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AF - 47937� � �� Caty of Fridley, Minn. BUILDING PERMIT DB�: May 28, 1968 �� sc� p�r; Russell G. �� Ten.ney B��r Russell G. Tenney Add�.ess 528 Janesville Ad�,� Same LOCATION OF BUILDING No. ..—Z2�...�. Street .� ��all St . N. E. �� p� of Lot I.ot ._._ 6�` �__ Block � — Addition or Sub-Div3s�tan .�_ �'�erview Heights Corner Lot __....._..____ Inaide Lot Sewer IIevation Setback �y.._ Sideyard .._..._._ Founda.tion IIevation DESCRIPTION OF BUILDING To be Used as: _ Gara�e Front 12� Depth 17' Hei�ht .— 10� Sq. Ft. 204 �, �, 2040 Front Depth fTeight Sq. F't. Cu. b't. Zj►pe of Constructioa Frame �� _ $1, 000 __ To be Completed Jan .1, 1969 In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above set forth aad in compliance with a'll praovisfons of ordinances of the dty oE F'ridley. �a�� In camsideration of the payment of a fee of $ 6.00 � p�t � hereby granted to Russell G. �ennev to construct the buflding or addition as deacribed a'bove. Thispe rmit is granted upon the express condition that the peraon to whom it ia granted and hia agenta, employees and worl�►en, fn all work. done in, around and ugon said building, or anypar� thereof, ahall conform in all reapects to the oraineac�s of Fridley, Minnesota regardin� location, construction, altera.tion, maiatenance, repair and n►cvia� of buil�� within the dty limits and thia pernnit may be revoised at any time upon violatio the provfsions oE said ordinaacea � Clarence Belisle I NOTIC� '�his pennb d�s aot eever ths cons�roeHoe, tnstap�lee �oe wirine, piumbtee, ea 6aNn�, �r�� e� w�tsr. B� wn ts as !Ire Buitdleg laspeetoe tor ssparata pormif� foe f6as ttfms. � . _ . - r. i ' r• �x � , C . �.. . . 1._,l ' � ��rr •yr . �X .'t'�' ' �.. ..,��; . ..� • � y ;� . '+3- . . . � . . r., .�i,;:.l ,. :., � �.qt�- .. . �� +� ;,�=1'! .'?al : .�, . , • +� „ . n .�:: i�. . •i . ' ;. ' F....:J�. ..'`�'`. �� .,[9 '�i, , „ �;"Gi,^a io :' ,� � _; ..� ' .�fi�:t:�.7�: � •. , • ' i ' � •°�,> .jw� .� '.•1�'i APPL�C.,"�fi'COI1T FOR $UtLD�NG PER�IT " � , .. _ � r9�r �4 ,'.f i, . • /' } �R:, 7.^ �, „.� . . 5 , • � � G .` , Wd.ii �r�.� CL�.L++L4+a�� 7QilA... , • 1 :�ri..�-� „ „J,� . ` , . ' � . � . 3 = i OWiVEg' S I� ��s.�� ti _ . �.r,--�',�-�.�t�,,�' �� . BtJIL��R ' ^. G'� M r°.�.�...-.=.. � - - ., . , ^t, : ,. • ; �. �nna��s :�'�� ..��.�^.�'I�l i �"� _`�-�� _� �nn��s _ .�.:�� _._.�: ...._ LOCATION OF BUII�b�G � . y , � N0. 2� ,_„_�,;;_fiTREET_-.��i;��,�w`'. S":% � ` � C i . . r; •;, ••. ,4 . . � ,:., � ; �LOT r �/- -, �SI.00K �J ADDITZON OR SDBDIVIS�'�N ; �r�,��'�� <' fs F � .r . �.. CORriER LOT _ ISIDE LOT i� SETBACR SIDEYARD_�„�,�,;.,;_, ______,_ � SEWFR E?�EVATION � t TaP..OF FOaT�NG � , Applicant:attach to this form Two Cert9.ficates of S�rveq of Lot sad proposed building location drawa on these Cgrt3ficates. DESCPSPTION OF BdJILAING - • � %5 � To Be �Jsed As s • '., s�� . �; �I,� �,� �4r �� ,e4 ��i�;,�ront ,� �%��_�___Depth�".��_fleig�t� � %' . Square� feet �r Cubic FeeC �� 4� Front bepth Seighe Square feet Cubic FeeC � Type of Conatructioa ��'M�' ��dv�� Estimated Cost ,/ �4,Q = � �� Ta Be CampieCed � a�. ��___,�_ 9 C� 9 The undersigned hereby makes applicatioa ior a permit for the wark herein specified, agreeing to do all wark in sCr3ct accordaace �rLth the City of Fridley Ordinaaces and rulings of the Department of Buildings, and hereby declares that all the facts and representatiaas stated in Ehis application are true and correct. DATE °�� ° , SIGNATURE -�,��%�� _ . (Schedule of Eee Costs caa be found on the Beverse Side). « R. �, 6 � _ . , � /`� s p � �. � . :` a � �-. � �. • ,. , _ �,. _ - �� "'-: _ - ' .. ' ♦i.