AF - 47980THE
THIS
AND
VERiI
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i �
� �
� `L _�___ COMMUNITY DEVEIOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC.
1955
RE8€?�T N O.
, � , � 9 �-�%
� /"'1 � CITY HALL FRIDLEY 55432 NUMBER REV.• bATE PAGE Of APPROVED BV
�.__.Jl.' �-� 612-571-3450 910-F15 6/23/88 / �
JOB ADDRESS 5980 Stinson Road N. E. (to be changed to 1663 Kristin Court N. E. )
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION
SEE ATTACHEO
DESCR. 1.6� Ex. E. 33' Aud. Sub. #92 (I�ot 15, Bl. 1, Eieather Oa.ks) SHEET
2 PROPERTYOWNER MAILADORES$ ZIP PHONE
Earl & Donna Steffen
3 CONTRACTOR
Brickner Builders Inc.
4 ARCHITECT OR DESIGNER
5 ENGINEER
MAIL ADDRESS ZIP PHONE LICENSE NO.
6230 Highway #65 N.E., Suite 104, Fridley 55432 574-9871
MAIL ADDRESS ZIP PHONE LICENSE NO.
MAIL ADDRESS
Z�P PHONE LICENSE NO.
8 USE OF BUILDING •
Residential
7 CLASS OF WORK
C� NEW ❑ ADDITION O ALTERATION � REPAIR � MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 42' x 44' DWelling and a 21' x 28' Garage (Approx.)
—_�__.. . w • .. . .. . � .. .
iEIEPHONE - ELCCl'�IC - C6�S �;c�
9 CHANCiEpFUSEFROM TO REQUIR�D �Y �.�a�
STIPULATIONS p�ovide a hard suzface driveway. Provide sod in the front and side yards.
Provide City with copy of verifying survey before capping. 5ee nota.tions on plan.
This house ca.n not be occupied until served by sewer & water and the plat of
Heather Oaks is recorded at the County.
WATER & SEWER LOCATION5: City does not have as-builts as yet from developer.
Paid $1,500.00 Park Fee. Paid $800 Storm Sewer Fee.
ITl' OF FRIDLEy DOES NOT GUARqNZEF THE SE�A��T� P,���I'�'� �?��8, pd .�,�E
'ACY OF UTILITY LOCATIONS ANa ���y,qT�ON� �� � FC��
1ATA IS FOR INFORMATlOid PilRp{�S�S p� 1 L Y, �`��N�''° ��'�+�I��a, ��.(„ p j� J 1 3 1 i 0 I L a ,� j� g� ���� � Sa
E R S O N S US I N G T H 1 S 1 N�'b,�����N S� a��
IT ON THE SITE,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING
AUTHORIZED IS NOT COMMENCED WITHIN 80 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
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND.ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIED $111 95O
WITH WHETHEN SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �`F>5�., SO
IDaTEi
���.�-G
CY GROUP
Sc7. F7. I CU. FT.
1584 + 747
OFFSTREET PARKING
STALLS IGARAGES
LOAD
$ 55.98
iAC CHARGE
CREDIT FROM WRECKED
$737.48 + PF & SS
1 THIS IS VOUR PERMIT
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ALZER [ ]
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City of EYidley EEfective 5/L88 3�z51�y
R-1 ADID R-2
Huilcling Permit l�p]. ication
�nstrt�tio� Adalress: ?9�o S�i� S� nl �7-� �S � l�� � ����sT��/ � v � 7'�
�y� . Gar /6 C����� �'H�° ��d�� ��' �v�>. al �.!q / /./g ,r
i�l i�Cr�irl�ilQ1• t` .� V� � i0 �N�R? �0�` Lur �s' �Gl� i/✓C���f��j� �Lt=e�.��
Owner N�ne & Address: �/�� d- l� o,vn, � S�-�� �� y,l
Tel. �
O�ntr actor : �� / c 1�' �v � � %� v I L r� � � � ,� � c� Tel. # S�% � r `� � %/
Aac7re�s : _G z � a j�a.�, � ,� �� � .� � � ��,� � � �,c?
Attach to this appl ication, a Certif icate of Stirvey of the
lot, with the proposoed oonstruction c7raa�m on it to s�cale.
i':,� •• �� �; �;' i.. � a i:�
i.TVTK: ARRn • �.s � Wl�l $��lt
--- ---- r�. �.
� ' ' �9� Wi� Eeic�t St�. I�t. '
D�t 1�RF�: Length Width Hgt/Groimd 9q. I�t.
�'$:.
Gbrner Lot [] Insic'� Lot � Ft. Yd Setback S� Side Yard Setbacks �'� ��
Type of Construction: S�� � : `�� . � ,����`���°/ � Estimatecl Cost: S_ � �
Approx. Completion Date: f(� p� �� e�� .
