AF - 479571 �.3 9 �2, s r��
RONALD F. NIEYER �
LAND SIIRVEYOR
LAND SURVEYINC3 SUBOIVISION DE3IGN
TELCAHONi 771-4866
6B8 J663iC ST. ST. P.�UL, M�rIN. 53101
t he�eby certify that this survey was prepared by me and that I am a duly
Registered Land Surveyor under the laws of the State of Minnesota.
/�'
i Reg. No. 9051 Date: � ��
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o Indicates iron monument
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Scales 1" = 40'
Lot 12. Block 1, HEATHER OAKS� Anoka. Countyo Minnesota,
Contains 12,170 sq. ft..
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� RONALD F. NIEYER
LAND SIIR4EYOR
I..ANO $URV[1/IN0 -$UBDIVISION DcsiaN
TEL[pNON[ 771-4dBd
08d Jtf�lt ST. BT. PAUL. MINN. Dd101
I hereby certify that this survey was prepored by me and that I am a duly
Registered Land Surveyor ander the laws of the State of Minnesota. .
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Reg. No. 9051 Date: �
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o Indioatea iron monwnenti
ISoale 3 1~= ll'0 �
Lot 12. Block i, HEATHF�R OAKS� Moka County, Minasaota.
Contair�a 12� 170 sq. ft. .
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City of Fridley 19943
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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; � REC .
� �y _ COMMUNITV DEVEIOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. 2 oZ,��S
✓
i.--_ A �/'��;,� C1TY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPqOVED BV
L J\ 612-571-3450 9�0-F15 6/8/89 / /
JOB ADDRESS 1639 Kristin Court N. E.
1 IEGAI LOT NO. BLOCK TRACT OH ADDITION SEE ATTACHED
DESCR. 12 1 Heather Od,kS AC�G�ltlOri SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Brickner Builders 6240 Highway #65 N.E., #208, Fridley, MN 55432 574-9871
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
�l NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Canstruct a 53' x 28' Dwelling and a 24' x 24' Garage
SEPARATE P�RMITS REQUIRED F�R
9 CHANCaEOPUSEFROM WtR{N�, HEA N �
STIPUTATIONS
Provide City with.copy o� verifying survey before capping, Provide sod
in the front and side yards. Provide a hard surface driveway. Paid $800 Storm
5ewer Charge. Paid $1,500.00 Park Fee. See notations on plan.
DRIVEWAY ESCRC7W: 16' + 6' = 22' x$13.50 =$297.00
SEWER WYE: 30` North of Manhole. WYE ELEV: 959.88 TOP OF FOOTING: 963.00 Minimum
WATER LOCATION: South of Sewer.
WARt�I��
TH� GiT`i` '0� FRIDLEY DOE� NOT GUARANTEE TNE BEtOfE dig�ttl$ C811 IOCaI uti!iiies
p�C,iJ�Y (�F UTII.�TY LOGATlQNS AND ELEY�►TIpNS. ���,EpNONE - EL�CTRIC -�AS ���
Tl�+IS a�oTA ��'QR. IfyFORMATI�N Pt�RPOS�� Qt�LY,
p�} p�Qt�� USING THtS INFQ�j1T10N $HpU[D. _�,�QUIRED BY tAV�1
VERIFY IT ON '�HE �ITE.
SEPARATE PERMITS ARE REQUIHED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOC� Fi'ciiCle
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SQ. fT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR If CONSTFiUCTION
OR WORK IS SUSPENDED OR ABANDONED fOfi A PERIOD OF 120 DAYS AT 1929 + 576
ANY TIME AFTER WORK IS COMMENCED. NO. OWIG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STA�LS 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 5�-�-4►200 $S%.I.O
DOES NOT PRESUME TO GIVE AUTHOAITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR IOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. tiSE192.O0 $575.00
P AN CHECK FEE TOTAL FEE
A $1,324.10 + PF,S5,
SIGNATUREOFCONTRACTOAOAAUTHOA�ZEDAGEN7 ioniE� -WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
SiGNATUREOFOWNER�IFOWNERBUILDERi IDATEI BIDG �NSP aTE
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ii. . � . . � . .... . . . . . . . � . � � .. .. �. � � . . . . ..
� � [ l Effective 5/1/88
�� [ ] R-1 AND i2 2
�+T� [ � &111C�1I1lg P�2Y7111t Aj7j�11Cdt1011 .
Constxuction Ac3dr�ess: ,.12�_'� n � S 7�� �� .
Lega1 Description: _
Owt�r Name & Address: �e1. #
.
co�tractor: _� v� c.�c �►. �,� ►,,1�� � dLe �rs Z�el .# S - J
Addres.s:
LIVII� �:
(�R�t� �:
D�3CR ARF�:
O'1'�R:
Attach"to this application, a Oertificate of Survey of the
lvt, with the prq�osed constnictian drawn � it to scale.
�� s: �+; w�M •', !i' �v�{;e�•/�Vi�,�
Ler�gth Width �ight Sq. Ft.
Iex�gth Width H�e.ight Sq. F`t.
Lergth Width Hgt/Graund Sq. Ft.
Corner Lot L l Inside Lo�t [] Ft. Yd Se�tbacJc Side Yard SetbacJcs
Type of ���knzCtion: Estimat.ea cost: S 1 1 y,'Lde •
Appr,ox. Caet�letion Uate: .
