PRE 2010 DOCSOMER:
ADDRESS:
TEL NO:
.-J'
CITY QF FItIDLCY Effective Aug. 1, 1981
'
/
APPLICATIM FOR RESIDENTIAL DUILDING PEPNITS
(New. Alterations, Additions, or Repairs)
BUILDER:
ADDRESS:
TEL 110:
Construction Location
STREET NO: STREET: 4`AlL�%/��-
LOT: BLOCK:ADDITION:
Corner Lot: Inside Lot: Setback.: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTMCTI014
Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of construction: Estimated Cost: S
7b Be Cbr-pleted:
/ Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ 97-00 $
SEE PEVF.R;!i SIDE OF SHEET
ZSie undersigned hereby makes application for a permit fcr the ♦:mrk herein specified,
agreeing to do.all work in strict accordance with the City of rridley Ordinances and
:rulings of the Department. of Buildings, an h eby declares at all the facts and
represc� tzt ons stated in this applic.=tio a e true an o act.
DME: zzf�5 S.TGNh UIS :
Stimulations:
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 repairs to any existing building or
structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below not forth and
In the manner herein provided to -wit:
Total Valuation
$1.00 to $500.00
Fees
$10.00 (Minimum $15.00)
$501 to $2,000.00
$10.00 for the first $500 plus $1.50
for each additional $100 or fraction
thereof, to and including $2,000
$2,001 to $25,000
$32.50 for the first $2,000 plus $6.00
for each additional $1,000 or fraction
thereof, to and including $25,000
$25,001 to $50,000
$170.50 for the first $25,000 plus
$4.50 for each additional $1,000 or
fraction thereof, to and including
$50,000
850,001 to $100,000
$283.00 for the first $50,000 plus
$3.00 for each additional $1,000 or
fraction thereof, to and including
$100,000
$100,001 and up
$433.00 for the first $100,000 plus
$2.50 for each additional $1,000 or
•
fraction thereof
Plan Check: 25 percent of building permit fee.
Driveway Depression Escrow: Concrete curb streets only.
Alternate "A": Removal and replacement of curb and gutter only -
Driveway width plus 6 feet times $13.50
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 $15.75
Permits for construction will be issued a minimum of 24 hours from the
time of application to allow for proper review of the proposed structure
and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation
once it has been constructed will be required before Rroceedina with the
framing.
1
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
TELEPHONE ( 612)571.3450
W
VVIV, November 15, 1983
Mr. David Hogness
Hogness Construction
7728 Lakeview Lane
Spring Lake Park, MN 55432
Re: Final Inspection at 7650 Lakeside Road N.E., Fridley
Dear Mr. Hogness:
A final inspection was made on November 14, 1983 of the above address
and the following items were noted which must be completed before the
structure can be finaled out:
1. Provide City with copy of verifying survey; by December 5, 1983.
2. Provide sod in the front and side yards; by July 14, 1984.
We will expect the above items to be completed by the scheduled dates
and a reinspection called for. If you have any questions on these
items please feel free to contact me at 571-3450.
Sincerely,
G. CLARK
Chief Building Official
DGC/mh
City of Fridley
SUBJECT
PERMIT NO.
7 0 51
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
R�COMMUNITY
DEVELOPMENT DIV.
®®'
r PROTECTIVE INSPECTION SEC.
i1 i �
�r���,•� CITY HALL FRIDLEY 55432
L
NUMBER
REV.
DATE
PAGE OF
AP ROVED BY
_-_-�
612-571-3450
91 0_171 5
7/14/83
JOB ADDRESS 7650 Lakeside Road N.E.
1 LEGAL
LOT N0.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
S. 104' of
Lot 1, Blo
2, Spring Lake Park Lakeside SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Bob Dickison 350 - 75th Avenue N.E. 784-6299
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Hogness Construction 7728 Lakeview Lake, Spring Lake Park 55432 786-7212
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
SEPERATE PERMITS REQUIRED FOR WIRINQ
5 ENGINEER MAIL ADDRESS HEATING, PLUMBFN(;PAND Sf • LICENSE NO.
a1
6 USE OF BUILDING
Residential
7 CLASS OF WORK
j] NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 42' x 24' Dwelling and a 20' x 23' Garage
9 CHANGEOFUSEFROM TO
STIPULATIONS provide a hard surface driveway. Provide sod in the front and side yards
Provide City with copy of verifying survey before capping.
