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PRE 2010 DOCSCity of Fridley, Minn. BLTHDING PERMIT N® 7304 kitlhaner: A-4--aal Builder Address Address LOQA ON F BUILDING No. U2? Street if VPart srLot Lot _ _ __ Block Addition or Sub -Division . _-. e_ v o Corner Lot , Inside Lot _� Setback , _ Side -yard Sewer Elevation 3, V 2- Elevation 5 �— j`u DESCRIPTION OF BUILDING TA Used C Front Depth Height Sq. Ft. Cu. F Front Depth Height —� Sq. Ft. Cu. Ft. Type of Constructs Est. o be Completed In consideration of the issuance to me of a permit to construct the building described above, agree to do the proposed work in accordance with the description above set forth and with provisions o ordinances of the city of Fridley. /,jam „ � w7 J U In consideration of the payment of a fee of $ , permit Is hereby granted to— to construct the building or addition as described above. This permit Is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, In all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regdtgg location, construction, alteration, maintenance, repair and moving of buildings within thhee city limits and this permit may be revoked at any time upon violatiem of any of the provisions of said ordinan Building Inspector NOTICE: ihb permit does not cover the construction, hutaffiMan for wiring, plumbing, gas hating, sewer or water. Be sure to see tW Building Inspector for separate permits for these Items. .. A Land Plan C875 �hmyOQf AtE. Land So 74vina... mimirfilz `ENG INEE ING-'.`�NC. Mif"501.9 Enyineers.. Sur veyor� 'T C461 cate of e .41— 1.) J - 4361411, zlef 7 77 '77.77 p -79.97 I 7/7 SOP /A z- sot I /-!, e - / -I- / /Y, A "Coe' / ;:e I /herel Cerhrly* ftt *6 /S a true ard awnd repremrWOin ore swmey elk Awmdvr4s ff lk dvov dw. vkd 107d and Opme /won '07h, d" P A.D SUBURBAN ENGINEERING , INC. Sur'reyors APPLICATION FOR BUILDING PErITET CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING p � n No. Street_ �edddz-�� Fart of Lot Loa�`5 'Block Addition or Subdivision f,,te e Corner Lot Inside Lot_ _Setback Side -Yard ff,gt;& f a SEWER ELEVATION FOUNDATION ELEVATION i V'a- —` Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: Front d Dapth Height Sq. Ft. /0 it ® Cu. Ft. Type of Construction To be Completed Front Depth Height, Sq. Ft. Cu. Ft. Estimated Cost % �o �d 1,765-- The 965 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE SIGMV=. c (Schedule of Fee Casts can be found on the Reverse Side). f i 1 M16,110 LOCATION OF BUILDING p � n No. Street_ �edddz-�� Fart of Lot Loa�`5 'Block Addition or Subdivision f,,te e Corner Lot Inside Lot_ _Setback Side -Yard ff,gt;& f a SEWER ELEVATION FOUNDATION ELEVATION i V'a- —` Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: Front d Dapth Height Sq. Ft. /0 it ® Cu. Ft. Type of Construction To be Completed Front Depth Height, Sq. Ft. Cu. Ft. Estimated Cost % �o �d 1,765-- The 965 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE SIGMV=. c (Schedule of Fee Casts can be found on the Reverse Side). f A BUILDING PEW= FEE SCHEDULE Section 2. The Inspector"of Buildings shall, before issuing any permit for the erection of any building or structure, or for any addition to any exist- ing building or structure, or for any alterations or repairs to any existing building or structure, upon application therefor, 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; 2.1. For any such permit for the erection of any fire -proof building, other than a garages warehouse, factory or grain elevator, or for the erection of any fire -proof addition, for similar occupancy, to any existing building shall be at the rate of $1.40 .for each one thousand cubic feet, or fraction thereof, in such cubical contents. 