� .l•.. �t . . .. ,t' � .) I.,` fd _pi, . . ... . • • T• . . ` BUILDING PERMi� FEE SCHEDULE .. _ . _� ' �_,..�: , , SEC'�IOAi_2..,:_T�e:Inspector of.Buildi�gs shall, befare issciing permit�'for the erection of �ny bailding or stsucture, or�for any.addiGi`ori to any exiating.aCructure".Qr build�ngp..ox;f�� anq alteratfori ar repairs to anp exieting buiidiag or structure, upon application therefore, require the -� � �• the° payme.a�t, by. the applicant for sueh p;�rmit of f�es to the amouat herein bela�w set forth aad in the manner~i�eria' p's'evided to-wit: .. �...�r�..ft; . . . _. . _ . •:t�.. .... .. . .-.-Un�f"a�. �uildfng Cqd�e; �., Type 1, 2, � 4-' $1.75 for each one thousand cubic feet, �r fractioa thereof; in suc�i cubical c�oatente. � Type 3 6 5- $1.50 for r,- each ane theusand �cub�ic; feet . v � . .. • , . f . . ' . _. . 4 .l �'. . . � . _... "'�J'J . . Fsr the �us�ose ef ct�guting fEes �for �iu�tdiog p�L+m3ts�.�the cubical aontents ef aay buflding o�:;ad�l�.tion t• a unifastn height throughout by mult�plying the ground area covered fr�m a point sin (6) iaches below the floo� line af tiie basenient or the cellar te the�aver�ge height of the upper surface or to�the average height o� the roof eurface of�the�main:gable of a .. � •� pi;.G�hed :��f . . . �•., � F�r°•r�pait�� or alteratione to .aa egisCing s�rucCure, the fee�.shall be.. at the ra�� 0#�$3.00 per eacb'five hundred'dollars ($540.Q0) or fractioa thezeof •-� •' i'q: �the coat sE �aL1 proposed work. . °�_. . ... . . .... ,�ti'�n4�case aha�l the fee chaxged for anq _permit as.set £orth in Sectien Z be leas than $5.90... . . � . .._ . .:� NSS3D C�nnection Ciiarges bamed� pR lo�ati''6ii= Are�'��1 or �i. �. - � .. . �, ... � �c:_ . .. , _ ;., "' : .�.;ax..��; . •�.,�r ^ � ' r; � . . . � P. ,..7! : :53:. .•.it'+; .�.. , � ... •, • �. r . - � , • , . ... �c � i ,..# ts � . 1.. .. . .i � �. • . 5s : . .. • • .. �: ��,�r. , ,f'"� "° = r`jniir , a�' : . . •�'�. . • . �. i' ' a'j' . a�':. ... . . .. r� . ,i , , , / • ...' i q. `� � � \ - .. � . � .I t ! . . .. . . .. -. .'1 -., t A � � : . ..i .. . . .. �� REGULAF� COUNCIL NICETING, DECErI13ER 4, 1967 PAGE 6 � ; � _ , the maintenance�problem. Councilman Harris said ihis �aould have to be 'y �' ' researched as it may have been part of a covenant. The City Engineer said that there �aas a need for a drainage ditch. • - MOTION by Councilman Harris to concur with the recommendation of ttie Building Standards - Design Control Subcommittee for a mortuary to be located'at 6210 High�aay ��65 N.E. based on concurrence with stipulations A, B,C,D, as listed in the Subcommittee's minutes. Seconded by Councilman Sheridan. Upon a voice vote, there being no nays, rlayor Kirkham declared the motion carried, 3. CONSIDERATIOV OF A PROPOSED ADDITION TO THE PRECISION SHEET METAL FACTORY LQCATED AT 5250 MAIN STREET NORTHEAST (PARCEL i875, PART LOT 4, AUDITORS SUBDIVISION ��47 (REQUEST BY HUGH THOZSON CONSTRUCTION COMP�vY, 100 WEST DIAl�IOND LAKE ROAD, riIND1EAPOLIS� �flNlv'ESOTA 55419): The City Engineer explained that this will be a small addition to the rear of the building, and of'the same'�type of cons�ruction as the present building. MOTION by Councilman Harris to concur with the Subcommittee and approve the addition subject to their stipulations. Seconded by Councilman �amuelson. Councilman Liebl said he wo uld like to see the concrete blocks of the.present building spruced up. The City Engineers said the Inspection Department could be instruc'ted to see if it is in need of painting. � • AMEND�IEi�T to the Motion by Councilman Lieb� that the Precisi�n Sheet Metal Company be required to paint their building,if the City Engineer determines .it necessary, before the permit is issued. Seconded 6y Councilman Samuelson. � The vote upoa the amendment to the motion was a voice �iote, there being no nays, Mayor Kirkham declared the amendment carried. The vote upon the motion was a voice vote, there being no nays, Mayor Kirkham declared the motion carried. � . BOARD OF APPEALS MEETING MINUTES, NOVEMEER 29,1967:_ 1. A REQUEST FOR A VARIA:VCE FROyI SECTION 45 . 