Water Lateral agreement signed. WARIANG
SEWER LOCATION: Plugged - May be Wye Only - Approx. 10' Dee%f es N lecal
Eutilities
156' N. of Nanhole (Inv. 893.74) Wye Elev: 894.43 Top of F
tC.
WATER LOCATION: Must be Tapped: 6" CIP 10' W. of Centerlineipa
REQUIRED, BY LAZA/
wo a" or moor wa mor C
vummmny
AGCURACv 0* UTILITY L0000#0 010 ELEVAMw,,^
THIS ',AIA 0 FOR INFORMATION PURPOSES ONLY AND
""ON "4G USING R SHOULD VERIFY TH! INFORMATIQN
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 CdMPLIED
$52,250
$26.13
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTH R STAT OR LOCAL LAW REGULATING CON-
$292.00
$425.00
STRUCT N R THE PER RMA OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$73.00
$816.13
NATURE OF C6NtRACJbFr0R AUT RIZED AGENT (DATE)
a
;46e
;WHEN PROPERLY V D TED TH IS YOUR P RMIT
"I- C
BLDG WSP DAT
SIGNATURE OF OWNER IIF OWNER BUILDER) IDAFEI �'-�
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CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATI94 FOR RESIDENTIAL BUILDING PER141TS � v
t w Alterations Additions or Repairs) rr U�
(1 P i I
ADDRESS: J —0 1 %S_l 4 -
TEL n0:
BUILDER: iCs s"
ADDRESS: 72P?-c/A1 -v1&4-<--1
TEL NO: �7e6 Zd—A
Construction Location
STREE, T � : !0570 • STREET:
LOT: f BLOCK: ADDITION:
Corner Lot: Inside Lot: Setback.: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
LLr-e7 C=r Front:
Square Feet:
Front: 90
Depth: -- Height:
Cubic Feet:
Depth: 9.3 Height: ZD
Square Feet: Cubic Feet:
p�
Type of Construction: Estimated Cost: $
'!b Be Cbr.�pleted: 04-/1? � 3 >� �� K �� • yv
• P Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: 9,6D
SEE P.F°VERSE SIDE OF SHEET
19ie undersigned hereby makes application for a permit for the work herein specified,
agreeing to do .all wort: in strict accordance with the City of Fridley Ordinances and
rulings of the Department of Buildings, a hereby declares hat all the facts and
representations stated in this applicati n are true ayM coct.
4 •� GG f
DATE: VL 1 4" % 6 SIGNATUIE :
Stimulations:
ab. f43 -
2
11
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 repairs to any existing building or
structure, upon application therefore, require ,the payajent by the
applicant for such permit of fees to the amount herein below set forth and
in the manner herein provided to -wit:
Total Valuation Fees
$1.00 to $500.00 $10.00 (Minimum $15.00)
$501 to $2,000.00 $10.00 for the first $500 plus $1.50
for each additional $100 or fraction
thereof, to and including $2,000
$2,001 to $25,000 $32.50 for the first $2,000 plus $6.00
for each additional $1,000 or fraction
thereof, to and including $25,000
$25,001 to $50,000 $170.50 for the first $25,000 plus
$4.50 for each additional $1,000 or
fraction thereof, to and including
$50,000
$50,001 to $100,000 $283.00 for the first $50,000 plus
$3.00 for each additional $1,000 or
fraction thereof, to and including
$100,000
$100,001 and up $443.00 for the first $100,000 plus
$2.50 for each additional $1,000 or
fraction thereof
Plan Check: 25 percent of building permit fee.
Driveway Depression Escrow: Concrete curb streets only.
Alternate "A": Removal and replacement of curb and gutter only -
Driveway width plus 6 feet times $13.50
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 $15.75
Permits for construction will be issued a minimum of 24 hours from the
time of application to allow for proper review of the proposed structure
and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation
once it has been constructed will be require before nroceedina with the ,,II
framing. (.dw�cthv e?y�O q��•r% Z�%/ x ri.�� =`Q`�.�a
�2, 2SQ i T: V. G XI I x Ry
aYW t C 10', k -let (9 35.