Al� A Alt. B
Prop�sed Driveway Width If New Opening Is Desired: $ $
Width + 6' See Back Page
� ��
L�ATE : � � �� - ��' APPLIC�NP: � v' ��`�°'� Tel. S � � ° `�
CQY DSE �Y
Pe*n+; t Ftee
State Surcharge
� � SAC Qlatge
I�t� Driveway Escraw
Park Ppe
�����
Z+OTAL
S��Q p�(� F�ee Schec�le on Reverse Side
$ � c� ��81,000 Valuation
$ � c�'�� 5!50 per SAC Unit
$ �'— Al� '�" or Alt. '�" Above
$ � �� � �1ee Determired by Ehgir�eering
� �� � A�eenerlt Neaessary [ l No� Neoessary
$ �3�0�
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The C�iief Building Official shall, before issuing permits for the erection of any
building or �ructure, or for any additi� to any e�cisting 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 belaw set forth and in the manner herein prwided to-wit:
TOTAL VALUE
FFES
$1 to 5500 S15 (�iinimtan Fee is S15 plus surcharge )
5501 to 52,000 S15 for first 5500 pl� S2 for a�ch additional $100 or fraction
thereof, to and including 52,000
52,001 to $25, 000 S45 for f irst $2, 000 plus �9 for each additional $1, 000 or
fraction thereof, to and including 525,000
525,001 to 550,000 5252 for first $25,000 plus 56.50 for each ac�ditional $1,000 or
f raction thereof, to anc7 irmluding �50, 000
550,001 to 5100,000 $414.50 for first $50,000 plus 54.50 for each additianal 51,000
or fraction thereof, t�o and including $100,000
5100,001 to �500,000 5639.50 for first �100,000 plus 53.50 for each additional $1,000
or fractio�n thereof, to and including �500,000
5500,001 to 51,000,000 52039.50 for the first $500,000 plus �3 for each additional
$1,000 or fraction thereof, to and including 51,000,000
$1,000,001 a�d up 53539.50 for the first 51,000,000 plus $2 for each additional
51,000 or fraction thereof
DRIVEfi�Y DEPRESSION E9C.'[�Qi�
(Concrete Curb Streets Only)
Alternate "A°: Renoval and replaaement aE curb and gutter o��].y - Driveway width plus 6
feet times 513.50.
Alternate °B": R�nwal ancl replaoement o�f curb and gutter and install a 3 foot wide
approach with 6 inah depth - Driveway width plus 6 feet times .$15.75.
1�+; � : M •� •" a�:�1��:� ��
Permits for construction will be issuecl a minim�n of 24 hours f rom the time of
application to allaw for proper review of the proposed structure and of the o�nstruction
site.
A Certif icate of Survey of the lat, shawing the location of the fotuzdation once it has
been aonstructed will be required before prooeeding with the fraaninc� .
e
n
�
lohn Bro�die �
+o►rchitectunoJ consuitants inc.�
„ sooe s� aT, a. E. ossEO� �k ee3s� N+_ ls�xl-s:s•�ns. _— _. 1
a �"���'�� �.�"'�' ��� �"�� ��� 11..11 ww�iw
Plon'�1 °3 -�� � Date � — � � ° � .
Owner� �,� c� � �� ��� - �--�-,=���� s,
Contractort g e-i ��--�-- d y- r'-A �'z s.
Site Address:
1)T07AL EXPOSED WALL AREA . °d I sq. ft �i U".L.�.
.-. _
2) TOTAL EXPOSEO ROOF�EILINQ AREA I s�� sq. ft. x�U° '�
MfALL AREA CALCULATIONS�
TOTAL WINDOW AREA
GLAZED
70TAL DOOR AREA
?OTAL GLASS DOOR NREA
_. GLAZED
TOTAL �IREPLACE WALL AREA
70TAL WALL FRAMING AREA
NETINSULATED WALL AREA
?OTAL RIM JOIST AREA
TOTAL FOUNDATION AREA (EXPOSED)
TOTAL FOUNDATION WINDOW AREA
�D.
4� ��
o �� �� , 4Z �
z sa.ft.x U __
�Cj n a� O'�1 �. ��
SQ.ff.x �
' ° ° sq.ff. x'��� � c�.�7 _ 3�
sq.ft.x�U��''� _
�_
� �-'I �,,f�.x ��" � �� = I � ,
� � 3`� sq.ff.x'u":."�_ �=�
I z°i Rq.n.xu", °4 =. s�
�� sq.ft.x`iJu � � 4 = ���
`�' � sq.ft.x�U�� � S'� = 2,_
3) TOTAL � 6. S
. It item 3 Is 1he some as,or less lhan ltem l, rou have met fhe Infent of
_ 2 MCAR 1.16008 A ond D.
