Loading...
PRE 2010 DOCSSUBJECT PE City of Fridley 1781 AT THE TOP OF THE TWINS BUILDING PERMIT _ r COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE 1 i � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 11/20/84 JOB ADDRESS 7580 Lakeside Road N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 15 1 Blomberg Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lloyd Mielke 9950 University Avenue N.W. , Coon Rapids, MN 55433 780-9270 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE ICENSENO. gO FOR 5 ENGINEER MAIL ADDRESR pERAT Si�l!!A� PHONE LICENSE NO. (( GGff�� `y AND j AND 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 361 x 44° Dwelling and a 24' x 26t Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side yards. Provide City with a copy of the verifying survey before capping. WATER LOCATION; 331 W of X,H.,.2111 N.W. of Hydrant SEWER LOCATION: Approx. 1W South. of WX Water Service. DRIVEWAY DEPRESSION ESCROW; 16' + 6' = 221 x $13.50.= 297.00 WARMING:; 03 CITY OF FM1V DON NOT GUARANTEE "r;F 1001,ytilititi 6CC1JPAC-V OF UTIUTY LOCATIONS AND ELEVATr�_., Before digging call IVIS BAIL. IS FOR INFORMATION PURPOSES OrAY .­ji) TELEPHONE - ELECTRIC - GAS Etc, 4"W ver TNt "obann110aiTHI REQUIRED BY LAW $M SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame 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 AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $71,000 $35.50 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- CONSTRUCTION. $335,50 $425.00 STRUCTION OR THE PERFORMANCE OF PLAN CHECK FEE TOTALFEE f $ 83.88 $879.88 SIGNATUR OFCONTRACTORO HORIZEDA( ATE) I WHEN PROdPERL ALIDATEYD THIS IS YOUR PERMIT BLDG WSP OAT SIGNATURE OF OWNER 0F OWNER BUILDER) (DATE) G0VVM0Cw 3 q G o,,j Muctpa NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] �R-1 AND R-2 IM ALTER. [ ] Building Permit Application Construction Addre Legal Description: Owner Name & Address: ko VC/ Tel. # Contractor: P Tel. # -92740 Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width C71 (c, Height / y Sq. Ft. DECK AREA: Length __ Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside LotO^[ ] Ft. Yd. Setback Side Yard Setback Type of Construction: W�� �, Estimated Cost: $ �,vue1 Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: A0 $ $ See Back Page for Explanation •-. c Tel. ` # D DATE: O � APPLICANT: CITY USE ONLY Permit Fee $ �3S',�) Fee Schedule on Reverse Side Plan Check $ 25$ of Building Permit Fee State Surcharge $ S!�.Sy $.50/$1,000 Valuation SAC Charge $ y.1 zo(j $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ e©y Agreement Necessary [ ] Not Necessary [ ] TOTAL $ O STIPULATIONS: QQ C/9 •(3(j Surveyors Certificate COMSTOCK & DAVIS, INC. Consulting Engineers and Land Surveyors C 1446CountyRoad J, Minneapolis, MN 55432, (612) 7849346 4rx/ef1r/J' �v/l�stT/O1% LOCATIom FoR. L1ojad MtelKe -9950 UNIVERSITY Ave. MW. Coon Rapidq, Mn. 33 S 890 OP 09" E -- /36.88' m ` ` I' Z6.0 In Q dr �9 I &'R' 0 .� 0 ~I..351!w 8 OO WO ,: •... O ' � '� floosL � • � � A Q y 0 Ai 8 89' c� DESCRIPTION Lot 15, Block 1, Blomberg Estates, City of Fridley, Anoka County, Minnesota. /fie un'04. lion Le ed Tie e wl /2//i118�/ SCALE: 1'r = 40 0 Denotes 1/2" diameter iron pipe monument set and capped No. 10832, in Ncvernber 1480 I hereby certify that this survey, plan or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. 10832 15 Wov.84 4739 9 Reg. No. Date Job No. Book No. SUBJECT ICity of Fridley F30379 AT THE TOP OF THE TWINS BUILDING PERMIT i RECEIPT NO. COMMUNITY DEVELOPMENT DIV. I ~ PROTECTIVE INSPECTION SEC. / 3� r 4J NUMBER REV. DATE PAGE OF APPROVED BY /"'1 CITY HALL FRIDLEY 55432 �'"" If ".j 612-571-3450 910-F15 5/21/90 JOB ADDRESS 7580 Lake.5 de N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 1 Blomberg Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lloyd Mielke 7580 Lakeside Road N.E. 780-9270 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. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW Ij ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 141, x 16" Three Season Porch over Existing Deck. 9 CHANGE OF USE FROM TO STIPULATIONS See notations- on plan. SEPARATE PM-MUTS FSE-WRED FOR WIRING, HES Filk,G, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $4,900 $2.45 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $72,00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $74.45 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG it DAT SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/90 ADEN R-1 AND R-2 A= � ] Building Permit Application Construction Address:�5 & % 4 /<,I—s % el E ad Legal Description: 4 O 7, lJ S I o mL L eef Li 7� 7t - s Wier Name & Address: �, C / ' % �� l k Tel. # 7J?D -%,�) 70 Contractor: 7``f-- 4 ► Tel. Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DF:SCRI CK OF Il It ROVEMENT IIMG AREA: length Width Height Sq. Ft. GARAGE AREA: length Width Height Sq. Ft. DECK AREA: length Width Hgt/Grwnd Sq. Ft. .. e� ��++ ° ivl �i OTHER:: _''i �--i Oi4� vS /)/ IF nrS P [9_ � ri le ,o !P �!� �C P ;fit' � � a /7aP �t Q 1, Corner lot [ ] ZIns de lot � � Ft. Yd Seettba�c`k Type of Construction: Approx. Completion Date: 14 Side Yard Setbacks Estimated Cost: $ � 4406 Proposed Driveway Width If New Opening Is Desired: Ft. $' $ Width + 6' See Ba Pae �7 DATE: S' /y 9'a APPLICANT• Tel. # /7,7® o�7C/ CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $600 per SAC Unit Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Aunt Necessary [ ] Not Necessary [ ] TOTAL STIPUTATIONS: �� • 3�5 CITY OF FRIDL EY INSPECTION DIV, Effective On January 1, . 6431 Unlversity Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AiR CONDITIONING SYSTEMS AND DEVICES . RATE JOB ADDRESS 7580 Lake Side Road SCHEDJJLE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shelf and Duct Work, Burner - rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 20.00 $ 20.00 representations stated in this application are true and correct. Dec. 17 ,1993 Gas Piping (Needed with new furnace) $10.00 $ OWNER Lloyd Mielke Gas Range $10,00 $ BUILDING USED AS Residence Gas Dryer $10.00 $ U ESTIMATED COST $1200.00 PERMIT NO. *Air Conditioning - AD Sizes $10.00 $ _ • DESCRIPTION OF FURNAQg 6N12 OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Amara 80+ Size No. GUI070 Commercial/Industrial BTU 70,000 HP 1/3 EDR 1% of Value of Appliance or Work $ Fuel Natural' Total Connected Load State Surcharge $ ,60 Burner Trade Name Size No. BTU HP EDR TOTAL FEE $C�. SZ� HEATING C ANY D.J.'s Heating & Air Conditioning MINIMUM FEE FOR ANY HEATING/COOL,IN_NENTILATION REFRIGERATION/AIR CONDITIONING PERMIT iS 115.00 Signed By o. 497-2661 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 Approved By (7, Rough -In Date Final Date"/ *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. FiLL OUT BACKSIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE R I CHIMNEY AND STACK VBRIFICATION The undersigned hereby verifies that the existing chimney or stack: .1. Has been carefully examined Yes *<'j No ( ) 2. Is free from rust or deterioration Yes ( No ( ) 3. Has no foreign objects lodged within Yes ( No ( ) 4. Is securely supported Yes) No ( ) S. Meets all current Code requirements for size -and total BTU's connected Yes { No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU' s Remarks HEATING COMPAN) Signed By Date CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Effective On January 1, 1997 -43 A0 RATE SCHEDULE JOB ADDRESS 7,66 AAW*_:It5r / The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side Vent — Fill Out Back)4 Gas Piping (Needed with new furnace) $10.00 $ 1997 �.� /- Gas Range $10.00 $ OWNER. BUILDING USED AS Gas Dryer $10.00 $ - ESTIMATED COST 76 � PERMIT NO. *Air Conditioning — All Sizes $ 25.00 $ /0' c DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs &Alterations (LIST ON BACK) `�� ��/£,�(� I% of Value of Appliance or Work $�_ No.. of Heating Units Circ One (Steam) (Hot Water) (Warm Air) 'f4 ��` Tra0e Name Commercial/Industrial Size No. BTW -4,6- HP EDR 1.25% of Value of Appliance or Work $ Fuel Total Connected Load. State Surcharge $ .50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE a HEATING COMPANY MINIMUM FEE FOR ANY HEATING/COOL ING/VEIN-TTLAT,, REFRIGE I CONDITIONING PERMvff—IS$25.00 > Signed By Tel No. PLUS T $.50 