�9 52, 1
S SPECIAL ASSESSMENT
1, Robert Di cki son the owner of the
following described property 7650 Lakeside Road
S.104' of Lot 1, Block 2, Spring Lake Park Lakeside
Hereby agree to pay in cash $ 837.18 (104' of water .1 at)
to the city of Fridley to cover my proportionate share of
the utility system, or in lieu thereof agree to have the
City levy an assessment against the property described
above to cover the cost of my proportionate share of
the utility system as provided in Section 2 of Ordinance
No. 113, passed by the Council of the City of Fridley on
December 11, 1958.
w
• . f
OWNER'S SIGNATURE
Tapping Permit No
MP 9-77
L
PAYMENT AGREEMENT °
DATE
1, Robert Di cki son the owner of the
following described property 7650 Lakeside Road
S.104' of Lot 1, Block 2, Spring Lake Park Lakeside
Hereby agree to pay in cash $ 837.18 (104' of water .1 at)
to the city of Fridley to cover my proportionate share of
the utility system, or in lieu thereof agree to have the
City levy an assessment against the property described
above to cover the cost of my proportionate share of
the utility system as provided in Section 2 of Ordinance
No. 113, passed by the Council of the City of Fridley on
December 11, 1958.
w
• . f
OWNER'S SIGNATURE
Tapping Permit No
MP 9-77
L
EXTERIOR ENVELOPE fiVFg1 GE "IT" COMPUT,�TION
CONTRACTOR_)` 0&&j &,5-62Ue-fl-ON PHONE
OhNER__ PLAN NO.
SITE ADDRESS— %65-L,A DATE
Determine working square footage of each
1. Total exposed wall area...... /1171%6 sq.ft.x ./ = Z86m
2. Total roof/ceiling area...... 065 sq.ft.x 47a
3. Total floor/cant. area....... �ZZ sq.ft.x
Total exposed wall area above floor
a. Total wall window area ........................ /�
b. Total door area .............
c. Total sliding glass door area .................
d. Total fireplace wall area .....................
e. Total wall framing area(everage 10I)..........
f. Total net wall area above floor...
g. Total rim joist area ..........................
Total exposed foundation area
h. Total foundation window area ..................
i. Total net foundation area above grade...,..... 3
Determine "U" value of each wall segment
a• xIIUI1�
b. �� x"U" a _�
C. 412, x "U::
do x''U" _
f x "U" 04,7 = 'v'EZ
94—'��
ITUIT
h xnU" _
Subtotal
4 . ..................................Total= I o;9,;). /
If item #4 is the same as, or less than item #1, you have met the
intent of SBC 6006(c)2.
P-LQti'L,�- r
Total exposed i area above floor=
a •
Total
wall windo.B area. . . . .�. . . . . . J . , . . . . . '�'7�
b.
Total
door area........ .q!?-0..............�
®
c.
Total
sliding glass door area .................
d.
Total
fireplace wall area.... ....
e.
Total
wall framing area(average 10%)..00.000.0
�®
f.
Total
net wall area above floor ...............
g.
Total
rim joist area ..........................
Total exposed foundation area=
h. Total foundation window aped ..................
i. Total net foundation area above grade.........
Determine "U" value of each wall segment.
a. XrrUtt
b. 413 ® YnUrt Q O� _ %®
c . XttUrr =
d. X"Urr _
e ® X"Urr
f . XrrUrr —
g 0 XrtUrr =
h. XrrU„ _
i . Xflu rr =
Total exposed roof/ceiling area®®�a
J. Total skylight ar*a...........................
k. Total roof/ceiling framing area ............... 1�7c>
1. Total net insulated roof/ceiling area......... --5'30.
Determine "U" value for each roof/ceiling segment
is X"Ul,
k. %0 X"Utr c Oq 2 1
XTIUtt
5. .........................................Total
If total of #5 is the same as, or less than #2, you have met
the intent of SBC 6006(c)l.