2.2. For any such permit for the erection of any fire -proof garage, warehouse,_ factory or grain elevator, or for the erection of any fire -proof addition,. for similar occupancy, to any existing building shall be at the rate of $1.25 for each one thousand cubic feet, classified as "fireproof" by Section 502 of the Minneapolis Building Code. HOUSES 2.3. For any such permit for the erection of any non -fireproof building other than a garage, warehouse, factory or grain elevatoi, or any non -fireproof addition, for similar occupancy, to any existing building - permit $1.00 for each one thousand cubic feet. GARAGES 2.4. For any such permit for the erect:in-: or any non-fire�,reof garage, warehouse, factory or grain elevator, ri {c : vAe:es:tio:a of any non-firaproof addition, for -similar occupancy, to oz:t:,t-ing lyes dIA. ng or for each such . _ ....- builAing or addition - ninety cenu <, ¢,; Znr e«xa one thousand cubic feet or fraction thereof, in the cubLe 1. cont rz thereof with a minimum of $4.00 -.- For the purpose of computing fees for butting permits, the cubical contents of.any.building or addition to a uniform he•L3;lt throughout by multiplying the ground area covered from a point six (6) inches below the floor line of„ihe basement or cellar to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. 2.5. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each Five Hundred.Dollaxs ($5.00.00) or fraction thereof in the cost of all proposed work. 2.6. In no case shall the fee..charged.for.any permit a$ set forth in Section 2 be less. than $4.00. City of Fridley, Mian.. N° 8385 BUILDING PERMIT Date: AUGUST 19, 1965 Owner: CLARENCE E. WITTMER Builder SUSSEL COMPANY Address 7629 Lakeside Road N.E. Address 1850 Como Avenue Fridley 32, Minnesota St. Paul, Minnesota LOCATION OF BUILDING No. 7� 629 Street LAKESIDE ROAD W.E.- Part of Lot Lot _ Block Addition or Sub -Division Corner Lot _ Inside Lot Setback Sideyard Sewer Elevation Foundation Elevation To be Used as: D. Garage Front Front Type of Construction DESCRIPTION OF BUILDING 22 Depth 26 Height 10 Sq. Ft, 5 7 2 Cu. Ft. 5,720 Depth Freight Sq. Ft. Cu. Ft. Est, Cost _$1,630.00 To be Completed The South 85 feet of Lot 19, Block 1, Spring Lake Park Lakeside Addition In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above set forth and in compliance with adl provisions of cndiaanoea of the city of Fridley. , In consideration of the payment of a fee of $-6 00 , permit is hereby granted to SUSSEL COMPANY to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work. done in, around and upon said building, or any part thereof; shall conform in all respects to the ordinances of Fridley, BRinnesotag location, construction, alteration, maintenance, repair and moving of buildings within the city limits avis permit may be revoked at any time upon violation of any of the provisions of said ordinances. ALLEN G._JENSEN Building Inspector NOTICE 1hh permit don mot oerer the condrudloe, hreaihdien for Wh%& plumbing, on heetfmg, awer or water. Be are to as the Building Mgmfte for apwM ponnifa for these Dame. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME C A i e " Ce BUILDER 5;,_TSe / Co ADDRESS A� 01 4 pec� ADDRESS_ Ca o /fie LOCATION OF BUILDING =N� Street Part of Lot LOT R ADDITION OR SUBDIVISION Corner Lot Inside LOT. Setback Side -Yard .SEATER ELEVATION FOUNDATION ELEVATION. Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as; 4 4d Hd,aQ Front — Depth .4 G Height / U Sq. Ft. '-,/ oZ-- Cu. Ft. % r% --f) Front Dept Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost /� 30 E� To be completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. (Schedule of Fee Costs can be found on the Reverse -Side). COF 1..1t )G- c -a,&- LOT NAME SIZE "co /i 1. L&2F—QG 7-7-,xZ& BLOCK ADDRESS VALUE AOD'N. AREA TYPE M 21p ��....