. •
ROOF/CEILINO CALCULATlONS�
�OTAL SKYLIGHT AREA
70TAL ROOF��`iEILING FRAMING AREA
NET INSULATED ROOF CEILING AREA
'_ q.it.x�U°'""_� �1
� _
1� ' - .+�.x�u�� ��- �� 1
9 '
' � q- 3 � sq.��.x'u"'=: �' _ � � �
_ �4jTOTAL . �•
.. If ifem 41s the sorrie os,a less lhon Ifem 2, �rou hove met 1he lntenf of
2 MCAR J.16008 A and O.
ALTERNATE BUILOING ENVELOPE DE310N
. To utilize fhe tolal envelope system method, the sum of Items 1 ond 2 aholl
be Qreoter thon the sum of ltems 3 and 4. '
:
,
_ . 1) +2) _
• 3) +41 =
a �
� 1 hereby ce►flfy ihat the DuUdlnp he�e described meets or ex eds Stat M' esoto
EnerQy Conservotion Acf. � , �
(signed) - �_ -`��
�� � � I �,�, ��� CONSTRUCTION
FRAMING SECTION
� Interior ofr film 0.68
2 � .� S�IL,¢r.�C_ .4S
3?t inches of soft wood �,g1
q Zsl sc e�.i�e++E L o 1,.
� ��o�..� d I
g exterior air f11m 0.1T
. TOTAL R � � � °
U = 1/R '._. °�
SECTION (INSULATEO)
� nte�ior air film 0.6
2 "s�.+i-•<� ,4S
3 S� �?�.i.F �.�. (, o
4�I s� e�� �-e N-E C,o �
5 s���.,z .SI
g exterlor oIr film p 17
• � TOTAL R Z.S . �
U = VR - ' °�j-
�IST SECT�ON �
� interior air fllm 0.68
Z 5z+ �+�1+ u-e. �9, o
3 �'1 ��'� t�...�rv �� o�l
.q L �3l P�J��FN�E L o,�.,
5 �si,����y � 8l
g extertor air fllm p,��
- � _ TOTAL R � � �
U = 1 /R o 0
ATION SECTION
� iote�ior a1r fllm 0.68
2 ����-r2� �.�7. � e
3� n`.�c� a��.�� 1 2'�
a exferior otr iilm
5 0.17
- - TOTAL R �'s
�U = !/R—LI�
�
VENTED
CONSTRUCTION � `�
CEILING SECTION (INSULATED)
( � linterior air ttlm 0.61
( 2 5/� �r+��*e « K � 5�
t3 ��.,., 1 �-� ,�
(q exterior oi� tilm (stilf) 0.61
TOTAL R 45"� �
U = 1/R . �DZZ
CEILING FRAMING SECTION •
( � j,.nterior air ftlm � 0.61
(2 �8 S�,¢cc.,L �Slo
� 3 • 7�,�,,.n..�► � uult_ • ��
(4 interior ofr film 0.61
�g �5 inches of coft wood 4.�5
�_ TOTAL R �3
U = 1 /R. . DZlO
CEILING SECTION � INSULATED�
( � interior oPr tilm 0.61
_ (2 5/v, Q2-oc �c . S(n.
�3 b "aat�J P-_P'Ti _ ':�J
(q exterior ofr fllm (stilij • 0.61
_ TOTAL R 3°�, F`.
U = 1 /R .� n�
CEILING FRAMING SECTION _
( �.inle►(or oPr film 0.61
. (Q 9A � rc .S l�
- �3�� np�'' 3�,c�0
(4 interlor air film 0.61
(5 �'Zinches of sof! wood S,Lr
Cp�- 'M-"�S� .TOTAL R 45,3�
_!I = I /R • OZZ
EXPOSED BEAM CEtLING SECTION
(,� Interivr a1r fllm 0.61
�2
(3
t4 .
(5 exterior oir tilm 0.17
TOTAL R
q a
� 4
L = I/R
RONALD F. MEYER
' LAND SIIRVEYOR
LAND SURVEYINO SUBDIVI�ION DEBION
' TQLEPNON6 771-4386
DAD JHt)e1C 8T. 8T. PAUL, MINN. 3!l101
r
I hereby certify that this survey was prepared by me and that I am a duly
Registered � Land Surveyor under the laws of the State of Minnesoto.
Reg. No. 9051 Date : /1��� /2, /9dB
� r. � - /9- 88
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SCALEs 1" = 40!
o Indicates iron set
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Lot 15, Block 1� HEATHER OAKS, Anoka County� Minne�ota.
Contains 10,070 sq. ft..
. "
RONALD F. MEYER
LA.ND SIIRVEYOR
LAND SURVEYINCi SUBDIVISION DEStGN
TELEPHONE 771-4586
_ 988 JES91E ST. ST. PAUL, MINN. 55101
I hereby 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.
,- � Reg. No. 9051 Date: /1�j� �2, /98B
�v � - /9- 88
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SCALE: 1" = 4Ql
o Indic�tes iron set
Lot 15� Block i, HEATHER OAKS, Anoka County, Minnesota.
Contains 10,070 sq. ft..
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CHIM�JEY AN�J STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1. Has been carefully 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
6. Has To ta 1 hea ti ng BTU' s of
All other BTU's
TOTAL
Rema rk s
No ( )
No ( )
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Com pa ny
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CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
Septemher 23, 1988
Brickner Builders Inc..