Proposed Driveway Width if New Openi.rig Is Desirecl: �_Ft. $ $
Width + 6' See BacJc Page
OATE: APPLICANT: Z+el. #
« � ��:�: r, i
Permit Fee $ d Fee S�edule an Reverse Side
State s�rd�arcle- S�_�.1C� $.50/$1,000 Valuatioaz
SAC Charge $�'.O� $575 per SAC ifiit ..
DrivewaY E-sc�'«�► S Z.�.f�li �r �Alt.� ��A'! or Alt. ��B�� �bove - .
Park Fee S I S� ►00 Fee �Determined by Ft�gineering
'�.�+M��.+� $ �� �e�ertt xeoessarY [ l rtot xeoessary [ J
To►rAL S_ ..:� i"� �� . / C
39z1•�o .
s-rix�r.��s: - !_ v'__�_._
I.v�woow� - W�_'T�... iE�►���,�,�5� i'r1utS ��L S�'t'!�r �Cic.d�S
�
�:_��� �. �, c ;.i;.y�y ;�:;�: : w:i��.0 -
�he Chief Buildir�g Official shal.l, before issuir�g permits for the erection of ariy
buildir�g or stn�c4�re, or for any additioaz to arYy existir� building or structur�e, or
for arYy altQxatiori or repair to any existirg buildirig or structure, upon applicatioa�
ttyerefor�e, require the payment by the applicant for such permit of fees to the amduYt
he.r�in below set forth ar�d in the marn�et herein provicled to�rit:
Z�rAL VAI�JE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
��
$15 (Minim�an Fee is $15 plus suz�harge)
$15 far first $500 plus $2 for each additional $100 or
fractian t2�ereof, to ar�d includirrg $2, 000
$45 fo� first $2,000 plus $9 for each ac�ditional $1,000
or' frdCtian ttyel�eof, to al'id including $25, 000
$252 far first $25,000 pltas $6.50 for each additional $1,000
ox' fraction th�reof, to at�d including $50, 000
$414.50 f� first $50,000 plus $4.50 for each additiw�al
$1,000 or fractioaz thereof, to and including $100,000
$639.50 f� first $100,000 plus $3.50 for each �dditional
$1,000 or frac�ion thereof, to and including $500,000
$500,001 to $1,000,000 $2039.50 fos the first $500,000 plus $3 for each additional
$1, 000 ar fraCtion thereof, to ar�d inclwdiuig $1, 000, 000
$1,000,001 ar�d up $3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction thereof
�., _ ..� �':rl� �IJ'.`. ��, .l:'�I�.� �
t�; .� - - • • - - •
Alternate ��A�� ; R�anvval ar�d replaoaaeat of curb arid gutter only - Driveway width plus
6 feet times $13.50.
Alternate "B": R�val ar�d r�la�nt of curb arrd gutter and install a 3 foot wide
approac� with 6 irtiii depth - Driveway width plus 6 feet times $15.75.
.�- �. �� �� .:
P�ezmits for oonstructioai will be issued 8 mi nimn++ of 24 .Y�a�^s � fran the time of
application to allvw for prcyper review of the prq�osed structure and of the
�struction site.
A Certificate of SuYVey of th�e lot, shawiryg the location of the fauxia�i.on oa�oe it has
it has been constructed will be requ,ir�ed before pr�oc.�eeding with the framirrg.
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� archltecturo►1 consvltanta inc.�
soa s�aT. i.E. os�cq.�w. saK� w!. Iuth�s-�ns, �.. i
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�Site Addre
1�TOTAL �
2) TOTAL
wa�� AREA CALCUlAT10HS� '
: Z I-� :Q.ft.x U" �¢ z��-'r o.
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T07AL VYIND�W AREA
GLA2ED
T07AL DOOR AREA
?OTAL GLASS DOOR AREA
_. GLAZED
TOTAL fIREPLACE WALL AREA
707AL VYALL fRAMING AREA
NET INSULATED WALL AREA
TOTAL RIM JOIST AREA
?OTAL FOUNDATION AREA (EXP�SED)
. �� sq.tt.x U" �.=_.�, z' �
. gO sq.ttx U"'�_= �= =
3,� sq.t4x�U" �=°�
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_ � � Z :q.�.x�� �_��
v � sq.tt.x"U"' �� = Z�
TOTAL FOUNDATION WtND01h' AREA . �p.t�x t�" ==
. • a) TOTAL Z �' S.
. 1t ifem 3!s fhe some os,a kss lhon Ilem l, you Aove a►et !be Mtent of
2 MCAR 1.16DU8 A ond D. '
ROOF�CEILINO CaICULA710NS�
?OTAL SKYLIGHT AREA
70TAL ROOF��EILING fRAM1NG AREA
NE7 INSULATE� RDOF CEILING AREA
C
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��li TOTAL . � , �
.. N Ifem 41s the some os�a kss than ltem Y, �rcu Aove me1 fbe M1ent of
2 MCaR J.16008 A ond 0.
�LTERNATE BUILQING ENYEIOPE OESION
�. To vfilize fhe tofof �nvelqpe syatem meMod, fhe wm of ftems / one 2 shop �
be preoler thon the :wn o�f ltems 3 ond 4. .
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� 1 Ae►eby cerlKy thot tAe pulldlnQ Aere cr�e �neets z i fhe Stote o� ��o
Enerpy Conservotion Act. �
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FRAMINO SECTION
� �ta atr tllrr� � p,�g
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4 �,3.Z� a+r.Dr-�tf� j ,c� .