26 , CITY CODE OF FRIDLEY, MIl�'iVESOTr1 1963, REVISED DECE�C�EP. 31, 1965, BY WAIVEF OF FRONT YARD SETBACK I�EQUIRE�TE�T FROri 35 FEET TO 23 FEET AND A VARIA.NCE FRO�I SECTION 45.24, CITY CODE OF FP.IDL�Y, MINNESOTA 1963, REVISED DECE�IBER 31. L965 BY WAIVER OF SIDE YARD REQL'IRE�IENT OF S FEET TO 4 FEET, TO PERI�IIT CO\STRUCTION OF �iV ATTACHED Gr�'AGE ON LOTS 6& l. BLOCK 0 RIVERVIE[d HEIG�?TS :�DDITIQ:I, A:�'OI� COiT�TY, �fINVESOTA SAL�IE BEING 725 KIME�ALL STREET :lOP.TLIEAST, FRIDLEY. TMIIN�TESOTA 55432. (REOUEST BY RUSSELL G. TENDiEY� 725 KIl`IBALI. STREET NORTE-�aST. FRIDLEY, ti1I�'ESOTA 55432) : � MOTION by Councilm�n Harris to concur with the Board of Appeals and approve the variance. Seconded by Counr_ilman Sumuelson. Upon a voice vote, there bein�g no nays, Nlayor Kir�cham declared the motion carried. '• . � ^ . � .� • � ±�E�� _f,_ . _ . . . 1 . .y ♦ . � , � .� � f t y � ;� �0... l � � � �, . y �^ `- .. ' .,. � . ( 1 �� - - ��► a 4 a r� ". _.._. . . ._, i� t_ " C /7 � .C��v� .�,, ' «� >� �, _ 0 ° - • . � 7 �- 3 � C'�/ f T � .. - T .� � W `�, , : �� __ . N __ �� ,.. � �� F sue�ecr P N O. City of Fridley � 14954 AT FHE TOP OF THE TWINS g U I L D I N G P E R M I T � � � RECEIP . � ; y _ __� COMMUNITY DEVELOPMENT DIV. �� r � � PROTECTIVE INSPECTION SEC. 1 = � �l /"�1 � CITY HALL FRIDLEY 5S4$2 NUMBER REV. DATE PAGE OF APPROVED BY L•"'� � �•� 612-560-3450 910-F15 10/11/78 � � JOB ADDRESS 725 Ki.mball Street N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oescR. 6, 7 O Rivervi.ewr Heights SHEET 2 PROPEHTYOWNER MAILADORESS ZIP PHONE Russell Tenney 725 Kimball Street N.E. 784-8987 3 CONTRACTOR 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK � NEW ❑ ADDITION O� ALTERATION O REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct orch roof 9 CHANGEqFUSEFROM TO STIPULATIONS SEPERATE PERMiTS REQUiRED FOR WIRli��Ge HEATING, PLUM�fNG �NC► SlG�1S. SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD VENTIIATING OR AIR CONDITIONING. �AIQOCI Fl"�e THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTEFi 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 OROINANCES GOVEFiNING THIS TYPE OF WORK WILL BE COMPLIED. $20Q yi+.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- �`7, SO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � PLAN CHECKFEE TOTALFEE yS`8.00 SIGNATUREOFCONTRACTORORAUTHORIZEDAG NT IDATEI WHEN PROPERL VALIDATED THIS IS YOUR PERMIT /o- r�7� a�s�.) �O i► %n� SIGNATURE OF OWNER 11 OWNER BUILD 1 IDATEI BLDG INSP pATE � . ��-. _,�' _ crTY �or- r-�ilu�cY . ' API'L I C/1TT O1� ('Of2 t2ES I I)f=tJT I/1L BU I LD I P�G PEI21'I I TS . � (iV�w, �1LTLR11T10f'JS, nDll1T10IJ�, OR REPAIRS) � a .. ,�.a„o ' . . ,. � � '�� .., � . OWIi�R: �,' .: �' �J � c�� —_ � J3UILD�R: ��_ ,,�.� � Address : , f��,T �.%�,z f:s-.��' � ..� ;L : TJ. �- 7►ddress : . • Tel. No. %�-4- � �9�� ' T No. � � � _ Str eet : �,�� ,�-�-'�`-° �_�___� � .