6230 Highway #65 N.E., #104
Fridley, MN 55432
Re: Final Inspection at 1663 Kxistin Court N;E.,,Fxidley
Dear Sirs:
A final inspection �r.as conducted qn Septemb�er 23, 1488 0� the ab.oye address
and the construction was found to b.e complete and we have f inaled it out.
If you have any questions on this matter, please feel free to contact me at
571-3450.
Sincerely,
DARREL G. CLPiRK
Chief Bui.lding Official
DGC/mh
m
� c�ty of Fr�a�ey S�a,Et, PE � 4�2
� A T TFIE TOP O F TN E T WI N S � � I L D I N G P E R M I T
r
; � R PT NO.
� ; y �_���_ COMMUNITY OEVEIOPMENT DIV. �� ��
� � PROTECTIVE INSPECTION SEC.
� _ �
� /'�'1 � CITY HALL FRIOLEV SS13Z NUM8Bi1 REV OATE PAGE Oi A�PROVED BY
�"'"� � �'' 612-571-3450 9t0-F15 10/6/00 / /
lOB ADDRESS 1663 Kristin Court NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACMED
DESCR. jS 1 Heather Oaks SNEET
2 PROPEFiTY OWNER MAIL ADDRES$ IIp PMONE
Dawn/Paul Christenson 1663 Kristin Court NE 571-5313
3 CONTRACTOR MAIL ADORESS 21P PMONE LICENSE NO
Same
d ARCHITECT OR DESiGNER MAI AODqESS IIP PMONE LICENSE NO.
5 ENGiNEER MAIL AODRESS ZIP PHONE LICENSE NO
8 USE OF BUILOING
Residential
7 CIASS OF WORK
O NEW � ADOITION O ALTERATION p REPAIR ❑ MOVE O REMOVE
B DESCRIBE WORK
Construct a 12' x 10' Deck Addition/with hot tub
9 CHAN(3E Of USE FROM TO
STIPULATIONS
See notations on plan.
- � � -,,
�EP�4RAiE ��RflAITS �efore d������ can fo�
REQUIRED FOR: ��� ����v ��cations
wrRinrG, HEAl1NG ��0002
��u�w�i�G ��� s�r�ts �E�U��� �Y ���
SEPARATE PERMITS ARE fiEOUIRED FOR ELECTFICAI. PIUMBING, MEATIN(3, �PE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTI�ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION pONING SO. FT CU FT.
AUTHORIZED IS NOT COMMENCED V�IITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 12p OAYS AT
ANV TIME AfTER WORK IS COMMENCED. NO DW�G. UNITS OFFSTREET PARKING
I NEREBY CERTIFV THAT I HAVE READ AND EXAMINEO TNIS APPLICA710N 1 STALIS GARAGES
AND KNOW TME SAME TO BE TRUE ANO COFiRECT. ALL PFOVISIONS Of �AW$ VAIUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMP�IED
WITH WMETMER SPECIFIED MEREIN Oii NOT. TNE GRANTING OF A PERMIT �1�320 �.66
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEqMIT fEE SAC CMARGE
PROVISIONS OF ANY OTNEH STATE OR LOCAL LAW REGUTATING CON• �SO.9S Fir SC �1.3Z
STRUCTION OR TNE PERFORMANCE OF CONSTRUCTION
PLAN CNECK fEE TOT � FEE
52.93
SiG 4T O� CON ,i LMeRhEED AGENT iDniE� E PR VAUO T THIS IS Up PE MIT
r ! v �����
S�GNAlUAE0�0 EpasOWtiEpBU�IDEp� �D�TE� BL r_'�NSP f��1E
� - _ �
N�n► . I l
ADDN �' [ ]
ALT�R [ ]
Construction Address:
Legal Description: �
Owner Name 8 Address:
Contractor: S Q �
0
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�
�
Effective 1/1/2000
(763) 572-3604 Bldg Insp
�Tel.#„��a..- 5���.5��3 �
MN LICENSE#b�r ��9-���?�w�����
Address: Tel. #
LMNG 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 � a- Width �_ HgUGround �� �? Sq. Ft
(9�J � / 3�a
J /�`/� � �
Construction Type: �(�G/C 9' /��-�v� Estimated Cost: $� �(J(OO 1G�G U�
Driveway Curb Cut Width Needed: Ft. 6 Ft = Ft x$ _$
DATE: Q '' � o�"�' APPLICANT: G^' � �"� �'�`�--� Tel. # � � �.� �l S��
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $,'�� fl 7�' Fee Schedule on Reverse Side
Fire Surcharge $ /� 3�. .001 of Permit Valuation (1/10th%)
State Surcharge $ , $.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
Sewer Main Charge
TOTAL
STIPULATIONS:
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ �a . 7
F
� , =.
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erecdon of any building or structur�, or for any
addition to any existing building or siructure, or for any alteradon 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 hereir.