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TOTI►� R • � �}-
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SECTION (lNSU�ATED)
� intsrlor oir film �g
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3 !��''b �►�IS .. f9.n
4 �it���E.- 2 •o,�
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ST 9ECTION � �
' t�r� r ir fllm � 0.68
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�xt�►ior oi► tilm 0.17
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f ION lECTION ' �
jLillrto► air filrn • 0.66
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�:f�rior air film -'� � �
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. TOTAL R �i!'�
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�ONSTRUCTION • � � •
�,i1LIN� tfCTiON i1NSUL�TEDi
' �� �r►terior eir tllm 0.6t_
�� S�Q b��*Q cr 1c .5� •
�
�� �xlerior oi► /ilm is���� 0.61
. . � TOTAL R.�S.]$
' ' 11 s 1/R..�,Q��.
� CEILING fRIINING SECTION .
� � jntertor oir Iilm � 0.61
. �j �►'� i��,�.�.,� .St� .
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�5 �'ilnthes e/ soft rcee �.c�
: TOTAL R r39•i�
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CEILING SECTIDN �INSULATEDi
( � inferlor otr tilm 0.61
_ �p �5,�p, ao[ K : S�/.'+
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S8 n_• -r�
. (4 e:lerfor 01► tllm (slilli • 0.61
, TOTAL R �_
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CEIUNG fRAMING SECTION . '
� ��ntcrlor otr lilm 0.61
. �e �v�r.o: r • .cL, .
, �3 -A � ol-'. � �E a0 .
. �� lnlErior ofr Iilm 0.61
�5 Ayzt�'thes ot sofl v�od �.L. ;
��-1'F-�z� .TOTAL R.��,,�
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�XPDSE� BEAK CEILING SECTION •
- �,� �nt�rlo� oi► lllm 061
iz
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�5 �It►i�r oi► /iim 017
TOTAL R ....__
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CHIMt�EY AND STACK VERIFICATION
The undersi.gned hereby veri.fies thaL the existing chimney or stack;
1. 'Has� .been_ careful ly examined � Yes (, )
2. Is free from�rust or deterioration � Yes ()
3. Has no foreign objects lodged within Yes ()
4. Is securely supported Yes ()
5. Meets all current Code requirements for size and
total BTU connected � Yes ( )
6. Has To ta 1 hea ti ng BTU' s of
All other BTU's
TOTAL
Rema rk s
No ( )
� � )
No ( )
No ( )
No ( )
�
,�
. Company
Signed By
Da te
0
sue�ecr PE .
City of Fridley 19 9 8 3
AT THE TOP OF THE TWINS g U I L D i N G P E R M I T
r
' ' R
� � .
� `y _ COMMUNITY DEVELOPMENT DIV. � � ���
r � • � PROTECTIVE INSPECTION SEC.
1 � �
� � �"'1 � CITY HALL FRIDLEV 55432 NUMBER REV. bA7E PAGE OF AGPROVEO BV
�""� � ��� 612-571-3450 910-F15 7/10/89 � �
JOB ADDRESS 1639 Kristin Court N.E.
t LEGAL LOT N0. BIOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 12 1 Heather �CS Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
B� Richard Ashland 1499 - 17th Avenue N.W., New Brighton 55112 633-9143
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Brickner Builders 6240 Highway #65 N.E., #208, Fridley, MN 55432 574-9871
4 ARCHITECT OR DESIGNER MAIL ADDfiESS ZIP PHONE LICENSE NO.
5. ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW C� ADDITION ❑ ALTERATION O REPAIR ❑ MOVE O FiEMOVE
8 DESCRIBE WORK
Construct a 16t x 12� Deck Addition
9 CHANGE QF USE FROM TO
STIPULATIONS
See notations on plan
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE Of CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WOFiK OR CONSTFUCTION 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 CERTIFV 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 COMPLIEO
WITH WHETHER SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT $i, 35Q $•68
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• 33.00
STRUCTION OF TME PERFORMANCE OF CONSTRUCTION. $
P AN CHECK FEE TOTAL FEE
$33.68
SIGNATUREOFCONiRACTORORAUTHORIZEDAGENT �DnTEi WHEN PROPERLY VA TED THIS IS YOUR PERMIT �
�
D
SiGNATUREOFOWNERIIFOWNERBU�LDEAi �DATEI BLDG �NSP n 7E
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I.IPII� AtiE�:
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I�1 Ai�ID R-2
aiila3n3 P+�it Applicatian
�r� � C? v..-� �—
�u.; ( �. �g �
1
Effective 5/l,/88
! �l f'�• ��r+c,, Iv uJ
F3,% Te1. # 633-9�43
�t. # 57�t - 9�r7 �
Attach to this applicaticn, a Oertificate of Stiuvey of the
lvt, w3th the p�opo�ed c drawn on it to scale.
�' C�TI�1 G�+ II�ADOH�T�
I�'�yti1 1�lidth iieic�t Sq. Ft.
Ie�th Width Hei9ht Sq. F't.