++ t -2d -ME ALAI A> LOWE I Q qSC ut�,mE� Uj%TH Nouse ®'�i�EGte.ir �EA.YC '��xSI �PEiJ�1.JC� Acl3 A's 1-0 Mr oc.e ► i.1 Nu 0 x26.6© Jt -A.13 10 Mr 1 N� es F+ L.U,j C),j IT 42 T "co 77 w 0 •a— M 21 ' 1a P 2 o " �E4 B c� 1�'rs !o USE < Kilo .� lot, 0i vi AMERICAN COUNCIL OF VOLUNTARY AGENCIES FOR FOREIGN SERVICE. INC. 200 PARK AVENUE SOUTH - NEW YORK., N.Y. 10003 T-45417 LOEI DATE: MAY 12� 1980 FILE ID # PLACE LOCATION: THE FOLLOWING PERSONS: NAME A NUMBER DATE OF BIRTH . SEX PLACE OF BIRTH 1. HANG LUE A25-036-413 SEP 5. 1957 M XIENGKHOUANGP LAOS h 2, VANG YER - A25-06--414 SEP 5. 1962 F 7. 8. 9. 10. 11. 12. 13. 14. 15. HAVE BEEN ACCEPTED -FOR RESETTLEMENT UNDER THE AUSPICES OF: - ;� ¢i VOLUNTARY AGENCY PRINCIPAL °SPONSOR LOCAL SPONSORS ftv b'2 LUTHERAN IMMIGRATION & REFUGEE SERVICE MR. & MRS. JAMES STANTO 360 PARK AVENUE SOUTH 7629 LAKESIDE RD. NE. NEW YORK.-N.Y. 10010 FRIDLEY, MN 55432 TEL: (212) 532-6350 ? TEL: (612) 784-7805 CH. 225-71.97 PARK BAPTIST P/. AIRPORT OF FINAL DESTINATION: MINNEAPOLIS MN SPECIAL INSTRUCTIONS: THIS AGENCY AGREES TO ASSIST THE PRINCIPAL REFUGEE NAMED ABOVE TO OBTAIN EMPLOYMENT AND HOUSING FOR HIM/HERSELF AND FAMILY IF ANY USPHS 1 ' QUARANTINE STATION SIGNATURE AUTHORIZED VOLAG REPRtSI_I ' ACVAFS FORM #1 MAY 2 81980 Ammavu DATE SEATTLE, WA. 3. 4. 5. 6. ' 7. 8. 9. 10. 11. 12. 13. 14. 15. HAVE BEEN ACCEPTED -FOR RESETTLEMENT UNDER THE AUSPICES OF: - ;� ¢i VOLUNTARY AGENCY PRINCIPAL °SPONSOR LOCAL SPONSORS ftv b'2 LUTHERAN IMMIGRATION & REFUGEE SERVICE MR. & MRS. JAMES STANTO 360 PARK AVENUE SOUTH 7629 LAKESIDE RD. NE. NEW YORK.-N.Y. 10010 FRIDLEY, MN 55432 TEL: (212) 532-6350 ? TEL: (612) 784-7805 CH. 225-71.97 PARK BAPTIST P/. AIRPORT OF FINAL DESTINATION: MINNEAPOLIS MN SPECIAL INSTRUCTIONS: THIS AGENCY AGREES TO ASSIST THE PRINCIPAL REFUGEE NAMED ABOVE TO OBTAIN EMPLOYMENT AND HOUSING FOR HIM/HERSELF AND FAMILY IF ANY USPHS 1 ' QUARANTINE STATION SIGNATURE AUTHORIZED VOLAG REPRtSI_I ' ACVAFS FORM #1 MAY 2 81980 Ammavu DATE SEATTLE, WA. 214-1 C I T'r' Ef-AVI R1iNMEN7RL OFFICER :ER FRI DLEY. file! 5,5432- 2 8 wy 1994 L.- Dear Health Officer: Enclosed is a copy of the American Council of Voluntary Agencies for Foreign Service, Inc., (ACVA Form #1) issued to this Indochinese refugee(s) (individual or family) who plans to resettle in your area. multiple names on the ACVA Form #1 represent members of a family unit. Prior to the issuance of a visa for entry into the United States, this refugee(s) was medically examined in Southeast Asia for excludable communicable disease conditions (leprosy, tuberculosis and five venereal diseases). The refugee(s) has been instructed to contact your office. Each refugee has been given his/her chest x-ray film and a copy of the visa medical examination report (OF -157) completed overseas. If the refugee does not contact you, you may wish to initiate contact for a health assessment. The local sponsor listed on the ACVA Form #1 may be able to give you additional information concerning.the refugee. This information is furnished for whatever follow-up action you deem necessary. Enclosure(s): ACVA Form #1 cc: State Epidemiologist Sincerely yours, JACK K. K X Officer -in -Charge U.S. Quarantine Station S-212 Seattle -Tacoma Airport Seattle, WA 98158 SUBJECT P City of Fridley �, 7 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. i �• __ CDEVELOPMENT DIV. fr r PROTECTIVE INSPECTION SEC. t ®� NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 �"'-�' •'� 612-571-3450 910-FlS 3/15/96 JOB ADDRESS 7629 Lakeside Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 