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 $500,0�
$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 $1� or
fraction thereof, to and including $2,0�
$69.25 for first $2,000 plus $14.00 for each additional $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 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 $500,000
$3,233.75 for the first $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,OQ0,000 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.
Altemate "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 $23.25.
VERIFICATdON OF FOUNDATION
Pemuts for construction will be issued a minimum of 24 hours from the tune of application to allow for prope�
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed wil
be required before proceeding with the framing. New Houses Onlv
�
�
° RONALD F. MEYER
� � ' I.AND SIIRYEYOR
LAND SURVEYING SUBDIV�S�ON DEHIGN
' TEtEPMONE 771-4586
985 JE981E ST. ST. PAUL. MINN. 55101
I hereby certify that this survey was prepared by me and that i am a duly
Registered Land Surveyor under the laws of the State of Minnesota.
, Reg. No. 9051 Date: %% 2� /98D
,�e% � - /9-88
�ev, � 2.3-g8
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SCALEt 1" = 40!
o Indic�tes iron'set
Lot 15, Block 1, HEATHER OAKS� Anoka County� Minnesota.
Contains 10,070 sq. ft..
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City of Fridley
AT TNE TOP OF TME TW�NS
r
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� �
� ; v _���� COMMUNITY DEVELORMENT OIV.
r � � PROTECTIVE INSPECTION SEC.
1 . ,
� _ �"'1 � CITY HALL FRIOLE� 53132
�"'"�� �'� 612-571-3450
�oe ao�Ress 1663 Kristin Court NE
1 LEGAL �OT NO. 9LOCK TiiAC'
EU ILDING PERMIT
REV
s�aF�s I 16/�/02 I /
RMIT NO.
32672
R NO.
�
Oi APPROVED BY
/
SEE ATTACHED
oesca. 15 1 Heather Oakds SNEET
2 PFOPERTY OWNER MAIL ADQR�S$ 21P PHONE
Paul Christensoa 1663 Rristin Court NE
3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO
Richard Hastings Contractor 6331 Riverview Ter NE, Fridley, MN 55432
4 ARCMITECT OR DESIGNER MAIL AODRESS 21P PHONE LICENSE NO.
5 ENGINEER
8 USE OF BUILOING
Residentiai
7 CLASS OP WORK
❑ NEW
8 OESCRIBE WORK
Reroof House & G.
9 CHANOE OF USE FROM
763-574-9966 4051
�a�L ADDpESS ZIP PMONE LICENSE NO
O ADDITION O ALTERATIQN [� REPAIR ❑ MOVE •❑ REMOVE
e (27 Sq) Tear-ofi
TO
STIPULATIONS
Underlayment must comply with the State Bu�lding Code.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTIIATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL ANO VOID �P WORK Oq CONSTRUCTION 20NING
AUTHORIZED IS NOT COMMENCED V�1ITMIN 80 DAYS. OR IF CONSTRUCTION
ON WORK IS SUSPENDED OR ABANQONED FOR A PERIOD OF 120 OAYS A7 `
ANV TIME AfTER WOfiK IS COMMENCED. ' NO- DWLG. UNITS
I HEREBY CERTIFV TMAT I MAVE AEAD ANO EXAMIN�D TMIS APPLICA710N 1
AND KNOW TME SAME TO BE TF1UE AND CORRECT. ALl PROVISIONS bF LAW$ VALUATION
ANO OROINANCES GOVERNING TMIS TYPE OF WORK WILL QE-0pMP�IED
WITH WNETMER SPECIFIEO MEpEIN Oii NOT. TNE GRANTING OF A PERMIT �2s894
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CAMCEI THE pEpMtT FEE
PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGUTATING CON• @83 � 2S
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION y�
�a • � � �
$�GNATUaE OF LON'aACTOA OA • MOpIZEO 4GENT IDAiE�
N4TUAE O� OWNEp ��� OwNEa Bu��DEA� IOAfE� '
d
ts
SO.FT
STALIS
$5.
r �ono
CU FT.
OFFSTREET PARKING
GARAGES
SURTAX
$1.45
SAC CMARGE
Fire SC $2.89
TOTA F'EE
92.59
TE THIS IS YOUR PERMIT �
c, • � -/O-�
O�TE
N� [ l Effective 1/1/2000
ADDN [] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: �f�� � 3 IC �� � .