� � �� , . , , 9� � : � � e �C. LOT: (� � °� _ Bu3CY : �_. I�DDITION : -0 CORNER LOT: ItJSID� IAT: SLTB7ICY.: SID�YARDS: Ap�licant attach 'to i:his form ��o Certiiicates of.Survey of Lot and proposed • bu�.lding locatian drawn on these Certificates. • , DESCRI PTIOPJ OF BUI LDI NG 0 � To Be Used 11s : . � Front: Depth: . _ ' Height: � 5quare Feet: _ _ __ Cubic Feet: � �Front: � Depth: � Height: " Square I'eet: __ Cubic Feet: � 5 Type of Construction: o,e�� Es��►ated Cost: $ �(�G) ,� C1 Ta Be Completed: Alt. A Alt. B Proposed Driveway Width If I�ew Opening Is Desired $ $ (gE� �VERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all �aork in strict accardance with the City of Fxidley Ordinances and rulings of the Department of Buildings, a»d hereby declares that all tlze facts and representations stated in tiiis application are true and correct. See reverse side iar aclditional intorn�ation. . � D21T�: �� - /% - �% � SIGNIITURE: Stipulations: . �`` � . l� �• J� . � �� v� . � _ _. - - � . ,. . � BUILDI(�G PERt�IIT FEt� SCHEDULE 5ECTION 2. The Inspector of Buildings 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 repairs 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: NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet. PLAN CHECK: 25 percent of building permit fee. DRIVEWAY DEPRESSION: (Concrete Curb Streets Only) � Alternate A: Removal and replacement of concrete curb and gutter on1y; Driveway width plus 6 feet x$14.50 Alternate B: Removal and replacement of concrete curb and gutter and install a 3 foot wide approach with 6 inch depth; Driveway width plus 6 feet x$17.20 �11 � : 1 �' : �l For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or th� cellar to the average heights of the upper surface or to the average height of the roof surface of the main gable of a pitched roof . For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars �($500.00) or fraction thereof i.n the cost of all proposed work. In�no case shall the fee charged for any permit as set forth in Section 2 be less than $7.50 plus $.50 state surcharge. • ; ' � 1 � �1� �� NOTE: Permits for construction will be issued a minimimn of 24 hours from the time of application to allow for proper review of the pro,�sed structure and of 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. ; � � � ':1 Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or accupancy of any structure for which a building �rmit has been issued; and sa:i.d structure shall not be used or occupied until a Certificate of Occupancy has been issued. � � - - ,. wELL Ot�'BORwG LOCATiOrv �� ES�A DE ARTMENT OF HEALTH Seai ng No. elI and Boring H 4 5 5 6 6 �o��+„ Name WELL AND BORING SEALING RECORD Mi��esota u�iq�e No. � �+ �y �pp Minnesota Statutes, Chapter 103! or W-series No. : S3V �l'Y.fS � (Leave 61ank R nm known) Township Name Toamship No. Range No. Section No. Fractian (sm. • Ig.) Date Sealed Approximate Date Well �''��.�1��`��! �:��:�� G�er�{4� �.� �ia��la��iiq '�1 ;%��`� ��c�Y orBoringConsWCted Numerical Street Address or Fire Number and City oF Weli or Boring Location ,� �� j,�y� �`',�'��,�,+`� }E,�'s DepthBeforeSealing Y 9�° ft. OriginalDepth R. Show exad location of well or baring Sketch map of well or bonng Static Water Level � Acwrate in section grid with'X'. location, showing property lines. N roads. and buildings. ❑ Approuimate i i i i -i - i - - � - -i � Single Aquffer ❑ Mulilaquiter ��i_ fl. �— below above land surface i f i i i ;. _T'•,.-- --- -: W�a - - � - -�- CASING TYPE � � � E , i i i i � -.......--- 'Lar�ifs�4':�i��,��? `�'e�;.{; -r -�- -r- -r � � � � �Steel ❑ Plastic ❑ Tile ❑ Other 'rl mfle _�_ _!_ _i_ _�_ � i � i i ..--'-...._:_.�._.. ---�._--' -._-- ° S Screen from �T�-z�' fo ft. Open Hole from to tt. �— f mtle —►I OBSTRUCTION/DEBRIS/FILL PROPEHTY OWNER'S NAME Q Obstruction ❑ Debris ❑ FII �':�`� , ��-a��L:�.- ti.�ii E,,��s_'.4'�l`�� "::� _. ? . �,a:r� �k�t',,.+�� ,v_? K�_ ;_.s . , �-°� 'sJ <�. � '� �;i,', Type of debris/obs[ruction Mailing Address it diHerent than property address indicated above. Obstruction(Debri�ll removed? ��Yes ❑ No _ -. - �' ii�T a �a i�i"y � � � krh �?' •� e_) � i°�P �i'e �+�, PUMP 3.