19 1 1 Spring Lake SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Krack 7629 Lakeside Road NR 7R6- 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 ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Basement remodel 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 1 HAVE READ AND EXAMINED THIS APPLICATION 1 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 $2,400 @ $1.20 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- $74.75 Fire SIC $2.40 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $78.35 StiT REOF C0NTRAC OR OR U H0RI ED AGENT (DATEi � WHEN PROPER AALLIDATED THIS IS YOUR PERMIT fie- � � 40"dWATURE s CJ✓L �/�� OF OWNER OF OWNER BUILDER) ATEi 4BLD )NSP DATE NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: 7 (p 2 � Ldk4s C dp_ Legal Description: Owner Name & Address: !qi h aL t Tel. # Contractor: .�- 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 EUPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Q �CAM 4P.V� -- R2 ma Jy_ Driveway Escrow Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Erosion Control Type of Construction: $450.00 Conservation Plan Review Estimated Cost: $ — 2 -fop Approx. Completion Date: Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL (Cost on Back) Driveway Curb Cut Width Needed: t. + 6 Ft = Ft x $ _ $ DATE: 2 16 _ APPLICANT: Tel. # %,S fo S5 %(o k+) (0 3s---���g Cw) CITY USE ONLY Permit Fee t. $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ /,20 $.50/$1,000 Valuation SAC Charge $ $900 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: %, , f ur rraULtY INSPECTION DIVISION _ 6431 University Ave NE®( Fridley, MN .55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, „763.572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $ 36.60 $ 10.00 $ $ 10.00 $ $ 10.00 $- $25.00 $25.00 $ State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ 50 $ SCJ _1013 ADDRESS U- a 9 4 OWNEkSdV f') 4 Effective On. January 1, 2001 V -Q -�Ro BUILDING USED AS I(3jE&� �O ESTIMATED COST 7D�, PERMIT NO. 15 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) ( arm Air Trade Name TV-0.nC Size No. BTU- 90, 0©O HP EDR Fuel _N� 6 S -, Total Connected Load - Burner Trade Name Size No. BTU HP EDR The undersigned hereby makes application for a permit for the work herein specified agreeing to do all 'work in strict accordance with the City Codes an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE D2 HEATING CO Sign y Y ` TEL 6 Approved By Rough -In Date Final Date BACK SIDE MUST BE FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION AIR VERIFICATION -41 COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes � No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes fo No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes(* No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes (,C) No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes (�) No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes (k) No ( ) Appliance Type and Sizb/Common Vent and Vent Connector Information Appliance #1 Type �/�'�-- BTU Input f*" Fan Assisted or Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height _ ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: on ('/,®"'U Signed By: Date PERMIT# J 2 J ADDRESS 7099 OCCUPANT qza,4e�m HEATING ���(4-Ca Yie- -1� cLc- HEAT LOSS �j��� DATE HTG. INST. TEST RECORD CITx- �- OWNER O C C - INSTALLED BY ELECTRICAL WORK BY TYPE OF BEAT GA _ FA HW _ STEAM SPACE HTR. UNIT HTR. OTHER �- GAS DESIGN MAKE / Vr AP1� MODEL ( 0 VS (-g3La ENI&I .)amI0=1:7 CONTROLS SIZE NONE FELTERS SIZE , to S NUMBER / PRESSURE 3 ,-�- PERCENT CO2 INPUT CFH PERCENT 02 C %o INPUT o, 07, SERIAL INPUT(BTU) Building $ BUILDING Permit No.A —0 % g