6. .........................................Total = �? �® 70�
If total of #6 is the same as or less than #r3, you have met
the intent of SBC 6006(c)3
ALTERNATE BUILDING ENVELOPE DESIGN
To utilize the total envelope system method, the values established
by the sum of items #4, #5 and ##6 shall not be greater than the
sum of items P. #2 and #3-
1.
#3.
1. 01 2.
/ ®r 3;)
3
4. 5.
38,5-/
6.1
5X6 36' 7"
4X6 30' Be
6X6 136' 7"
5X4 30' B"
7X6 36' 7"
1.5X4 36' 1"
1.5X3 34' 8"
4X5 36' 7"
4X4
32'
S"
3X4
22'
9"
7"
3X6
26'
3"
6XS
36'
7"
5X6
34'
1211
2"
5X4
6"
4X6 36' 7"
4X4 130' B"
3X4 27' 4"
------ -- - -- -----3G - 7"
PLATE TYPE--RLPINE
C� CAGENERRL RTES NE IMREF
TRUSSES BUILT IN CONFGRI OCE PITH 'QUALITY CONTROL
THERE SHRIL HE NO YRNONTIES OF THIS DESIGN, AERP
RIPINE CONLCTURS RRL MRNFRCIUI@D FROM 20 GAUGE
UNLESS DINENWISE SHORN, MEETING fEOUIRI:WNTS OF AS
APPLY COMNECTORS TO BOTH FACES AT EACH JOINT AND
"ERRING WtOT116 ARE 4- WMIT+il UNI LSM OIHERVIbj
17I1N SCOCONFORM WITH APPLICABLE PROVISIONS OF aW
a- TPI - IRM PLRTE INSTITUTE, N
_ WEB _
WEBS: -2X4 *3 HEM-FFIIB*FIR-TSH@ OR
* �s • SO. PIXIE.
P-
'Ohm. l
Ewe
3X9
36' 7"
3X8
34'18"
43VTS F=
3X7
38'
7"
3X6
26'
3"
3X5
22'
8"
LOCATE TOP CHORD OFF -PANEL SPLICE
WITHIN 6" OF PANEL 1/4 -POINT.
DASHES SHOW
DIRECTION OF 'Ap
ELONGATED
HOLES IN
PLATES ON TYPICAL CONTINUOUS JOINTS
4 EO. TC PANELS
3 EO. BC PANELS
MEASURED FROM
INSIDE SCARFS
MIN BRG
SPAN
3.58"
36' 7"
O�E� �INaHWT-
.O 7HYffiNING EIONRrOfIR INGSEEWT-76kK_
BY &IPI, INKIN: WOOD TRUSSES= COMMENTARY AND RECDfiTENDATIM-
S OR IMPLIED. a1Pll. SEE THIS DESIGN FOR Ti00ITIDNFIL SPECIRL SRTCINO
VI1FIIdFD STEEL RIOUIREMENIS. UNLESS OTFERVISE SHOYN, TOP CHDAD SHALL
A446 CRROE fl. IIE LATERALLY MAUD 917W PROPERLY ATTACHED PLMW
SITE AS SHOWN. SWATHING, SDTIG" CHORD WITH RIGID CEILING OR SRRCING
DUN. DLSIGN AT fWIMtM OF 10 FEET 0. C. 00 NOT USE THIS DESIGN
7 AND •IN 49 1 WITH FIRE RETRROFW TRERIED LUMBER.
- NATIONAL DESIGN SPECTFICRIION FOR WOOD CONSTRICTION
A COPY OP TmTR Tarnnm mn rvrrmrnO r•nvTvarmna
N
0 0 0 0 0 0 0 0
ALPINE ENGINEERS) PRMUCTSM INC.
P.O. BOX 2225
POMPANO BERCHMFLORIOR 3=1
305-781-3333
DESIGN CRITERIA TPI
TC LIVE LOAD - 40.6 PSF
TC BEAD LOAD " iB.B PSF
BC DEAD LOAD a 18.8 PSF
TOTAL 68.8 PSP,
DUR. FACTOR 1.15
SPACING 24.8" OC
S'o " OVERALL SPANS
PINE 2X6 TC 2X4 BC
SS DEN RD 36' 7" 36' 7"
SS DEN 36' 7" 36' 5"
SS ICD 36' 7" 34' 6"
SS 36' 7" 32' S"
I DEN RD 36' 7" 34' 6"
I bi.N 36' i" 32' 8"
RD 36' 7" 30' 10"
#i 35' 7" 29' 6"
#2 DEN RD 36' 7" 30' 7"
02 DEN 34' 1B" 29' B"
#2 RD 33' 11" 27' 7"
#2 131' 6" 1 25' 11"
LORDING SPRCING
60.0/1.15 24.0 "
2XG/2X4
PITCH
tbs. ".