Legal Description:
Owner Name & Address: �7 � �_�_�„o Tel. #
Contractor:
LMNG AREA:
MN LICENSE # `/-v S 1
Tel.# S7 �-"�l'i6�
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
GARAGE AREA: Length Width Height Sq. F�
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: Z 7
Construction Type:� � Estimated Cost: $ � �� ��
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: APPLICANT: �r �. �� !��'��� Tel. #
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ c� •� S Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ /. �/S $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
$ $1100 per SAC Unit
$ �� �C� $5.00 (State Licensed Residential Contractors)
$
$
$
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary []
TOTAL
STIPULATIONS:
$ . S9
¢
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 alteradon 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,Q00
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$1Q0,001 to $500,0(}0
$500,001 to $1,OQ0,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $5� 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 $50,0�
$643.75 for first $50,(�l0 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,QQ0
$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 first $500,000 plus $4.75 for each additional
$1,000 or fracdon thereof, to and including $1,000,(�0
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Ci,ub Streets Only)
Altemate "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
Pemuts 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 Certifica.te 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. New Houses Onlv
Building MECHANICAL P�t No.:�i�
Inspections RESIDENTIAL APP�.ICATION Received By:
763-572-3604 CITY OF FRII�LEY Dat��t: o%
DATE YOUR E-MAIL ADD12ES5
SITE ADDRESS d' � e �
THIS APPLICANT IS: ❑ OWNER �fCONTRACTOR
PROPERTY NpME: a
OWNER/ ADDRESS: ' � CITY STATF��ZIP-��i�
TENANT PHONE:�� �—�%/`���9
CONTRACTOR co�a� Nn�: / ` " �
SUBNIIT A COPY OF CONTACT PERSON: °
YOUR STATE STATE LICENSE # EXP DATE
LICENSE WITH ADDRESS: � � CITY�� Q V' '� U e�' LGI STATE�ZIP � o�
APPLICATION pHONE ` - I� AX
PERNIIT TYPE � SINGLE FAMII.Y ❑ TWO FANIII.Y ❑ TOWNHOUSE
TYPE OF WORK' � �W � ��CEMENT � ALTER`'`TION/REMODEL
DETAI�ED DESC�ON OF WORK � � '� �. � � � / / �'" 1 1 ��
lJ�'e�,: h ,�
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, wluchever is greater, for the
improvement, installation 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 $500 = cost of labor x.OS =
FOR PROJECTS Wf�RE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT Wf�RE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELO�
Equipment Installed MFG: MODEL: SIZEJBTU
MEG: MODEL: SIZFJBTU
MFG: MODEL: SIZF/BTU
_A/C $25.00 FIItEPI.ACE (GAS) $15.00 _GAS RANGFJOVEN $10.00
AIIt TO AIR EXCHANGEER $IS FIItEPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
_BOII.ER $35.00 _FURNACE $35.00 GAS UNIT HTR $10.00
CHININEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.0{1 GAS PIPING $10 00 VENTII.ATOR $15 00
1'� . ° , :�� �.� _ ,�'a �� �. ✓: .��t�_ , � .,=z , ,, _7 ; -�, �, . ,P���`�'.��� ��%l� � Q�;�-���;�'���i! . . _;:
Permit Fee $_�. Number of fixtures @$10.00 x$10 00 =$
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $�_.� Number of fixtures @$25.00 x$25.00 =$
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Tota1= $
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that tlie 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 an application for a permit and work is not to start without a permit; that the work will be in accordauce with the
approved plan in the case of a11 work which requ' es review and approval of plans.
SIGNATURE OF APPLICANT �' �, PRINT NAME� .l�l,��G�i� DATE a O
,,�����������_� .>. � ��� �����_ ' �,��.����. . ��_ _��?�%'��;��-:_ �:-:
City of r'ridley
Building Inspections I�epartment
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
Building
Inspections
763-572-3604
DATE ' � ' � �
S1TE ADDRESS I
THIS APPI.ICANT IS:
PROPERTY OWNER/
.TEN�NT �
CONTRACTOR
SUBMIT A COPY OF
YOUK STATE LICENSE
WTTH APPLICATION
' PROPERTY TYPE
�UILDING
RESIDE�"]C'IAL APPLICAT"I�DN
CI� OF FRIDLEY
YOTJ2Y �-MAII, ADDRESS
❑ OWNER
Permit No..
Received By:
ADDRESS: _ S�. �✓i -� v CITY STATE ZIP
PHONE:�� `° �j �%T ' �S � % — .
STATE LICENSE #
��
E??CP DATE
����
FAX %G3 3 ^ �
PERMIT TYPE 0�DITION L�7 GARAGE/SF
❑ BASEMENT FIIVISH � ROOF
❑ DECK � SIDING
� SWIIvIlVIING
iYPE OF WORK: � �R' � ADDTfION
0 MAINTENANCFJREPAIR ❑ REMODELIt
DESCRIBE WORK BEING DONE: � JrP r�p -� e I� ��o ���
SIZE OF INII'ROVEMENT �,�G�
� ❑ xou�� �.Y
NUMBER OF SQUARES ❑ HOU�S� & fi'rARAGE
GARAGES ❑ ATTt1��ID GARAGE
PROPOSED SIZE: ❑ DEi`.��D GAR?.GE
PROPOSID HEIGHT:
❑ DRA.II,T TILE
0 CYH'H�R
T3.ASEIv1ENT REMODELING SUBMIT•
I. Existing Floor Plan
2- Proposed floor plan
3. List of shuctival membeis to be used
Ft.