s� � [nspections $ RESIDENTIAL APPLICATION Received By: 1:>g $ �-1 .001 times the total job valuation Surcharge 763-572-3604 CITY OF FRIDLEY Date Rec'd: tbkvM 763-5024977 FAX GOO $5.00 (State Licensed Residential Contractors) SAC Charge $ EFFECTIVE 1-1-08 $1825 per SAC Unit (Plans to MWCC for determination) DAA A RE Ir ADDRESS SITE ADDRESS Erosion Control $ $450 Conservation Plan Review Park Fee THIS APPLICANTIST ❑ OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME:C G $ ADDRESS:lu iTYd GC 0 W —STATEWO ZIP ✓L TENANT $ PHONE: 3l Make checks payable to: City of Fridley Attach Stipulations NAME: NZIP 363 3-33i�- CONTRACTOR ADDRESS: t' CITY _ STA SUBNGT A COPY OF PHONE— FAX YOUR STATE LICENSE - STATE LICENSE # 01 EXP DATE PROPERTY TYPE MINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHEDWINDOWS ❑ BASEMENT FINISH E3 ROOF ❑DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:Eq(&L-le aY mo SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SO FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used. PROPOSED HEIGHT: • FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS & PORCHES SUBMIT: ❑ Vinyl ❑Soffit I . Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS Uees ONO LOCATION OF WINDOWS OR FOR NEW OPENINGS- CRIBS 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: // ING 997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ L!� OCCUPANCY TYPE Permit Fee $ ( q( , 0 6 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ �-1 .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ GOO $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 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 $ 1 ' —] Make checks payable to: City of Fridley Attach Stipulations I hereby apply for a building permit and I of the City of Fridley and with the Minni permit on site; that the work will be in cc SIGNATURE OF APPLICA _ APPROVED BY THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED the info io bove is complete and accurate; that the work will be in conformance with the ordinances and codes that nderstand this is not a permit but only an application for a permit and work is not to start without a " i e case of all work which requi%s.=iew and approv f ans. PRINT NAME DATE 4 DATE Building $ Permit Fee BUILDING See Back Page for Fee Schedule Permit No. . :'.20qA0163 Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Receiv Bg, mnq 763-572-3604 Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) CITY OF FRIDLEY $ Datd:. 763-502-4977 FAX $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review EFFECTIVE 8-19-09 $ Fee Determined by Engineering DATE YOUR E-MAIL ADDRESS kr& G rb-.,Q - r co SITE ADDRESS _7(a 2 /p P,s 1 d if zed, N& , 'Fr�d Ill., 1??N r-.1ry— 43 �-- THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: 0 Jl 1 TENANT ADDRESS: 'e- dU C—CITY STATE ZIP S�`�i 3 �i PHONE: Ip — 6 -- 5-8 i 6 CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ADDITION 11GARAGE/SHED ❑ WINDOWS BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ADDITION ❑ MAINTENANCEIREPAIR REMODELING DESCRIBE WORK BEING DONE: g� SIZE OF IMPROVEMENT y LENGTH L 3 , WIDTH Z D HEIGHT LFld I IS SQ FT ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: PROPOSED HEIGHT: ❑ DETACHED GARAGE 3. List of structural members to be used --II Z& GO (O ' FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING (0 15 ADDITIONS. & PORCHES SUBMIT: F6Viny1 1I1soffit 13 Aluminum 13 Trim COW 1515 C 1 • Site Plan/Survey showing the existing structures and proposed project. 