng, »w�r or waNr. Bs sun to tM �
tb� BuiMiny Inspecro� fo� sepanta p.rmin for th•s. items.
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AP.PI.IC�,TTQN �Qit AE$IAEI�T�aI,. ��.T��TZar�,
4A AAAITI4�i BUILDING PBRMIT
C�TX AF F1�IA�,EY� MINN��CITA
QW�1RR' S N�E s�,���-c� � CD�-u-2 �,,Q�BUIL�SR s� � C�,
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A n�►py�1� : // jiV,��y�p� C�-t�� S •
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�o� sar�rr�
L4�� � �N� ��T �r.ocKs�_ A�?IT�ort: r
t�BR LOTs I�I$Ifli LOTs� ✓ 88TBJ1CICS 3 SIDEYpRD: �.�....�.^ � S
�i� #�t�acb '#a #� �p�t�o, Cartiticato� f S, u_, o� Lot apd propo�ad
�i,i�t� l�ocation d� oa� �s C�stificatsa,
�=
��Se�tIPTION OF BUILAING
7!� �e iiss�d ,A� : � _� y� � ;,!
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5 � � � aepti�: Aeight : � �
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� � C.t.C/` FraRtt,,,..�.� : Depth;y_�� Height:,,�b�.,
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�►p�o� o# Co�et.r+,tcti.a�;
�+� D� Oo�pl�t�di
; • Cubic Feett
: 3 �, � c�
2�,�. $stia�ated �osx _$ ,_, '. �, J
�'bs taed�i�C►sd hersby a�k,ss app��c�ttiv�n �cx, a pe�t fax tite �oxk bareia
#��i#�ada, agrma�ng tro da all 11�►sk ia� stt�ct aacordaace witii the G�ty of
�'eldl+r� Oxd#�Kuoes sod s+tl�+� �# tl�e Depsrt�en� Af Ba��,di�, aNd heseby
i�a�as�e# �R all tba �acta a�d �reseatat3,aas stated �q Kbis appli,ca�i
a�s+s tsu� � cosreat, . ,� °'.
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�BUT�AING P�RMIT F�� S�H�DULE
V SFCT�ON 2. 7.'he Inepectox vf �ui.ldi.ngs sk►all, befo�e iasuing pexmit� for the
���,�t�,oa ot any building ox etructure, ox for any addition to any Wcist�ng
��aiid� ox stxuG�ure, ox fot any alteration or xepairs to any ex�.�ting
�u�,i��.ng ox stxuctuxe, upou &pP���ation therefore, require the payme�� by the
a�s�11��t fox such per�ait ai fees tro the ae�ount herein below set �orth and ia
t�� mannez hs�s�� pxGVided �a*wiGs
UNLFORM BUZLDTNG CODEt Type 2� 2& 4-$2.15 for each ame �housa�d cubic
�e�t, pX fz�ction thex�ea£, in such cubical con�ents. 1�pe 3& 5-$�.85 �or
sach ons l;housauid �b3c �seC. ,
A�D i T�U1�IAi� I NF1)�tMAT I ON : ,
s.
Fa� �he pu�gose of CaanPu�inS �ees for building pextnits, the cubical contents
of any building or addition, i� determi�ed by multiply�.n�"the ground area
, �oveaCed �pm a poittt siac (b) inches below the floor iine o� the basement
t� t.be �l�ar �o the average heights of the upper surface or to the average�
�3,�tC of the �oof �uxface o� the unain gable pf a pi�ched xoo�,
� sap�tirs ox alterations � aa existing str�tuue, the f�e shalJ. be a� , t,he
s��e o� $3.� �x' e�t+cl� five h�dred dollar� ($�OQ.04) � fra�ctian thereof i.n
�� coat a� a�l� propr�sed work� . '
7�t �+ �a�e shall ��� �ee �ed fox �wry pexmit as set fo�t� �n Se��i.oa 2 be
3.aRS t.i�au $5 . tiU.
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- Y�Ri���ATiQN 0� �UUNDATION
aTQTE2 Y�7naits for ��stxuetion wil� be ia$ued a a�ininaxm o� �4 i�ours f�'aa the
' .ti#e of �►p�2icat�on, �o ���ow €or prQpex revf.ew of the p�oposeti a�su��re �d
. �P t't�e tt+aRSt�uGtion si�e.