SIDWG FUR NEW CONSTRUCTION INCLUDING DECKS,
❑ V�Y� ❑SO� � A.DDTITONS. & PORCI�S SUBMIT•
❑��� ❑ T� 1. Site Plan/Survey showing the existing struchues
❑ Other O Fascia �d P�P�� P%lec�
WIlV�OWS 2. Two sets ofconstrvction plans
IN E7IISTII�TG OPENINGS OYes �No LOCATION d� �ktIDt1�OWS 3• ��SY �lculations
OR FOR NEW OPININGS-DESCRIBE SIZE OF
OPENING CHANGES 8c
TYPE OF WIIdDOW TO BE INSTALLED �R OF WAIDOWS
ALL FEES ARE BASED ON VALUATIO1Vi,.11'��i,UDING THE COST OF LAB�OR AND MATERIALS:
(USING THE 19�9�1' U.B.0 FEE SCHEDULE)
TOTALJOBVALUATIONS /!9. �S'l� �- nrrrrnsrrrv �rw�
Penmit Fee
Plan Review
Fire Surcharge
Surchazge
License Surchazge
SAC Charge
Curb G�t Escrow
Erosion Conlrol
Park Fee
Sewer 1tilain Charge
Total Due
$/' 15'. �� See Back Page for Fee Schedule
$ b5% of Building Permit Fee
$ /O� .001 times the total job valua.tioa
$ ,`i •�9 .0005 x Permit Valuation Minienum $.50
$ �, Ol�- $S.QO (State Licensed Residential Contractors)
$ $1550 per SAC Unit (Plans to Mi�dCC for determination)
$ ft+6ft= ftx$21=$
� $450 Conservation Plan Revi�ew
$ Fee Determined by Engineering
$ _ Agreement necessary ( ) Non 1"decessary ( )
$ /(�, /� Make checks payable to: C�t+v 4f Fridlev Affac
THIS IS AN APPLIC.A�il�d FOR A PERNIIT NOT VALID UNTII, �ROCE$SED
I hereby apply for a building permit and I acl�owl� that the information above is cnmplete and accurate; that the work will be in
conformance with the ordinances and codes of the Cit� i�E�ridley and with the Minnesota Conshvction Codes; that I understand this is not a
permit but only an application for a permit and work i� ac�t to start without a permit; that th�e ,work will be in accordauce with the approved
plan in the case of a11 work which r r'ew and a�-ae�vva.1 of plans.
SIGNATURE OF APPLICANT� �� PRIIVT NAME�� ��Z �fC'Y) DATE �'� C� °` ��
Building
Inspe�ti�n�
763-572-3604
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
Permit No.:
Received
'`��
�AT'E �1 �� �07 Y�UR E-MAIL ADDRESS � �'�v� c S � � �Lc� �n s n , [ _ 6 +^
�rrE ,ann�ss �jQ k- r: �k',,. � o�„r t
THIS APPLICANf IS: L�f OWNER OCOAITRACTOR
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERNIIT TYPE
TYPE OF WORK:
ADDRESS: !(2G�z -- � T,', �.'.. Coe„� � , CITY STATE ZIP
PHONE• 7� Z—�' 7 r— ef f� �
STATE LICENSE #
M�1:�i�7:11Ya
ADDRESS: CITY STATE ZIP
PHONE
L7F!SWGLE FAMILY/N!
❑ TWO FANID,Y/NEW
FAX
'9�BASENNIENNT FWISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDIIJG 0 OTHER
O SWIIvIIvIII�G PaOL
u
DESCRIBE WORK BEING DONE:
S1ZE OF IlvIPROVEMENT.
ROOFING
NUMBER OF SQUARE,S
GARAGES
PROPt)SED SIZE:
PROPOSED HEIGHT:
SIDIlVG
❑ V'myl
o wummwn '
❑ Otiter .
i���r.�. �, �
❑ HOUSE & GARAGE
❑ ATfACi�D GARAGE
❑ DEl'ACi�D GARAGE
�Soffit
❑ Trim
❑ Fascia
wwnows
IN E�QSTING OPENII�iGS OYes ONo L.C�ATTOld OF WIlJDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENIIdG CHANGES &
WIDTH HEIGHT
BASEIJIENT REMODELING SUBA9IT:
1. Existmg Floor Plan
2. Proposed fl�r plan
3. List of struchual members to be used
Ft,
FOR NEW CONSTRUCTfON 1NCLUDIIJG DECKS,
ADDI1'IOA1S. 8c PORCHFS SUBMIT:
l. Site Plan/5urvey showing the existing sUuc4ues
artd praposed project
2. Two sets of construction plans
3. Energy Caiciilations
' WINDOW TO BE INSTALLED MIMBER OF WINDOWS �
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $/,�()� .(�D OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
S�rcharge
License Surcharge
SAC Charge
Curb Cut Eserow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
� �'2�f L�
$ 3S-�D
$ � ,..�
$ �S
$
$
$
$ �
$
$
$ �l. 3s
See Back Page for Fee Schedule
65% of Building Permit Fee
A01 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1675 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary (
Make checks pavable to: Citv of Fridlev
THIS IS AN APPLICATIOId FOR A PERMTT-NOT VALID UNTIL PROCESSED
Attach
I hereby apply for a building permit and I ac�owledge 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 an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work which requir s review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME � w�� p, / DATE � a—t I��
Page 2- Bui.lda.n.g Residential Application
h . ,
.