13 Other Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS []Yes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB VALUATION $ Iu, G )997 U.B.0 FEE SCHEDULE) OCCUPANCY TYPE Permit Fee $ h M IQ See Back Page for Fee Schedule Plan Review $ 14 / /, )3 65% of Building Permit Fee Fire Surcharge $ -6 I'(, .00T times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 1 I ,— Make checks savable to: Citv of Fridlev 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 applicatio o 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 rk tlik e yeview and approval of 1�6 $. / �� �^ SIGNATURE OF APPLICANT PRINT NAME h In L DATES 13' 26' 35' w, vj& W -"l -w x 20'D = 400 sq ft or 18' 9" pOeket door � eves Foundation 26' x 4()' -1040 sq ft 40' 29' 5" 1 25" ,Mti1ever 95'%100' t lot line Edges of page rept 2191 A ft =104�0+5�+96+23 = Lot coverage % = 25.7, 35 allowed Lot Coverage c,,' uie. 0.1 Ind►=1 foot Gate572 sq 22'x26' _ � r r r r r r r r r r r r r r r_'rrrrrr r r r r 1JOt Ljne 15' to street Driveway 8500 sq ft qs kJ Lot size = It CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE Effective On August 1, 1995 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 70-? 4 peg e j. ej . Residential Furnace Shell and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Neode wp new furs ce)� Gas Range Gas Dryer *Air Conditioning — All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work Commercial/industrial 1.25% of Value of Appliance or Work The undersigned hereby makes application for a permit for the work herein Rate . TOTAL specified agreeing to do all work In strict accordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and $ 30.00. $ representations stated in this application are true an .correct 1� $10.00. $ o , Ob [ / / - _ OWNER �l u M� L ° �` iit C G� 7 r 6 ' S 76 $10.00•... $ BUILDING USED AS $10.00 • $ /o. G ESTIMATED COST PERMIT NO. r $ 25.00 $ State Surcharge ' TOTAL FEE PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. .50 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade -Name Size No. BTU HP EOR Fuel, Total Connected Load Burner:Trade Name Size No. BTU- HP EDR HEATING CO PANY 30) Signed B Ta Tel No. B 6 5 '7i6 Approved By Rough—In Date Final Date FILLOUT BACK SID OR STACK VERIFICATION ON REPLACEMENT FURNACE Remarks: List ALTERATIONS B ft Done: HEATING CO: Signed By: Date: CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () 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 bther 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 B ft Done: HEATING CO: Signed By: Date: xts�T wLrtire�;71. • FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287 May 14, 1997 John Krack and C. J. Moore 7629 Lakeside Road Fridley, MN 55432 RE: First Notice of Noncompliance of the Fridley City Code at 7629 Lakeside Road Dear Property Owners: 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 exterior storage requirements state that nothing shall be stored in the front yard. All materials shall be kept in a building so as not to be visible from any public right-of-way, except for stacked firewood, boats, and trailers placed in the side yard. A recent inspection revealed a pile of stacked pavers along the side of the garage. We understand that you may have been unaware of this requirement. 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, IDLEY 2,14se Schneid"er Code Enfor ement Officer KJS:Is CE -97-165 7629 Lakeside Rd. Fridley, MN 55432 786-5876 10 June, 1997 City of Fridley Building Inspection Dept. Fridley Municipal Center 6431 University Ave. NE Fridley, MN 55432 To Whom it May Concern: This is a request for a second three-month extension, until September 15, 1997, on Building Permit number 24007, a basement remodeling project at 7629 Lakeside Rd. All rough -in inspections are complete; the drywall is installed, taped, and painted; the fireplace is installed, inspected, and enclosed; and the ceiling