I,�ngth _Lc�_ Wi,�ith � 2 Hgt,/c�auri � sq. F't. I�Z
�rnes Iot [] Inside Iot [] Ft. Yd Se�tback Side Yard Setbacks
� of o�.-r.��: �tea �t: s b�e�. 13G�,a �
Approoc. �amplet3.q, �ate: � ' ��j .�
Pt'oposed D�iveway Width If New Ope�it�q Is Desired: Ft. $ $
Width + 6• See Back Paqe
�'E: APPLIQ4t�iP: �. �
Permit Fee S C�
State 9u�arge $
SA+C �at9'e S
Ik'1VE1�T8jr �'SCL'OW $
Park l�ee � S
sew�r Hain Q�an�e S
ZOTAL $��
STIi�JIATIQ�IS:
�
.+ 4 4 � :�: • ,�
l�ee Sd�e�ule an Reverse Sic3e
$.50/$1,000 Valuation
$575 per SAC Unit � �
Alt. pA° G�' lllt. xB" AbOVe '
I�ee Dete�ned by Fngineering
� �LY [ ] � �tiY [ ]
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Zhe Chief Buildir�g Official ehall, befc�e issuing peimits for the erectioai of any
buildinq o� sttt�caire, -c� fo� any additian to any e�ti.sting buildir�g ar str�vr�, or
for any alt�eratian os repair' to ar�Y ��3 ��9 ar��. � aPPlicatian
therefore, require the payme.rit by t1�e applicant far aydi peimit of fees to the amauit
herein belcw set fa�tii and in tt�e mar�er herein p�vvided to�rit:
'l�AL �TAItTE '
$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
� a.
S15 (Minin�mn �ee is 51.5 Plus suraha�ge)
$15 fa� first $500 plus $2 iat each additianal $100 or
fraction ti�ere�f, tc ard includinq $2,000
$45 fa� first $2,000 plus $9 for each add.itianal $1,000
or fracticrl theY+eof, to ar�d fncludir�g $25, 000
$252 far fizst $25,000 plus $6.50 for each ad�ditia�nal $1,000
ar' ftaction therecf, to ar�d includir�q $50, 000
$414. 50 fo� first $50, 000 plus $4 . 50 for eac� aciditi�al
$1, �00 C�' fractica'► thereaf, to at�d includirg $100, 000
$639.50 fo� first $100,000 plus $�.50 for each additiac�al
$l, 000 ar fraCtioa� thereof, to and inCludirg $500, 000
$500,001 tfl $1,000,000 $2039.50 for the first $500,000 plus $3 for each additia�al
$l, 000 0�' frdction therepf, to arxi includil�g $l, 000, 000
$1,000,001 and up $3539.50 for the fizst $1,000,00� plus $2 for each additional
$1,000 or $actian thereof
ntIVF.1�►Y �'P�SI�1 F.�GZiOW
(Cbc�cret�re Curb Streets On1Y)
Alternate ��A�� ; R�noval ar�d r�plaamie�t of cu� and gutter anly - Drivearay width plus
6 feet times $13.50.
Alternate •�g��; Ranoval ard replaoaoent of c�trb ar�d gutter and install a 3 foot wide
appYOach with 6 itrii de�i - Drive�y width plus 6 feet time.s $15.75.
�'/�; �;� !', M(• � •�' :.�.�i. ��_ Y • .
Peimits for oonstnu.tia� will be issue�d a minin�m of 24 hairs �nn the ti.me of
applicatian to allcw fo�r p�oper ieview of the p�raposed stn�re arici of the
c�onstruction site. �
A Oertificate of Svzvey of the lot, si�owing the locatian of the fauxlatiacr cnoe it has
it has been vo��ed will be req�ured before pzvoeeding with the ftmning.
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- su��cer MIT NO.
City of Fridley 30039
AT TME TOP Of TME TWINS g � I L D I N� P E R M I T
r
' ' NO.
;� � COMMUNITY DEVEIOPMENT DIV.
:,. ----- d�
f � � PiiOTECTIVE INSPECTION SEC.
i-.-_�; �"' �•� CITV NA�L FRIOIE� SS�J2 NUMBEA pEV D�TE ��GE Of �►nnOVEO er
t 612-571-3450 9t0-F1S 8/10/99 / /
lOB ADDRESS 16�9 Kristin Court NE
1 LEGAI �OT NO. BLOCK TRACT OF ADDITION SEE ATTACMED
oescA. 12 1 Heather Oaks Addition s"EET
2 PROPERTY OWNER MAIL AOORESS 21V PMONE
Richard Ashland 571-8120
3 CONTRACTOR MAIL ApDRESS 21P PMONE LICENSE NO
Rite-Way Waterproofinl; 448 Lilac St Lino Lakes I�fit 55014 786-0550
� ARCMITECT OF DESIGNER MAIL AODRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAII ADORESS tIP VHONE IICENSE NO
6 USE Of BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION �x ALTERATION O REPAIR O MOVE O REMOVE
8 DESCRIBE WOFiK
9 CHAN(3E OF USE fROM
STIPULATIONS
TYPE OF Ci
SEPARATE PERMITS ARE REOUIREO FOR ELECTfiICA�, P�UMBING, MEATING,
VEN7I�ATING OR Alii CONDITIONING.