STATE SURCHARGE --- REINSPECTION FEE $42.00/Hr Approved B Rough—In Date Final Date-1---(:—� *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR -STACK VERIFICATION ON 1�,C written permission from adjoining property owner. REPLACEMENT FURNACE Remarks: . List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CHENINEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes O No ( ) 2. Is free from rust 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 total 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: . List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUM FITTING PERMIT 1 Effective On January 1, 1997 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Pictures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater —Electric $ 7.00 Water Heater — Gas** $10.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS Rte:)\1 The un specifiq and rul and- rel Owner :by makes application fora permit for the work herein do all work in strict accordance with the city codes (ding Division, and hereby declares that all the facts. fated in this application are true and correct. 9��.1998 Building Estimat aPERMIT NO. A �� PLUM BI ANY M.iFA 6�OflVDUSTAYA N.#114 SIGN WMN TEL N0._ ` 1.5% of Value of Fixture or Appliance AQ Approvi State Surcharge $ .50 34 MI NI Ml TOTAL FEE $ ®ad PLUS **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) Rough—In Date Final Date MINIMUM SIZE 9 SQ INCHES. a�C T' FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 May 14, 1997 Lloyd and Clementine Mielke 7580 Lakeside Road Fridley, MN 55432 RE: First Notice of Noncompliance of the Fridley City Code at 7580 Lakeside Road Dear Mr. and Mrs. Mielke: The City of Fridley has established a City Code for the purpose of promoting a pleasant and attractive suburban environment. A recent systematic code enforcement inspection of your neighborhood and property revealed that not all Code requirements are presently being met. The following item does not comply with the City Code: Fridley City Code requires that all solid waste must be kept in secured 32 -gallon containers with tight -fitting lids stored in the side yard (screened from view), rear yard, or garage, except on the day of collection when the containers may be placed up to 3 feet from the front of the garage. A recent inspection revealed two visible refuse containers. We understand that you may have been unaware of these requirements. Your prompt attention in correcting this situation will greatly assist us in helping make Fridley a better place to live. An inspection will be conducted on or shortly after May 28, 1997. Please have your property in compliance at that time. If you have questions about the systematic code enforcement process or would like to discuss your particular situation, please call me at 572-3595. Thank you for your cooperation! Sincerely, CITY OF- F I DLEY Ku Je -Schneider Code Enforcement Officer KJS:ls CE -97-189 SUBJECT City of Fridley (r.2" 8 406 664 THE TWINS r ? BUILDING PERMIT 572 RECEIPT NO. ►v COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY l 612-571-3450 910-F15 10/26/98 JOB ADDRESS 7580 Lakeside Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 1 IBlombergEstates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lloyd MIelke 780-9270 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION O ALTERATION REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof house and garage 34 SO Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 WORK OR CONSTRUCTION ZONING SO. 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 AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 2913 $1.46 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $74.75 FireAc $2.91 PLAN CHECK FEE TOTA F E .12 NAtupE qF CO 'aAC10ROR AU ORRED AGENT iDA7E� ACI7 %01, EN RO A IOAT HIS IU MIT Az BLO NSP BATE SIGN SURE OF OWNER, OWNER BU4 DEiii iOATEi NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: /p[� / � Tel. # 7?e — 1�270 Contractor: ® JZ- MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: RP 9QD 0 i �esceS- —/— 0,a-, o, 3�i3O S Construction Type: Driveway Curb Cut Width Needed: Sq. Ft. Sq. Ft. Sq. Ft. Estimated