BUII.DING PERNIIT FEE SCHEDULE
The Chief Buildang Official shall, before issuing permifs for the erection of any building or
siructure, or for any addition to any exi.sting building or structure, or for any alteration or repair
to any existing buildi.ng or structvre, upon applica.tion therefore, require the payment by the
applicant for such permit of fees to the amoun.t herei.n below set forth and in the manner herein
provided to-wit:
VERIFICATION OF FOUNDATION
Permits for canstructi�n will be issued a minimum of 24 hours from the time of applica.tion to
allow for proper review of proposed structure and of the construction site.
A Certificaxe of Survey of t�e lot, showing the location of the existing foundation will be
required before proceeding with the firaming. New Houses Onlv
City of Fridley
Build.ing Inspections Deparlment
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
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Buil'ding� -• BUILDING Permit No:: � I�- I
Inspections RESIDENTIAL APPLICATION xeceived sy:
763-572-3604 CITY OF FRIDLEY vate Rec'd: `e
763-502-4977 FAX EFFECTIVE 8-19-09
DATE � I ��/ c)�i YOURE-MAILADDRESS 1 w 5�"cthCl2.� � C�hl�(���z ��a�
SITE ADDRESS l%�o � f C v,` ��1 �.� ��-w't
THIS APPLICANT IS: L�OWNER ❑CONTRAC'fOR
PROPERTY OWNER/ NpME: )_; r. ��c�,kc I P. V
TENANT qDDRESS: �(0 3 Lv j�¢ i A � v 1\� CITY �v, d.l.t STATE �`^ZIP ��`73 `L
PHONE: (01 Z^ 9� 7� 7�? b L
CONTRACTOR NAIvtE: �,1, �
SUBMIT A COPY OF
YOUR STATE LICENSE STATE LICENSE # EXP DATE
AND CERTIFICATE OF ADDRESS: CITY STATE ZIP
INSURANCE pHONE FAX
PROPERTY TYPE 1�; SINGLE FAMILY/1VEW CONSTRUCTION SIZE
O TWO FANIILY/NEW CONSTRUCTION STORIES
PERMIT TYPE ❑ ADDITION � GARAGFISHED O WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING � OTHER �
❑ SWIMMING P�L
TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION
15� MAINTENANCF/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: -��ILI h4i O�u L.�os.t/� o�'� .�� R�� ( �. vn a wcrGf {a�. � 6eC o-u,,.`.
SIZE OF IMPROVEMENT /SFf LENGTH WIDTH HEIGHT S Ff
ROOk'ING ❑ HOUSE ONLY BASEMENT REMODEI.IIVG SUBMIT•
NUMBER OF SQUARES ❑ HOUSE & GARAGE 1, Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan
PROPOSED SIZE: O DETACHED GARAGE 3. List of structural members to be used
PROPOSED HEIGHT:
IDING FOR NEW CONSTRUC'I'ION INCLUDING DECKS,
� V��Y1 OSoffit ADD1TlONS_ & PORCHES SUBMIT•
O Aluminum 0 Trim 1• Site Plan/Survey showing the existing structures
❑ Other � Fascia and Proposed project.
2. Two sets of construction plans
WINDOWS 3. Energy Calculations
IN EXISTING OPENINGS OYes ❑No LOCATION OF WINDOWS FOR W[NDOWS — PROVIDE U-VALUE AND
OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE S1'ICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
r.LL rr.�,.� n�.r. nr.�r.,, v�� vA,..uA��v�v, ��v�LUliiN� inr; �u�i ur La�sux ANU MATERIALS:
S G THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ �D ��°� OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion'Control
Park Fee
Sewer Main Charge
Total Due
� �;� �� °'8 � See Back Page for Fee Schedule
$ ��S •��� 65% of Building Permit Fee
$ 0� .001 times the tota) job valuation
$ ,,�,�`.� .0005 x Permit Valuation Minimum $.50
$ $5.00 (State Licensed Residential Contractors)
$ $2000 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$22=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ �? �, �- Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATTON FOR A PERMIT-NOT VALID UNTIL PROCESSED
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 Cons�truction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of all work c r ' es review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME � J,,,_ ,�jUl/ DA-fE ( l�Cf S
E- `
Page 2- Building Residential Application - �
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 surchazge)
$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 fraction, 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 includin $50,000
$50,001 to $100,000 $643.75 for 1�` $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 forthe 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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