7MIS PERMIT BECOMES NULL ANO VOtO IF WOIiK OR CONSTRUCTION 20NING
AUTHORIZEO IS NOT COMMENCED WITMIN 80 OAYS. OR IF CONSTRUCTION
Of1 WOpK IS SUSPENDED OR ABANDONE� FOii A PERIOD OF 120 pAYS AT
ANV TIME AF7ER WORK IS COMMENCED. NO DWLC
I MEREBY CERTIfV TMAT I MAVE REAO ANO EXAMINEO TMIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND COiiRECT. ALl PROVISIONS OF LAWS yp�UATl01
ANO ORDINANCES GOVERNING THIS TVPE OF WORK WI�L BE COMPLIED
WITM WMETMEfi SPECIFIEO MEpE1N Ofi NOT. TME GRANTING Of A PERMIT �Z6SO
OOES NOT PRESUME TO GIVE AUTHORI7V TO VIOLATE OR CANCEI TME pERM11fE
PROVISIONS Of ANY OTHER STATE OR LOCA� LAW REGULATING CON•
STRUCTION OFi TME PERfORMANCE Of CONSTRUC710N ,$$3.25
S�GN�iUAEO�CON'i7I,CTOAOp4UTMOp�2E0AGENT ID��Er
��GN�iuAE O� OwaEp ��� OWNEp BU�lOEAi �DATE�
Peimit inspection Csrd=
Wiil Be Matled
To Homeowner To Po�#
� .
OCCUPANCV GFiOUP OCCUPANCV LOAO
SO. FT CU fT.
fS OffSTiiEET PARKING
STAILS GARAGES
SURTA%
$1.33
SAC CMAFiGE
Fire SC 2.65
. TOTA� F
�8% 3
' OP �IOA?E IS IS Y PERMJT
,, � !
o r�crf
�repaid Plan Check $ Effective 1/1/99
Estimated Cost $ .� � � CITY OF FRIDLEY
Receipt # �ONIlVICRCIAL & IIVDUSTRIAL
BUII.DING PERMIT APPLICATION
Constructia� Asjdress ��� 9 f'� �"1.�fll'I �Gl//' � ��
�1
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1 �/
• - • • • - - f .dt'.�fi � I%�' �� - ' ,
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- - , / -
- -. S� .• -- -•
TYPE OF WORK
.�- � .
[] NE�►r [l
�
BUII.DING CONSTRUCTION
��lteratio� -Descri]�
OFC. AREA: Ler�gth Width Height Sq. Ft.
Wi�SE AREA: L�th Width Height Sq. Ft.
dI��t ARF�• Lervgth Width Height Sq. Ft.
. /
�_ AP'�1��4,�'�'N� : ' .* �, °:;; ' . ' ..w* .��, . . ,,,Y . @�. 1� �/J �r � y�
, . : T Lo -/�'.S'S0 «� Da�e �9
t
_ _
' n:, �,: ,, : ;
VALUATION
Sq. Ft. x$ Oost/Sq. Ft. = valuation $ ) ,,._
Sq. Ft. x$ Cost/Sq. Ft. = Valuation $ )_$ v�cPs d ,
sq. Ft. x$ Cost/sq. Ft. = valuation $ ) 217rAL vaL�)E
.
Building Use �tructi� 'I�pe Oacupancy Graup c c� Q
Air C�ditioning Il Yes I] 1Jo Fire Protectiari ' ded [l Yes Il No
Performance Bar�cl Anrxmt $ See Reverse for Scheclule R�eceived ❑ Yes [] No
Fexmit Fee S .a S
Plan C'heck $
F� s��� s�. c� S
State S�.ircharge $ � 3 �
� � $ ,.
Erosi� C7oaztrol $
Park Fee $
Spec . Assess�r�rits $
Driv�e�nray Escrow $
so►r�w s �7� �'r�,
See Fee Schec�.ile � Reverse Sic�e
In E�aeess of Prepaid Amcxint - See Reverse Sic�e �
.00l x Pexmit valuation cl/loth �)
$. so/$l, o0o valuatio� (see sct�ed. for >$1 Milliari) ';
$1050 per SA� Unit (Plans to Nd�TCC for d+eternninatic�) _
$450.00 Oonsezvation Plan Review
Fee Dete�tisied BY E�cJin�e-ri�x1
Agreement NecessaYy [] Not NecessarY []
feet x $13.50/foot .
:;�.-
ATTACH STIPULATIONS �:��;':
� ;�;� .
a�,�s�.
$1 to 500
501 to 2,000
2,001 to 25,000
25,001 to 50,000
SQ,001 to 100,000
100,001 to 500,000 .
500,001 to 1,000,000
1,04)0,001 and up
$1 to 2,000
2,001 to 25,000
25,001 to 50,000
50,001 to 100,000
100,001 to 356,000
Over $356,000
BUII.DING PERMIT FEE SCHEDULE � � � -' �
$21 (Minimum Fee is $21 plus surcharge) ;
$21 for 1 st $500 plus $2. 75 for each addn' 1$100 or fraction, to and including
$2,000
$62.25 for 1 st $2, 000 plus $12. 50 for each addn' 1$1,000 or fraction, to and
including $25,000
$349.75 for lst $25,000 plus $9.00 for each addn'1 $1,000 or fraction, to and
including $50,000
$574.75 for lst $50,000 plus $6.25 for each addn'� $1,000 or fraction, to and
includiug $100,000 '
$887. 25 foF 1 st $10O, 000 plus $5 . 00 for each addn' 1$1, 000 or fraction, to and
including $500,000
$2887.25 for the lst $500,000 plus $4.25 for each addn'1 �1,000 or fraction, to
and including $1,000,000
$5012. 25 for the 1 st $1, 000, 000 plus $2. 75 for each addn' 1$1, Ot)0 or fraction
PREPAID PLAN CHEC� FEE SCHEDULE
$29.25
$29.25 for lst $2,000 plus $5.85 for each addn'1$1,000 or fraction, to and
including $25,000
$163.80 for lst $25,000 plus $4.225 for each addn'1$1,000 or fraction, to and
including $50,000 ,
$269 . 43 for 1 st $50, 000 plus $2. 925 for �each addn' 1� 1, 000 or fraction, to and
including $100,000 '
$415 . 68 for 1 st $100, 000 plus $2. 275 for each addn' 1$1, 000 or fraction, to and
including $356,000
$1,000 (Balance due with issuance of building permit)
PERFORMANCE BOND POLICIES
When a building permit is issued for a commerciai, industrial or a multiple dwelling residential project which requires
outside improvements,a Performance Bond or a Letter of Credit shall be submitted to the City. The bond will cover
all outside unprovements, including but not limited to landscaping, irrigation, curbing, blacktopping, screening fences,
l:�t��g, vc�ater �i sanitary s�w�r serviees, and s�c� dr�ina� -s�st�.