grid is partially installed. I have yet to finish the ceiling grid installation, the lighting installation, and the wiring. I have every expectation that the project will be ready for final inspection by September 15. You can reach me at 635-6579 during business hours with any questions. Thank you. Yr ally, Jo L. Krac J 7629 Lakeside Rd. Fridley, MN 55432 786-5876 14 March, 1997 City of Fridley Building Inspection Dept. Fridley Municipal Center 6431 University Ave. NE Fridley, MN 55432 To Whom it May Concern: This is a request for a three-month extension, until June 15, 1997, on Building Permit number 24007, a basement remodeling project at 7629 Lakeside Rd. All rough -in inspections are complete, the drywall is installed and partially taped, and the fireplace is installed and inspected. have yet to finish the drywall taping, the fireplace enclosure, the lighting installation and wiring, and the ceiling. You can reach me at 635-6579 during business hours with any questions. Thank you. C' lly, Jphn L. Krac " SUBJECT P City of Fridley 28263 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. ((� ^�� r PROTECTIVE INSPECTION SEC � i i CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY _•--�"'1'� 1 ' 612-571-3450 910-F15 10/15/98 JOB ADDRESS 7629 Lakeside Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 19 1 1 Spring Lake Park Lakeside SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Krack 86-5876 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Ideal Roofing 1680 McAndrews Rd. Burnsville 55337 435-3061 20147392 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK O NEW Q ADDITION 0 ALTERATION Rk REPAIR 0 MOVE : 0 REMOVE 8 DESCRIBE WORK Reroof house and garage (28 Sq) Tear -off 9 CHANGE OF USE FROM 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 SQ. FT CU FT 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 OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ISTALLS 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 2399 $1.20 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- STRUCT ON OR T E PERFORMANCE OF CONSTRUCTION $74.75 FireAc $2.40 PLAN CHECK FEE E 1 SI NATURED CON• A TOROpAUTHORIZEDAGENT IOATEI N ROj&V&JDHIS IS YOUR PERMIT 8L0 INSP DATE SIGNATURE OF OWNERoF OWNER BUILDERI ,DATE' NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FA MY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 7 �C2 ! Legal Description: Effective 1/1/98 Owner Name & Address:%( r� Tel. # 7S6 — 5�7� Contractor: & ( MN LICENSE # �,� 7--2 Address: IL�6 A —"A &ol re NIP Tel. # _ y3��-36&/ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: /L'I'a P '4ddf- "Ye /-1&'V'e1- _V Construction Type: re) Estimated Cost: $ 239 � (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: S APPLICANT: -Dere f< j e1 Tel. # ��� 6®%� . STIPULATIONS: CITY USE ONLY Permit Fee $ 71 S Fee Schedule on Reverse Side Fire Surcharge $ J_ .001 of Permit Valuation (1/10th%) State Surcharge $ Z.2 O $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge _ $ .00 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary ( ] q 3.3,r TOTAL $ . STIPULATIONS: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 N'AX: (763) 571-1287 PERMIT, N! 2004-01546 4 DATE ISSUED: 09/07/2004 ADDRESS 7629 LAKESIDE RD NE PIN 123024110050 LEGAL DESC UNAVAILABLE WATER TREATMENT APPLIANCE LOT BLOCK PERMIT TYPE PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 330.