' ����.�.�i�ad. Suxv�y v� th� l+at, �i� tfier �ocat�t af thQ faua�atiaa� .o�� i��
has � r»�nst�ted, Wiii �� required be€ore proceedinA with, the fr�qiag, ;
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CERT�F�CA�'� QF (�C�iJPAN�Y
Ap�li�►t�c�t �c� a G�ac�i:�is:a� a# oacupaaacy shal� ba mada xe�n (1Q) days pzi.ox
to �he �se ox occupa�cy o! eray �tructnre for whiah a building pexnti.� has bean
isst�ed; � s$id stxuckurG #�hal� pot be used ar occupied uatil a G�xtificate. -
of ���upa�cy haa beeu i��sued. ,
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ENGINEERING
7708 LAKELNND AVENUE
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GEOTECHNICS � LAND SURVEYING �� °�
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P.O. OSSEO, MINNESOTA PHONE (612) 425-2181 :,�
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CERTIFICATE OF� S
URVEY
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! I hereby ctrtify thct this is o true and correct representation of a survey of the boundaries of the lond describgd =
� above. It does not purport to show improvements or encroochments, if ony. As surveyed by me this Z2N0 �'
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ENGINEERING
7708 LAKELAND AVENUE
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PHONE (612? 425-2181
CERTIFICATE OF SURVEY
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I hereby certify thot this �s a true ond correct representation of a survey of the boundaries of the lond described
above. It does not purport to show improvements or encroochments, if ony. As surveyed by me this __._ /B Ty
day of __ _ F2`j/�14/�y---- 19_7Z
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HE�4T LOSS C�CZL"A�IO�s� �'ATING& AIR CONDITIONING CO. � MINNEAPOLIS, MINN.
Weatherstrips A.S.H.V.E. Construction No. Insulation
Windows Doors Guide Out. Wall Int. Wall Ceiling Roof Floor Kind HowAp�ied- �
Reference
Yes—No Yes—No �g
Fly� `' �' Room Length Width Height Fi. � Room Length Width � Height
Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area
No. W�drh Height No. of Lineal ft. Area No Width Height No. of Lineal ft. Area
of ane of pane lights of crack sq. ft of ane of pane lights of crack sq. ft.
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Infiltration
Glass
Exp. wall �
Net exp. wall
Int. wall
Ceiling
F I oor
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Infiltration Q Q
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Exp. wall � Q
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Int. wall.
�Q Ceiling �j �� � ('
F I oor '
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. ��,� Room Length � Width � Height
Windows and Doors—Crackage and Area
No. N/idrh Height No. of Lineal ft. Area
of pane of pane lights of crack sq. ft.
/ 2D 3 / �
Total Btu. �
Required Sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI � Room Length Width Height
Windows and Doors—Crackage an Area
No Width Height No. of Lineal ft. Area
of ane of pa li hts of crack sq. ft.
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Infiltration
G lass
Exp. wal I � /X
Net exp. wall
Int. wall
Ceiling C � � / 2..
F I oor
Total Btu.
Btu
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area �
( FI. Room Length Width Height
Windows and Doors—Crackage and Area
No. Width Height No. of Lineal ft. Area
of nane of pane li9hts of crack sq. ft.
_
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling �
F I oor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
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Infiltration , D
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Exp. wall " � lJ'C)
Net exp. wal I � ���
Int. wall.
Ceiling � �� Q �j �Q
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Total Btu.
Required Sq. ft. E.D.R, or sq. ins. W.A. Leader area
FI. Q Room Length �, Width Height
Windows and Doors—Crackage and Area
No Width Height No. of Lineal ft. Area
of e of p lights of crack sq. ft.
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Btu
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G lass
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Net exp. wal I
Int. wall.
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Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
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PLUME I ��r, PERf1 I T APPL I CAT I��J
Job Address
S 7�'sJ S'EFFE'i�so iv iU,E�
ner
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Contractor L
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Kind of Building /
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,� Plumbing Fixture Rates: N0. RATE TOTAL
I! Number Fixtures x$2 . 00 ��Oy
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I' Future Fixtures � x $1.50 �
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'� New Fixture-Old Open. x $1.50
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� Catch Basin x $3.25
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�� Water Heater-99,000 BTU �_ x$3.00 �-�
! Ground Run Old Bldg. X 2
�_ $3. 5
II Elec. Water Heater x$2.00 �
� Gas Fitting Fees:
lst 3 Fixtures _� X $2,00 �• �
i - ___'
' Additional Fixtures x $ .75
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( Gas Range-199,000 BTU x $5.00
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( Repairs & Alterations
See
, Description: Code
IState SurcharAe .50
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� TOTAL FEE $ �
!The undersigned hereby makea application for a permit
for the work herein apecified� agreeing to do all work .
i�n strict accordance w ith the Citp Ordinances and ruling
of the I�partment of Buildinge, and hereby declare that
a11'the Facta and repreaentations etated in this
application are true and correct.
ture
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sus�ctT p
City of Fridley 2 � 9 2
AT TME TOP OF THE SWINS g � � L D i N G P E R M I T
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� �' v__��_ COMMUNITV OEVELOPMENT OIV. NO.
f � � PROTECTIVE INSPECTION SEC.