Calculation of bo� amounts will be determined by the building permit values. The bond amount will be 3% of ttne
building permit value up to a 2 million dollar project or a$60,000 bond. Actual amounts will be rounded to the nearest
$100. The City reserves the right to require greater or lesser bond amounts based on unusual circumstances. Projects
with no outside improvements, generally will not require a bond. �
Bonds must remain open until the project is fully completed. Reproducible "as-built" drawings of all exterior
underground utilities must be submitted to the City Engineering Dept before the project is considered complete and
the bond released. All bonds will be held over one winter and through the next growing season to insure the survival
of all landscape installations. The City will then inspect these properties in August of the year following the initial
planting. Bonds may then be released in October of that year if all improvements are satisfactorily completed.
*
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CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefullg exammed Yes O No O
2.
3.
4.
5.
6
Is free from rust or deterioration
Has no foreign objects lodged within
Is securely supported
Meets ali current Code requirements for size
and total BTLT's connected
Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater
8. Has combustion air been provided for water heater
Remarks:
List ALTERATIONS Bein Done •
HEATING CO:
Signed By:
Date:
�
Yes ( ) No ( )
Yes()No()
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
Yes()No()
�
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'� s��n ��
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� � �,a �, � �..
��3 ��
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"+ I�'i, w
� sus�cti . �
city of Fridl�y 3 2 4 3 5
�
AT THE TOP OF TME 7V4�NS g u I L D i N G P E R M I T
; � � RECEIPT NO.
COMMUAIITY OEVELQPNIENT DIV.
' j V �'••• , . . . �
r � �� PROTECTIVE INSPECTION SEC. � �,
i . ,
� � �'�'1 � CITY HALL FRIOLEY Sj1� NUMlEN REV OATE o�GE O: �WROVEO Sr
�"'"'�"� �'' 612-571-3450 s�aF�s 2/25/02 / /
10B ADDRESS 1639 Kristin Court NE
1 IEGAI �OT N0. BLOCK TiiAC OF NDDITION SEE ATTACNEO
OESCR. 12 1 Heather Oaks Addition SNEET
2 PiiOPERTY OWNER MAIL ADORQS$ IIP PMONE
Richard Ashland 1639 Kristin Court NE 763-571-8120
3 CON7RACTOR MAIL ADDRESS ZIP PNONE LICENSE NO
Rite Way Waterproofing 448 Lilac St, Lino Lakes, MN 55014 763-786-0550
4 ARCMITECT OA OESIGNEii MAIL AODRESS ' ZIP PMONE LICENSE NO.
5 ENGINEER MAIL ApDRESS Z�P PMONE UCENSE NO
6 USE Of BUIL�ING
Residential
7 CIASS OF WOfiK
p NEW D AQO�TION O ALTERATIQN �7 REPAIR O MOVE , O REMOVE
8 DESCRIBE WORK
Install interior basemer_t drain tile system
9 CHANGE Of USE FROM TO
STIPULATIONS
Electrical extension cords can not be used as part of the power source
to the pump.
Permit Inspec�ion Cards
T �`iil Be Mailed
o Homeowner To Post
" tYP CF CO ST. OCCUPANCY GROUP OCCUPANCV �OAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAI, PlUM81NG, MEAT�NG.
VEN7I�ATING OR AIR CONDITIONING
THIS PERMIT 9ECOMES NULL ANO VOIO IF WQRK OR CONSTflUGT10N jONING SO. FT CU fT
AUTMORIZEO IS NOT COMMENCED V�1ITHIN 60 OAVS. OF IF CONSTRUCTiON �
OR WORK IS SUSPENOEO OR ABANQONEO fOR A PERiOD OF 120 DAYS A�
ANV TIME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS OfFSTREET PARKING
I MEREBY CERTIfV TMAT I NAVE READ ANO �XAMINED TNIS APPlICA710N 1 STA�LS GARAGES
ANO KNOW THE SAME TO 8E TtdUE ANO CORRECT. ALl PROVISIONS OF ��w3 VALUAt10N SURTAX
ANO OROINANCES GOVEiiNING TNIS TVPE OF WpAK WILL Q� C(�MP�IEO � i� SOO �• 75
WITH WHETHER SPECIFIEO HEREIN Ofl NOT. TME GpANTtNG OF A PERMIT
OOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE Ofi CAyCEI TME pEqMIT fEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE OR IOCAL LAW REGUTATING coN- �54 .00 Fire SC � 1. SO
STRUCTION OR TME PERFORMANCE Of CONSTNUCTION
PLAN CMECK fE TO A� FEE
Licens C City $56.25
S�GN�iUAEOFCON'AACTOpOp�UTMOp�2E0�GENT �O�ifr MEN OP � VALID T D TMIS IS V UR PERMIT
�-� G-6Y
S�GN�TUAE O� OWNEp��� O�NNEp BU�IOEA� � �OAfE� l0 �NSO ' ���TE
Prepaid Plan Check $
rsstimated Cost $ 1 . ��
Receipt #
2.�� CITY OF FRIDLEY
/R , COI�RCIAL & INDUSTRIAL
BUILDING PLRMIT APPLICATION
Effective 1/1/2001
(763)572-3604
Construction Addreea �(0 3Cl ��,(' i�-�.v; (���1' i-_ Zoning
Legal
Owner & Address [�'
CONTRACTOR & ADDRESS r. I�� to - G
. . r. , . _ . . . •
.