"° . p"exed
by m or oils OF Oraat
43VTS F=
O
O
O
Q G
O
000STo0
,a•°
COPYRItiST 1979
4080643
Du�NTa� No.l Isu
6 / 2 4,,2 9 •.DRAW# A41911, 133
7IEE=
oAL
o
D
O
X—"#�
TRUSS
o
0
ALPINE ENGINEERS) PRMUCTSM INC.
P.O. BOX 2225
POMPANO BERCHMFLORIOR 3=1
305-781-3333
DESIGN CRITERIA TPI
TC LIVE LOAD - 40.6 PSF
TC BEAD LOAD " iB.B PSF
BC DEAD LOAD a 18.8 PSF
TOTAL 68.8 PSP,
DUR. FACTOR 1.15
SPACING 24.8" OC
S'o " OVERALL SPANS
PINE 2X6 TC 2X4 BC
SS DEN RD 36' 7" 36' 7"
SS DEN 36' 7" 36' 5"
SS ICD 36' 7" 34' 6"
SS 36' 7" 32' S"
I DEN RD 36' 7" 34' 6"
I bi.N 36' i" 32' 8"
RD 36' 7" 30' 10"
#i 35' 7" 29' 6"
#2 DEN RD 36' 7" 30' 7"
02 DEN 34' 1B" 29' B"
#2 RD 33' 11" 27' 7"
#2 131' 6" 1 25' 11"
LORDING SPRCING
60.0/1.15 24.0 "
2XG/2X4
PITCH
tbs. ".
"° . p"exed
by m or oils OF Oraat
43VTS F=
q.0/12
ovulwn "A noIam
SPANS TO 36' /'
• dalF QspatanA Pro'
,a•°
COPYRItiST 1979
4080643
Du�NTa� No.l Isu
6 / 2 4,,2 9 •.DRAW# A41911, 133
N2 613
CITY OF FRIDLEY
PUBLIC WORKS DEPARTMENT
TAPPING APPLICATION AND PER54IT
FOR INSTALLATION OF WATER & SEWER SERVICE
I) This form to be completed before a tap is made to any existing water or
sewer line.
T + 's I iw' Rl
.nnlr .� A A M+i." Sd 1? i A)(_ LAII-L A4.
Address ' o i=}eLS /O
Owner L r. S S -r-
Ph
•.
Pl9 wjqin�
CHARGES TO BE PAID BEFORE TAP IS MADE — WHERE
ASSESSMENT HAS NOT BEEN LEVIED AGAINST PROPERTY
II) Water & sewer connection permit must be registered before this Tapping
Permit can be issued.
City supplies all material and labor for 1" or under water tap. Con-
tractor supplies all material and labor for water tap over 1", and all
sewer taps.
WATER TAP: Materials Used: $ 160• 60
Street Patch: x �
: $ � � o
���L Ir
®���' TOTAL: $
SEWER TAP: Street Patch: x $
III) If this property has not paid a full Lateral Charge for its share of the
water and sewer system, additional charges will be placed against it.
This will be in addition to the normal connection and tapping permits,
meter deposits, etc.
Water
ASSESSMENTS TO BE LEVIED: Lateral: $ �a w�
Sewer Lateral: $
TOTAL ASSESSMENT: $
Clerks Signature
Supt. of Public Works (J
M/P 3/76 White P.W. Canary Finance Pink Prop. Owner Goldenrod Plumber
SUBJECT
P
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
rp
EIP
COMMUNITY DEVELOPMENT DIV.
'
4
r PROTECTIVE INSPECTION SEC.