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� �"'1 � CITV HA�L fR10LE� SS1J2 NUMlBF AEV OATE v�GE OF �PVnOVEO Br
�---•�' ,•' 612-571-3450 9t0-Ft5 9/22/98
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�oe AooRess 5790 Jefferson St NE
1 IEGAL �07 N0. BLOCK TRACT OR ADOITION SEE ATTACHED
oescR. &Pt of 4 1 Adams Street Addition SMEET
2 PfiOPERTY OWNER MAIL ADORES$ ZIP PMONE
David & Terri Meissner 571-6071
3 CONTRACTOF MAIL ADCRESS ZIP PMONE LICENSE NO
Ron Miller Construction Inc 953 Mississippi St NE Fridley 55432 571-3514 6354
1 ARCMITECT OR pESIGNER MAI� AODaESB ZIP PMONE UCENSE NO.
5 ENGINEER MAIL ADDFIESS ZIP PHONE IICENSE NO
8 USE OF BUILOING
Residential
7 CLASS OF WppK
O NEW O AODITION O ALTERATION Q REPAIR O MOVE O REMOVE
8 . DESCRIBE WORK
Reroof house & garage (22SQ) Tear-off; Reside
9 CHANGEOFUSEfROM TO
STIPULATIONS
Reroof - Underlayment must comply with the State Building Code.
Reside - Call for building wrap inspection before covering.
SEPARATE PERMITS ARE REOUIRED fOR EIECTFICAL, PLUMBING, MEATIN(3, TYPE Oi CONST. OCCUPANCV GROUP OCCUPANCV LOAO
VENTI�ATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULI ANO VOIO IF WOiiK OR CONSTpUCTION 20NING SO. FT CU fT_
AUTHORIZED IS NOT COMMENCED W,.ITHIN 60 OAYS, OR If CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 OAYS AT
ANY TIME Af7ER WOqI( IS COMMENCEO. NO. DWLG. UNITS OFF57fiEET PARKING
I HEFEBV CERTIFV THAT I MAVE REAO ANO EXAMINEO TMIS APP�ICATION STA��S GARAGES
ANO KNOW THE SAME Tp BE TRUE AND CORRECT. A�L PiiOVIS10NS Of �AWS yA�UATION SURTAX
ANO ORpINANCES GOVERNING 7HIS TVPE Of WORK WILL BE COMP�IEO @
WITM WNE7MER SPECIFIED MEREIN Ofl NOT. TNE GRANTING OF A PERMIT W6sHHS.00 �3.�F�{
OOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL TME pEqMIT FEE SAC CMAiiGE
PROVISIONS OF ANV OTHER STA7E OR LOCA� LAW REGULATING GON-
STqUCT/I� pR TME PERFOflMANCE OF CONSTRUCTION �IZ.�F.75 ire .5�.' �6.88
/I/�/ _ PIAN CMECK FEE TOT l EE
� ���� L c e SC .00
bv�i/ $140.07
- S�GN�TUA • CTOpOpAUTNOp�ZED�GENT iD�rE, EN ROO VA�IO T TH�S I �qM=T/�
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S�GN�TUAEO�OWNEAi��O�NNEpBU0.0�Ai iO�TE�� �ti5o - �i�iE
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CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/ 1/98
ConstructionAddress:_ �% 90 Je cfS�� �5�� ll%L �--�i�r ��,�
Legal Description:
Owner Name & Address: t� (�,�, �l, . d- T,e r,�,' �vt e �' S S h C'✓� Tel. # J�% �- �O 7�
Contractor: �, �, l �t.r �.-�SfY�J�-,L, (9�►% �hJ �1_ MN LICENSE # � �. s� `r
Address: /�' S' 3 �'I � f S� !1'� �%� �f. t%, � (� Tel. # _ � % 1 `,� .l7�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTI�R:
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
0
Width
Width
Width
�
Height
Height
Hgt/Ground
�l1 dC
Sq. Ft.
Sq. Ft.
Sq. Ft.
���. �v ' /�jY�-
Construction Type: Estimated Cost: � ��r
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
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"
$ -��
$ �
$
$ .S-C1�J
$
$
$
$
$ /�/a, o
CITY USE ONLY
Fee Schedule on Reverse Side
. 001 of Permit Valuation (1 / l Oth %)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [] Not Necessary [ J
� � �
BUII.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 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 $100,000
$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 or
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 $25,000
$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 Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B": R�moval 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.
r - r �