��v� �`e��il:iLil.r ��i:�i�i �-71a i��'i i"�'�el �-{3:1�d _-.0�7��' �.�3 !d..r.l.s3.�4i.�� 3-^':�a%_:. a v ��, Z �] ��;� Q �i j�l; �� :-� ,� `y�, -- � � � �Q � Removed ❑ Not Present ❑ Other CASING GEOLOGICAL MATERIAL COLOR �RDNESS OF �OM TO FORMATION Diarneter Depth Set in oversize hole? MnWar space initially grouted? If not known, indicate estimated fortnation log from nearby well or boring. �_ in. from _�y. to ��, ft. ❑ Yes �� No ❑ Yes ❑ No ❑ Unkrrown in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown in. from to ft. ❑ Yes a❑ No ❑ Yes ❑ No ❑ Unknown METHOD USED TO SEAL ANNULAR SPACE BE7WEEN 2 CASINGS, OR CASING AND BORE HOLE: q' No Mnular Space 6dsb ❑ Annular space grou[ed with tremie pipe ❑ Casing Perforation/Removal in. from to ft. ° ❑ Perforated ❑ Removed in. from to ft. ❑ Perforated ❑ Removed Typa of peAorator ❑ Other GROUTING AANTERIAL �:V��° I �".:�+1'�;C'�:i ti; ? i ;:j a '� � Grouting maierial from to ft. yards 6ags from to ft, yards bags REMARKS, SOURCE OF DATA, DIFFlCULTIES IN SEALING fmm to ft, yards bags �;`�ta�:��T��'J IIV PI'�" �4�t�j .`_�:liki"�'3:� ��5� from ta fl. yards bags :�'�` 1+:3��'t"��i'��' m � s �IE�','�;t9F��.[� �°�$:,�?�if T+�i� FrtF ��.�;��e.� 3?,' UNSEALEDWELLSANDBORINGS �� 4 k�� , �� 7 ;�� e Other unsealeU well or boring on property? ❑ Yes � No LICENSED OR REGISTERED CONTRACTOR CERTIFlCATION This wall or bormg was sea�ed in accordance with Minnesota Rules, Chapter 4725. The information coMained in this reporl is We to the best of my knowledge. Contraclar sin ``1�lame±°^ " '' ' ' ' ' °'° LipenseorRegfstratlon�No. se �'C�� +��°-�� ','>� i_��t� d�•8�-�3rA��a r��;-s?Q y�$-�-, � ,�, *'' .s��-- �� a�-� : c�, Authnrized Representative Signatu�e Date LOCALCOPY H �JJR� •�� Y �,��?°3�ti� '�� c?�:i ��4 L�� Name of Person Sealing Well or Boring HE-01434-01 WELL �ORI s LoCAi��ON �� °' � 1 MI�NESOTA�EPARTMENT OF HEALTH Seai ng No�ell and Boring H �� Cai,�.Ty Name WELL AND BORING SEALING RECORD M��eso►a uR�a�e No. . � ��+ Minnesota Statutes. Chapter 103I or W-series No. ILeave blank it not known) . Tovmship Name Tovmship No. Aange No. � Section No. Fraction (sm. � Ig.) Date Sealed � Approximate Date Well �' � � �1��.'a�x �� v �3.s�� .: �'$� �.4 .,� i�Q;�3 �r3i�a �� f4 �� 1 3� �.� � v � �r or Boring Constructed Numencal Street Address or Fire Number and Ciry oi Well or Boring Location l::;i �`s��,`3��a ��+��,� ��" DepthBeforeSealing �`" fl. OriginalDepih k. Show exacl location of well or bonng Sketch map of well or boring StaGc Water Level � Accurate in section grid with °X". location, showing property lines, N roads, and buildings. ❑ Approximate i i i i -� - i - - � - -� �}ySingle Aquifer ❑ Multiaquifer � ft. below above land sudace i : i i i -4+ , - � - - L - -�- . CASING TYPE W �, i i i E - - i i i i � _. .. _ Qa '� �, `: , F i � :�i�.' �v�:'_. -r -�- -r- -r i i � � �� , ��Steel O Plastic ❑ Tile ❑ Other i i i i j . -� - �- -; - -� � .,_�..__��,__.�_.n__�__a---___,._..._A._. S � Screen from .�" �� to ft. Open Hole from to ft. � �mj�� OBSTHUCTIOWDEBRIS/FILL - � ��'�,. � . . ..-`.k ❑ Obstruction ❑ Debris ❑ Fill PROPERTY OWNERt' NA'CM�E � i �l'a�i e �°�il .�.a:a�: "_�Si�� a�)c�t'i3i�a� Type of debris/absVUCtion Mailing Address rf different than property address indicated above. ObsWCtion/Debris/Fill removed? ❑ Yes ❑ No �:�i � ��;�� .�� tj�)w��*{1'i:�.'e PUMP /�,;;,�E� iti��.Dii.7JLV ivik�!'bia�..:d� �4P� �i?��lL 1�3�l1.�`S�F�: SS�� G`�'� �LS �:`3��./.�Y 3 6 L?� i�t L�� 1 e �.�I� �4 ; a�:� a� j t?! �.