Cost: $ .?!913 (Fee Schedule on Back) Ft. + 6 Ft = Ft x $ _ $ DATE • �� — APPLICANT: Tel. # CITY USE ONLY Permit Fee $ Fire Surcharge $ 9! State Surcharge $ SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $� ,LL STIPULATIONS: Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] Building $ BUILDING See Back Page for Fee Schedule Permit No ' r.11V Inspections RESIDENTIAL APPLICATION Fire Surcharge Received By: 763-571-3604 .001 times the total job valuation CITY OF FRIDLEY $ Date Rec'd- DATE '� 6 YOUR E-MAIL ADDRESS 17 SITE ADDRESS $5.00 (State Licensed Residential Contractors) SAC Charge THIS APPLICANT IS: -'OWNER ❑CONTRACTOR $1550 per SAC Unit (Plans to MWCC for determination) PROPERTY OWNER/ NAME: (8 le-49:1 AZ A,' e-- 4i' P Lk e-- ADDRESS: -%56 T (14 CITYSTATji�ei WP & TENANT PHONE: 76 3- Igo— Q a 7 0 Park Fee CONTRACTOR NAME: D W Ale- le— Fee Determined by Engineering STATE LICENSE # EXP DATE $ SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE SINGLE FAMILYNEW CONSTRUCTION SIZE TWO FAMILYNEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ,iq ROOF Cl DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES 15(HOUSE & GARAGE BASEMENT REMODELING SUBMIT: —4 GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ 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 ❑Yes ONo LOCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER 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 $ OCCUPANCY TYPE Permit Fee $ c 7 -.2 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 3. / .001 times the total job valuation Surcharge $ ( _ &0 .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ /o P.6 V Make checks pa able to: City of Fridley Attach Stipulations 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 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,wwhich requires review and approval of plans. y� / SIGNATURE OF APPLICANT ([i PRINT NAME �� Q e � Pe, � 19ATE co — �� "� FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 BUILDING PERMIT APPLICANT: PROPERTY OWNER I, C /ex/ P-- iii /� e- / /cam, , understand that the State of Minnesota requires that all residential building contractors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. As the owner of the property at 75-9-0 ,C kAn- s . d' -e- X CL , Fridley, am exempt from the state licensing requirement only if I am not building or improving this property for purposes of resale. By signing this document, I attest to the fact that I am improving this house for my own use and do not intend to sell it. I hereby claim to be exempt from the state licensing requirements because I am not in the business of building or remodeling on speculation or for resale and that the house for which I am applying for this permit, isl the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license, I forfeit any mechanic's lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. Furthermore, I acknowledge that I may be hiring independent contractors to perform certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minnesota law, and that I would forfeit my rights to reimbursement from the Contractor's Recovery Fund in the event that any contractors I hire are unlicensed. I have also been informed and acknowledge that by listing myself as the contractor for this project, I alone will be responsible to the City of Fridley for compliance with all applicable building codes and city ordinances in connection with the work being performed on this property. Date � " — 6 K, Warranty Deed. Form No..3—M.Milicr-Davis Co., Minneapolis Individual td Corporation. Minnesota Uniform Conveyancing Blanks (Revised 1976) kA�jt� �rtbeture .Made this .............. .15th ....................day of ...................�une.................................., 19 81.. ►, . , between ...... xh.Q.ma.S... E.....B.14mkz.vrg..fid...Kax. a...A.....]omtteig...... hmsband... an,d-mi.fe.a...G.ar.y..1?!Aig.l.e.......... single and Anthony Stulc, single F ofthe County of ....................... AT#gko............. _..... ............... _............ and State of ........................ xinne.sata.......................................... part-I.C.s.. of the first part, and .....C,kty... of ... Fridley .............................................................................................................................. .............................................................................................................................................................................................................................................., iso a corporation under the laws of the State of .......................M...........nne............ta......................................, party of the second part, WftntgOd j, That the said part ..... ies of the First part in consideration of the sum of ONE DOLLAR AND OTHER VALUABLE CONSIDERATIONS***********;k*******************13 ............................................................................................................................................................................................................................... . to.............them...................................In hand paid by the said party of the second part, the receipt whereof is hereby acknowledged, do............ hereby Grant, Bargain, Sell, and Convey unto the said party of the second part, its successors and assigns, Forever, all the tract..... or parcel...... of land lying and being in the County of ............. An.o.k................................................. a ........and State of Minnesota, described as follows, to -wit: .. Lot 15, Block 1, Blomberg Estates Subject to restrictions, reservations and easements of record, if any. �,PIPc�NS' UIPa�rTy,. — .52No�l� To Jbabe anb to Oolb ttje *amt, Together with all the hereditaments and appurtenances thereunto belonging, or in anywise appertaining, to the said party of the second part, its successors and assigns, Forever. ,find the said .....Th.ama.s... E.......lombe g...aand...Karla...A......Al.Q.mbe.rg,...b.u.sband...aud..Wife, Gary ...A.:.Aigl.e.......s.i.n.gl.e... and ... An.tbony....S.tulc...... single ................................................................................................................... part ..... i.e.sof the first part, for ..... .thems.e.lues.-their................... heirs, executors and administrators, do............ covenant -with the said party of the second part, its successors and assigns, that ....the..y...are......................well seized in fee of the lands and premises aforesaid, and. ha.. Ve... good right to sell and convey the same in manner and form aforesaid., and that the same are free from all incumbrances, .qnd the above bargained and granted lands and premises, in, the quiet and peaceable possession of the said party of the second part, its successors and assigns, against all persons lan-fully claiming or to claim the whole or any part thereof, subject to incumbrances, if any, hereinbefore mentioned, the said part............ of the first part will IYarrant and Defend. In TeIt{monp Wbereof, The said part...ie.s. of the first part have...... hereunto set..... their .......... hands.... the day and year first above written. Otate of Atnneoota, Countyof ....r ................................................. ! i The foregoing ittstrtttttent it -as ackttote•Iedged before the j 1 this ... l..S.n day of.... .K .................................................. 19...V........ Thomas E. Blomberg and Karla A. Blomberg, husband and wife, Gary D'Aigle, single and by.. Anthony-.Stu1c.,....s.ing.le........... rmaim (NA,%Tfi OF PERSON ACKNOWLEDGED) NOTARY P' PLIC — t: iN":E:CTA ANC.KA COUP v 1; 21 ( ... ............................._ ........ �y camr-INexpire* Jan. 2, ;21 (SIGNATUR PERSON TAKING ACKNOWLEDGMENT) ............................................................................................................................. THIS INSTRUMENT WAS DRAFTED BY (TITLE OR RANK) ! Ewing's Closing Service j ....................................... 13084 Goodhue St. N.E. (Name) Blaine, Mn. 55434 (Address) � I t ` L I 3 Go : o pt "y 0 't1 W O •� N C� i O w : �' �' � ca 4.11 zt V O °'� Obi n ��. •.�.: z:, e ;k r O• °� �` ci .� L' nay 0 � 'O ,� O ZJ .. .� ti •u J t ❑ O a R Q� o