/ f50,?-
1 �
i CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
9/19/84
JOB ADDRESS 7650 Lakeside Road N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
Pt. 1
2
Spring Lake Park Lakeside SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Robert L. Dickison 7650 Lakeside Road N.E. 788-9638
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Hansen- Kan Eze 15943 Central Avenue N.E. Ham lakep MIST 55303 434-7556
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 101.x 141 Shed in Rear Yard
9 CHANGE OF USE FROM TO
STIPULATIONS
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
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
$1500
$.75
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$25.00
Y
TRUCTION O, THE. ERFO MANCE OF CONSTRUCTION.
�
LAN CHECK FEE
TOTAL FEE
$25.75
STZ`aNATURE OF CONTRAC OR OR AUTHORIZED AGENT (DATEf
WHEN PROPERLY V DATED THIS IS YOUR PE MIT
N
�r
/J
JJ
j 6
SiGNATUREOF OWNERIIF OWNER BUILDER) (DATE)
BLDG )NSP DATE
NEW [ ] City of Fridley Effective 4/1/84
ADDN. [ ] R-1 AND R-2
ALTER. [ 7 Building Permit Application
Construction Address:
76,"70 )LAN3 612E 1::RIVIR ME -
Legal Description:
Owner Name & Address: �� �� �� �� Tel. #
Contractor: Tel. #
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
Height
Sq. Ft.
DECK AREA:
Length
Width
Hgt/Ground
Sq. Ft.—
OTHER
L-A Gly N
RN
Corner Lot [ ] Inside Lot [0 Ft. Yd. Setback �— Side Yard Setback
Type of Construction:
0JO01- }-RADE Estimated Cost: $
Approx. Completion Date: 1 b — I — 2 ef
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE:
_ _--,Y1/APPLICANT: ZC 1141YS__1/ Tel.
1%iv.516'ly - /14N- Z -11"Z5
CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
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 Valuation Fees
$1.00 to $500.00 $10.00 (Minimum Fee is $15.00)
$501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each
additional $100 or fraction thereof, to and including
$2,000.
$2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each
additional $1,000 or fraction thereof, to and
including $25,000.
$25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each
additional $1,000 or fraction thereof, to and
including $50,000.
$50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each
additional $1,000 or fraction thereof, to and
including $100,000.
$100,001.00 and up $433.00 for the first $100,000 plus $2.50 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 $13.50
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 $15.75
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of
application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
M- -
Quit Claim Deed. Form No. 28-M. Millcr-Davis Co., Minneapolis
Individual to Corporation. Minnesota Uniform Conveyancing Blanks (Rcviticd 1976
/3
ThioJnbenture, .blade this............ i5th. ................clay of ................ June ..................................... 19...83...,
between......................Ma r g a re.t.. At .... .ege r .,...lai d ow..........._.............................................................................................................................
ofthe County of ............. Anka ........................................................ and State of .................. Minnesota ................................................
party.......... of the first part, and ................. i.ty..o.f.....F.rid.l.ey..........................
................
.Vmun l cipa..............................................................................................................................................................................................................................
a corporation under the laws of the State of ............. Minnesota .......................................... party of the second part,
I
Witnegittb, That the said part y. ....... of the first part, in consideration of the sum of
....One .... ($.1..00.)...do.l.lar....and..nol.lM s...................._................_........................................................................................DOLL.4RS,
to............................................................in hand paid by the said party of the second part, the receipt whereof is
hereby acknowledged, does...... hereby Grant, Bargain, Quitclaim, 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......................... Anoka ............................................ and State of Minnesota, described as follows, to -wit:
A five (5) foot utility easement over the North five (5) feet of the
South 104.00 feet of Lot 1, Block 2, Spring Lake Park Lakeside.
The City of Fridley hereby accepts this easement for utility purposes.
NO STATE DEED TAX REQUIRED.
Q --
SIDNEY
-SIDNEY . INMAN, City Clerk
0
T. g)abe anb to JI)olb the ba111e, To(%ether With, all the hereditaments and appurtenances there-
unto belonging or in anywise appertaining, to the said party of the second part, its successors and assigns..
Forever.
3n votimonp Wbereof, The said partY__... o-" the ,fasst part ha S ... hereunto set. her
hand. .. the day and year first nZrore Ir.I WC71.
.............................................................................................................
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