Tel# (Z1.3) S7(� 1�
Tel# ��_� % e"� �.�1%
Architect Reg.# Engineer Reg.#
BUILDING CONSTRUCTION
TYPE OF WORK [] New (] Addition Alteration -Describ �1��,�,� cln _ -
. __ —_,_.,,,-,..°._-_____�._ � ... _— ,. _ .
�. ° o.�/►�! -S^� C.J��cA.,�h` � 5�.1 % �(�v�-
OFC. AREA: Length Width Height Sq. Ft.
WHSE AREA: Length Width Height Sq. Ft.
OTHER AREA: Length Width Height Sq. Ft.
APPLICANT ` Tal #(oSl ��7 l�a � S.S� Date a—�i �"U%
VALUATION
�.} �� ;. , . .,. x: �� �
Sq;f�F� µ �'., ? ..Xet�r�a� .��'COS.��`SQ...�L`+`", �r.a�i?�1�:tI�t10A:r��:t;..s, ,i'r .4�t.�-,�'rwx : "? 'ti�, .
Sq. Ft. x$ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE
Building Use Construction Type � Occupancy Group � S�b-��C�'�-
Air Conditioning []Yes []No Fire Protection Provided []Yes LINo
Performance Bond Amount $ See Reverse for Schedule Received []Yes []No
Permit Fee $ ��
Plan Check $
� Fire Surcharge $ (. SD
State Surcharge S S
SAC Charge $
Erosion Control $
Park Fee $
Spec. Assessments $
Driveway Escrow $
TOTAL $ � Co • � S
PERMIT FLES
See Fee Schedule on Reverse Side
In Excess of Prepaid Amount - See Reverse Side
.001 x Permit Valuation (1/lOth �)
$ . 50/$1, 000 Valuat.iQn ,.(�ee Sehed. foX > _ $1 �Million� '
$1150 per SAC Unit� (Pla'ns to MWCC`�for determination)-
;. ; �
$450.00 Conservati,�on Plari Review
Fee Determined By Engineering
Agreement Necessary [] Not Necessary b?'
feet x $15.50/foot
.. • • j
ATTACFI STIPULATIONS
�
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$5Q,001 to.� $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and ,up : .. , �
BUILDING PERMIT FEE SCHEDULE � � � '
$23.50 (Minunum Fe� is $23.50 plus surcharge)
$23.50 for lst $500 plus $3.05 for each addn' 1$100 or
fraction, to and including $2,000
$69.25 for � 1s� $2,�00 p�hi$ $i4.04 for, each addn'1 $1,000 or
fraction, to and including $25,000 ' '
$391.25 for lst $25,000 plus $10.10 for each addn'1 $1,000 or
fraction, to and including $50,000. � :
$643.7� �f��r t$50,000 plus $7.00 fQr each. addn'1 $1,000 or
fraction,� to dnd�inc�uding $100,000 •
$993 .75 for l st `� 100,000 phis` �5 . 60 �or xeach addn't $1,000' or
fraction, to and including $500,000
$3,233.75 for the lst $500,000 plus $4.75 for each addn'1
$1,000 or fraction, to and including $1,000,000
,$5,608.75 for the lst $1,OQ0,000 plus $3.15 for each addn'1
--�-1;9A�e�-€F'�ae-�i�r - � � -- _
PREPAID PLAN CHECK FEE SCHEDULE
Per Minnesota Building Code - 65% of building permit fee.
PERFORMANCE BOND POLICIES
,� ; _�,� � .,, ,":
WhER a building permit is is�ued. for a,commercial, it�dustrial or. a multip�e dwelli�,g•
residential project which requires outside improvements, a Performance Bond or a Letter of
Credit shall be submitted to the City. The bond will cover all outside improvements, including
but not limited to landscaping, inigation, curbing, blacktopping, screening fences, lighting,
water & sanitary sewer services, and storm drainage systems.
Calculation of bond amounts will be, determined by the building permit values. The
bond amount will �be 3% of the building permit Value up to a 2 million dollar project or a
$60,000 bond. Actual amounts will be rounded to the nearest $100. The City reserves the right
to require greater or lesser bond amounts based on unusual circumstances. Projects with no
outside improvements, generally will not require a bond.
Bonds must remain open until the project is fully completed. Reproducible "as-built"
drawings of all exterior underground udlities must be submitted to the City Engineering Dept
before the project is considered complete and the bond released. All � bonds will be held over
one winter and through the next growing season to insure the survival of all landscape
installations. The City will then inspect these properties in August of the year following the
initial planting. Bonds may then be released in October of that year if all improvements are
satisfactorily completed.