� � ❑ Removed L�I Not Present ❑ ana. CASING GEOLOGICAL MATERIQL COLOR HARDNESS OF �OM TO FORMATION Diameter Depth Set in oversize hole? Mnular space initially grouted? If not known, indicete estimated tormation log (ram nearby well or boring. `� �" in. from �,ra to ��;ft. ❑ Yes � No ❑ Yes ❑ No ❑ Unknown in. from to ft. ❑ Yes ❑ No ❑ Y� ❑ No ❑ Unknoxm in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknovm METHOD USED TO SEAL ANNULAH SPACE BETINEEN 2 CASINGS, OR CASING AND BORE HOLE: Q;TIo Mnular Space Exists ❑ Mnular space grouted with tremie pipe ❑ Casing Pertoration/Removal in. hom to R ❑ Perforeted ❑ Remwed in. from to ft ❑ Pertorated ❑ Rerrroved Type of pertoraror ❑ other GROUTING lAATERIAL �dt'��c��!�'�� !' �,� .�:i:;`x Grou[ing material from rro ft. yards bags from to ft. yards bags REMARKS, SOURCE OF DATA, DIFFlCULTIES IN SEAIING from to ft. yards bags '�t�J��:.��'�� g� �� z?;j �s�tlF`�i� �=�� from to ft. yards bags ��" �_°1��.,�`'��'�5�� s u o �:�E<-'�sr?�1�ti�'�.�� _r�F`� T�_%�' t ��'� ;.�`�``s_.°�T?�?d.a � 4 UNSEALEDWELLSANDBORINGS � � �f��4' � � � �� 6��Y @ a . Other unsealed well or boring on propertyl ❑ Y� ❑ No LICENSED OR REGISTERED CONTHACTOR CERTIFlCATIQN This well or boring was sealed in acxordance with Minnesota Rules, Chapter 4725. The infarmation cantained'm this reporl is true to the best of my knowledge. t' • n =7:- `� a. -'� -�, <-�, Con a� or siness ame "' '_< ° f,� Lr�� or Regislra'7ron INo � i lt s' ` iT�� P°�°��,?��- � � .: �:= 8�:� 1�a x �i� a=�3a�, ��:._ i ��aa4_� 9, �*, .�� ,/� '� � �a� a �s � r`Aa� Authorized Representative SignaNre �' Date 45�� A� ��_�� :�� :�a ��,� f��.�p- LOCAL COPl° H Name of Persnn Sealirtg Well or Boring HE-07434-01 �� m ,� n Z 3 � � 'D � � n -a � � O O t� Z m o� m 3 � � �'a �' p O m o 7 'a . � A -a a 0 �� - � � Q. � � c .. ��- �r � D C rn-i� z�- � � �v z r" D � c� � m � _ i�i � � � D O z Z � -a < � . ti. � � �� °a `, � c �n s I 7 v �: m � w � � r � / � u� w � ID a � . m z 0 � 1 �lD � O o � � � � � � rn � ca � � �, � � -� � � � � � � � � °. 3 0 � n v N n < � Q. � P1 H �; -. � O � � � � � '" C p. � � �� g�° D � � � � � �p Ac�c F. 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W � � z Q � � � (D (� O Q O � D � � 'D I D Z -G � I � � m � � � Z 0 � \ \ --1-� b � �. O � m � � S �� ' a� Q+ a� - � � -v - n.. a m a m c � t � � � � ct� � a � N � O � O � (( � � m � � m. a o c� � � � m - N � p ( m a°-i N.r. � o �. � m � r► v O. ( � rA -• � N O � L m ? 3 Z v � � � � a � s �'► � m i � m � - �- o � Q �Q�� m � z c o m c m � � � � °- -► ? i 0 3' � : , o •°-; m . � � � � m — � � � `� - i �. m � . o % �" � m� i SJ N � � �..► � � O � v v � � � � -\ � � � � r � � � � � � � . �.. � . . . � ., . . . .. . . -. .. �.. ' . � . . . .. .. - . _.- . � : . . '. ... . .. .. - . . ... � D � � Z C � � m � O � � � � m � O m Z --I D r r v � Z � _ T r O O � �n m � � o � � � t�u � � o � 3 � a �' O m 3 'p m n � Q O � � � � � � �� Q � 3 O � m �" �� 0 nc �-� � � � T � �v zm � m� � D C� � m � � � � � Z � m z � � m n � O Z m m � N 3 1 -a v < m a o� � � O c c� S 1 � v � � � m 7 � a O A z Z 0 � 3 w v Q.' 1 � � `� �_ _ D -a z � r � K� �� Z c� i � N � �� A � � � ma �a C 'a 1 v_ � �' A m � 0 � --I � O � � � � c m �- m cQ � �� . o �� o ~ n m `� Q. � .� � � O � 3 � � �� D � m ZN m � �m O � �� O �r ..� � �w � Z a C� 3 � (71 O � � .7�-� � � � c `� 7 � � -a s� a m z m m _ 'D � m z a � � .� �ao�z m ° _ a- � °, m m 3 � m � � c � � 2 � � � � A � ii o 0 ' � m � � � Q. � � o m 3 a o o -- � • _ O m � � � � 3 D �_ � m � v � 1 N� o�a C �N N N o 3 a �o �-,�� av �° � m mm��nw Z m m m m�3�, fl. � .�► Q a�= v � � � � . m W� o � n � . � v � A � m '` � � � � � � .i �i J (� O O O O � O O O O � m � � � v Q 0 � � � � � �I � \ � m � � � Z O �.f � � � c v Z � C � m v � � �n � --1 O r � � 3 � m A m � � 3 � o,Q� �?m � ��m �,�3a � Q- � �- am°m � s � o � � � � m ma ? O N� -v_ A � � � ID �? .