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A GAS WATER HEATER. STATE SURCHARGE, PLBG FLAT # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 1 # GAS DRYERS # OF NEW FIXTURES # WATER TRMT APPLIANCES APPLICANT KRACK JOHN L & CAROLINE J 7629 LAKESIDE RD NE FRIDLEY, MN 55432 OWNER KRACK JOHN L & CAROLINE J 7629 LAKESIDE RD NE FRIDLEY, MN 55432 0 # GAS RANGES 0 0 VALUE (FOR MINIMUM CALC) 330 0 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law re lating const ction or the performance of construction. lic I \ nnDate 1 I PLBG PERMIT MINIMUM FEE 0.00 PLBG FIXTURES (NEW OPENINGS) 0.00 PLBG FIXTURES (EXIST OPENINGS) 0.00 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 PLBG REPAIR/ALTERATIONS 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 35.50 PAID WITH CHECK # 0407 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY INSPECTION DIV. 6431 Unkvgrsity Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT P N(qq-5— MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 JJ. U-'' $10.00 $10.00 $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance -Is-1W State Surcharge $ .50 TOTALFEE JOB ADDRESS 7W 9 { La�c�� li �� U The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: 2- 20 OWNER �5 6 �'n � f I [06a GC. BUILDING USED AS ESTIMATED COST ® PERMIT NO. PLUMBING CO SIGNED BY , � Lc Lk_ TEL N0. Approved By COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. Rough -In Date Final Date "PROVIDE COMMON VENT INFO ON BACK SIDE I FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No( ) The undersigned also verges that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from separately as per current codes. the common vent and vented Yes () No( ) Appliance Type and Vent and Vent Connector Information Appliance #1 Type (A� kpd 14, Appliance #2 Type Appliance #3 Type p -Size/Common BTU Input 400 d Fan Assisted or Nat BTU Input Fan Assisted or Nat BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date Engineering LOAD LIMIT L —�-y Department MODIFICATION APPLICATION Permit N .: 763-572-3551 CITY OF FRIDLEY Received By: 763-571-1207 fax EFFECTIVE 1/1/2010 Date Rec'd: l /� APPLICATION DATE: 3 � Z Z� YOUR E-MAIL ADDRESS: �t�CZ�dt�S THIS APPLICANT IS: MAULER ❑ PROPERTY OWNER PROPERTY OWNER: ®Fvs� k=-rAe JOB ADDRESS: Q 62-ct `~ V MATERIAL TO BE HAULED: o "a cre}C -Fz;. I^ a DATES TO BE HAULED (UP TO 3 DAYS): 'Z— i L =fid THIS PERMIT IS ISSUED TO ALLOW AN INCREASE OF AXLE WEIGHT FROM FOUR (4) TONS PER AXEL TO FIVE (5) TONS PER AXEL OVER THE FOLLOWING DESIGNATED ROUTE: NOTICE: This permit is valid only for vehicles enroute to construction address during the hours of 8:00 am to 5:00 pm. See Resolution #01-2004 and State Statute Section 169.87 PERMIT MUST BE IN VEHICLE WHILE HAULING ON ESTABLISHED ROUTE. NUMBER OF LOADS ;7— $25 p load PERMIT FEE $ _741 THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED 1 hereby apply for a load limit modification 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. I understand this is not a permit but only an application for a pe and hauling op restricted roads i not to start without a permit. SIGNATURE OF APPLI NT f����/ PRINT NAMEECJ S DATE L APPROVED BY D°' DA COPIES GIVEN TO: ❑ O CE ❑ ENGINEERING City of Fridley Engineering Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3551 FAX: 763-571-1287 _&Tco 24 September, 2010 City of Fridley Building Inspection Department 6431 University Ave. NE Fridley, MN 55432 Attn: David Jensen RE: Permit #2009-01535 Dear Dave: As we discussed, I am requesting a 6 -month extension on Permit # 2009-01535, issued October 7, 2009, for an addition and other improvements to my house. While we've made a lot of progress over the last year, we still have a ways to go. I expect to be ready for the framing inspection yet this Fall, and will be working on the interior over the Winter. Please advise if you need any additional information. Thank you for your help. Cordially, John L. Krack 7629 Lakeside Rd. NE Fridley, MN 55432 763-786-5876 krackj@gmaii.com