�. S ♦ .�
NEW [ ]
ADDN [ ]
ALTER [ J
CITY OF FRIDLEY ���'� v�02�� Effective 4/1/2004
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: %� � 9 1�'� � s"`71�i � G�'r _
Legal Description:
Owner Name 8 Address: t� � c� A p o �-� � L� N/� Te�. #
Contractor. � �t�i► �4.c2 �'1 !-�ASfi � ��' S MN LICENSE# �� S ( _
Address: � ? ? 1 � � �-'� � � �' � T' � �- • Tel. # S 7 �{ — F �� �
LNING AREA:
GARAGE AREA:
DECK AREA:
OTHER: �
Attach to this application, a Certificate of Sunrey of the
bt, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width _ Height Sq. Ft.
Length Width f_ Hg�/Ground Sq. Ft
� _ � ��
v ���a
Construction Type:��A R- °�� �' Z� � or, F Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ __ _$
DATE: �26 p APPUCANT: ��y,�/ ld��� Tel. #� ��"� �6�
Call (763) 572�604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ , o�s
$
$
$ %• � o
$
.� �ov
$
$�
$
$
CITY USE ONLY -
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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
TOTAL $ ��� STIPULATIONS:
�!r-��
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 alteradon or repair to any existing building or
structure, upon applicadon 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
$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 addidonal $1,000
or fraction thereof, to and including $25,000
$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 fust $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 $500,000
$3,233.75 for the fust $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
CURB CUT ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually deternained
rate
Permits for construcdon will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the existing foundation will be required before
proceeding with the framing. New Houses Onlv
Building
Inspections
763-572-3604
763-502-4977 FAX
From: unknown Page: 2/2 Date: 1/4/2010 822:03 AM
MECHANICAL Permit 1vo.:
RESIDENTIAL APPLICATI4N
CITY 4F FRIDLEY
DA'1'B �lM10 dave devesheatln a
YOUR E-MAIL ADDRESS � 9 ndair.com
SlTB ADDRBSS � � �IST1N COURT
7'Fi[S APPUCANT IS: O 4WNER OCONTRAC7'OR '
CKVCN:K'l'Y NAMP,: R���p �HIANQ
OWNEW AoQRr3ss: �g39 KRISTIN COURT ���. FRIOlEY STAT ME� �2
7'ENANT 7s3-5�1-8120
PHONE:
SUQMIT A COPY OF
YQUR STATE
LLCENSE WiTH
APPLICATION
PERMIT TYPE
COMPANYNAMH; DAVE'3 HEATING, AIR 8 ELECTRIC
CONTACT PERSON: �Y MADVIG
STATE LICEtJSE # BXP DATE
ADDRBSS: 1601 37TH AVE NE ��Ty CCILUMBIA HEiGWTS STATB MN ZlP �21
PHONE 783-781�80'i FAX 7B3-789-88Q8
FAMILY fl TWO FAMILY
TYPE OF WORK: I❑ N�w �PI.ACEMEN7'
Q TOWNHOUSL'
a a�.Teaarroxi�aMaue►,
DETAILED DESCRIPTION OF WORK REPLACE FURNACE W/ LENNOX M#G81 MPV-36B-090
l�EES AR� BA$fCD ON S1Q00 PER FIX7'URE, f:XC�PT �1+kC1�RE NOTLQ FIXTUAES: (1NDICATE TOTAL NUMBER QF BACH BEL�y1�
Fquipment Inualled MFG: � MODEL: �� 9iZE/BTU �
MFQ:
MODEL: SIZFJBfU
MFG: MODEL: SIZFJRTU
�5.� �FiREPLAC6 (GAS) Si 5.00 GAS RANOF.�OVEN 510.00
TO AiR EXCHANGEER S I S R6PLACE (WOOD) 833.00 TiEW CFAS dRILL $10,00
LER 535.� RNACi 535.00 dAS UNIT HTR Sf 0.00
MNEY LINER SI0.00 AS DRYER 510.00 POOL HEAT�R 535.00
;T WORK SI0,00 ____GAS PIPINO SI0.00 VEN'tYI.A`I'UR SI 5.00
Numbar of fxtures (� � LO 00. x S16.OU =$
Nutnber of �xturas (p� S 15.40 _____ x al g.Op = S ;�
Numbet offixturea ��25.00 � x 525.00 = S_,_,____,
Number of fixtures � 535.00 � . x $33.00 = $ �•�
State 3urcharge = S .SU
1 hereby appty for s C
conformance with the
not a permit but only
approved plan in the c
SIGNATtJR13 OF
� ���. �t�
'1'HIS IS AN qPPLICAT[ON FOR A PERMIT NOT VALtD UNTII. PRqCFSSBD
mit and 1 acknow(edge that thc infornistion above is complete and accarate; thet the work wiN bc in
and codes of the City of Fridley and with the Minnesota Construction Codes; that .I understand this is
�n for a pertnit and wock is not to start without a permit; that the work will be in acc;ordance with the
�rk whi�n ��@y� revi and epproval of pl
�..N! V ► l� 1 � I�.bnIT 1� � ��C �nn � � 1Mr.�r.1 �n.Ql. � �u _ � ,1
`� City of Fridley
Building Inspections Department
6431. University Avenue ]VE, :Fridley, MN SS432
7b3-572-3604 FAX: 763-502-4977