(A-► �. 1 3 � �� a � � `� A 7 � � O O � ° fl. m �, �, � � � � 'o �m 1 ��3 O � � O m � r. � ° � m s � � � � � � � o (n 0 �c � Q � m 0. n m � � � o�°i o- � n � 0 W � v v �o m � � � � � N Q � � i�1� � � ` O zm � � � I,1 � N < � � z ' m� m -�! � Z � � � � � y ?° C rna �� ZZ �7 � O � � '� D �� O � Z � v� _' z z t�n zp� � �� n = m �� z C�i �O r mZ v� .n < m Z � � 0 z � � m O � w � � � a�i CHIlVINEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No () 2. Is free from mst or deterioration Yes () No () 3. Has no foreign objects lodged within Yes () No () 4. Is securely supported Yes () No () 5. Meets all current Code requirements for size and total BTU's connected Yes () No () 6 Has totai heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No () 8. Has combustion air been provided for water heater Yes () No () Remarks: � � HEATING CO: `� � �; �� Signed By: ,� Date: � SUBJECT City of Fridley 2 5 9 3� AT THE TOP OF THE TWINS g � I L D I N G P E R M I r � • � � • COMMUNITY DEVEIOPMENT DIV. r � v � PROTECTIVE INSPECTION SEC. �� 1 � � 1 /�"1 � CITY HALL FHIDLE� SS43P NUMBER REV DATE PAGE OF APPROVED BY �°"� � �'' 612-571-3450 9/0-Ft5 4/16/98 / / JOB ADDRESS 725 Rimball Street NE t IEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACNEQ DESCR. (� 7 0 Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Tim Fay 725 Rimball Street NE 3 CONTRACTOR MAIL ADDRESS Z�P PHONE IICENSE NO To Gun Inc 5014 Parrish Ave NE, Ro ers MN 55374-9009 428-4559 3388 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL AODRESS ZIP PMONE LICENSE NO. 8 USE OF BUILDINO Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O AEMOVE R 8 DESCRIBE WORK Reroof House 8 S Tear—off 9 CHANOE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOUIFED FOR ELECTRICAL, PLUMBING, HEATING, VENTI�ATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULI AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF t20 OAVS AT ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OfFSTREET PARKING I HEREBY CERTIfY TNAT I HAVE REA� ANO EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORFiECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WOqK WILL BE COMPLIED WITM WNETHER SPECIFIED HEREIN OFi NOT. THE GRANTING OF A PERMIT $667 �.SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL TME pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 26. SO Fire SC �. C)% STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � PLAN CHECK FEE TOTAL FEE License $5.00 $3 67 SIGNATURE OF CONTRACTOR OR AUTMORIIED AGENT IDATEI p pERI VA ATED TNIS YOU PERMIT � S�GNaTURE OF OWNEA i�F OWNER BU4DERt �DATE� � BLO �NSO rypTE NEw ll ADDN (I ALTER � ) CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Effective 8/ 1 /95� �� ,U� ' �� J � ` \ ConstructionAddress: `�� L� �� - Legal Description: ° — � �� . Owner Name & Address: �(� � �� °�'��-� ��e • � Contractor: TOP CUN, �� _ MN LICENSE #��c�� Address: 5014 PARRISH AVE NE Tel. #�� 5� Attach to this appli��bS9a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LI�ING AREA_ GARAGE AREA: pECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Leng�Ch� : .. � Width Height . . � Sq. Ft.. � . . Length Width Height Sq. Ft. �ng�h Width Hgt/Ground Sq. Ft. Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yazd Setbacks S� Type of Construction• � �L�L� �� CO�= $ Approx. Completion Date: �� (Cost on Back) Driveway Curb C�t Width Ne,eded: 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 APPLICANT: $ � � . .� $ �, � �1 $ ��. $ $ � , c� $ $ $ $ — $ ��- � ��1 Tel. # CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $850 per SAC Unit . $5.00 (State Licensed. Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Ne�ssary [ ] Not Necessary [ ] STIPULATIONS: ��- `` ��j � � 0 sue�ccr c�ty of Fridley AT TFIE TOP OF TME TWINS � � I L D I N G P E R M I T i � � � � • COMMUNITY DEVELOPMENT DIV. � ♦V �� r � � PFiOTECTiVE INSPECTION SEC. 1 . � i---_� ��"' �,� CITY NALL FRIOLE� SS132 NUMBEII AEv t 612-571-3450 9t0-F15 JOB AODRESS 725 Kimball Street NE t LEGAL �OT NO. BLOCK TRACT OR ADDITION oescR. 6,7 0 Riverview Heights 2 PROPERTY OWNER MAIL ADOiiES$ Tim Fay 725 Kimball Street NE 3 CONTRACTOH MAIL AOORESS Same d ARCHITECT OR DESIGNEA MAIL ADDRESS 5 ENGINEER MAIL ADDFiESS 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW 8 OESCRIBE WOFiK Reside House & Garage 9 CHANGE OF USE FROM OATE 8/28/00 ZIP v�GE OF � / PE�6�-- �31350 RE NO. ��-� �hvROVEO Br SEE ATTACNED SFIEET PNONE 763-780-3850 PHONE LICENSE NO PMONE LICENSE NO. PHONE LICENSE NO O A�DITION � ALTERATION �] REPAIR O MOVE D REMOVE TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall coverittg. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering. SEPARATE PERMITS ARE FiECUIREO FOF ELECTiiICAL, PLUMBING, MEATIN(i, ''r� v� v�••�• VENTI�ATING Oq AIR CONDITIONING. THIS PEFMIT BECOMES NUIL AND VOID If WORK OR CONSTRUCTION ZONING AUTMOR12ED IS NOT COMMENCED V�IITHIN 80 DAYS. OF IF CONSTRUCTION OR WORK IS SUSPENOEO OR ABANOONEO FOR A PER100 OF 120 DAYS AT ANY TIME AFTER WORK IS CpMMENCED. NO DWLG. UNITS I HEREBY CERTIfV TNAT I MAVE READ AND EXAMINEO THIS APPIICATION 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION ANO ORDINANCES GOVEFiNING TNIS TYPE OF WORK WI�L BE COMPLIED WITH WHETHER SPECIFIED HEREIN OF NOT. TNE GRANTING OF A PERMIT �2sOOO DOES NOT PRE$UME TO GIVE AUTMORITY TO VIOLATE OR CANCEL TNE pEqMl7 FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFOHMANCE OF CONSTRUCTION �69.25 /1 S�GNGTUpEO�CON:AACTOAOpAUTMOp�2ED4GENi IOATEi �D�rE� v OCCUPANCYGROUP OCCUPANCV�OAD SO.FT CU FT. OFFSTREET PARKING STALLS GARAGES SUIiTAX ` $1.00 SAC CHARGE Fire C $2.00 TOTA fEE $ 2.25 A IOAT D MIS IS Y PE IT � J f�6TE NEW [ ] ADDN [] ALTER [ ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/2000 (763) 572-3604 Bldg Insp � �� ,— a Construction Address: � � .S �Ci �j ,d� /� �� . �/ � • Legal Description: Owner Name 8� Address: ��/h �� S/ Tel. # 7� 3�8° r�T75�3 Contractor: �5� / �' MN LICENSE # Address: Tel. # LNING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft Length Width Hgt/Ground Sq. Ft _ ��sid� �i�� a�a�.� Construction Type: � � � rH � ��' J � Estimated Cost: $ � �� ° — Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �` �( �' ° APPUCANT: �r �, �-� Tel. # � 3 �- �� ' s s CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ ��-�� Fee Schedule on Reverse Side Fire Surcharge $ �< <�`� .001 of Permit Valuation (1/10th%) State Surcharge $ /, C� a $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary [] TOTAL STIPULATIONS: $ �� +.,:, a _ s 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 siructure, or for any alteration or repair to any existing building or struchue, upon applicarion 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,�1 to $1,000,000 $1,000,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each addirional $1,000 or fraction thereof, to and including $25,0� $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $SQ0,000 $3,233.75 for the first $SQ0,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,0OO,OUO $5,608.75 for the first $1,000,000 plus $3.15 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 $15.50. 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 $23.25. VERIFICATION OF FOUNDATION Pernaits 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 lxen constructed will be required before proceeding with the framing. New Houses Onlv