PRE 2010 DOCSCity ®f Fridley, Mian.,
BUILDING PERMIT N° 6590
Date:
Owner: '/ �� Builder
Address Address
LO I OFJLDI G
NO. I Street ^ :Wart of t
Lot _. _Block Addition or Sub -Division
Corner Lot — Inside Lot Setback �� / Sideyard _ _ res
Sewer Elevation
Foundation Elevation
/ DESCRIPTION OF BUILDING
v aB:
Front _4 Depth Height Sq. Ft Yl e) cu. r
Depth �' weight Sq. Ft. Cu. Ft.
Type of Clcoon Fst.�C To be Completed
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 SVt forth and in ce with all provisions of
ordinances of the city of Fridley.
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 location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and permit maybe revoked at any time upon violatio8.of any of the provisions of said
ordinances. � �a 1
Building Inspector
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, cower or water. Be suns to see
the Sulhlhhg Inspector for aparato pwmhs for thea home.
City of Fridley
Application for Plumbing and Cras Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK 3—
Number, Kind and Location of Fixtures Location
y
c i
v
�j
w
z
�O
•
F
t
N
WATER HTR.
GAS
ELEC.
Base
r
1st
1
1
l
2nd
3rd
4th
_
• Future Connection Openings
e New Fixture, Old Openings
Connected with
Sewer
Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ...................... x $1.50 $�9.
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ............................ x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $
New Ground Run Old Bldg. ............ x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
let 3 Fixtures ..........................� x $1.50 $
Additional Fixtures .................... x .50 $
Gas Range -to =,0M BTU... ...: -.. - -x -4-.00 -$� --
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$ _
TOTAL FEE
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true ano correct.
. 25 -lam' e3
Fridley, Minn
Owner
Kind of Building
Used as
r
To be completed about
19_
Estimated Cost, $
Old—New. Building Permit No 44 Permit No. �-
Signed'
By
Business Phone No
ROUGH
FINAL
42 2M
SUBJECT
PER
City of Fridley
0 18175
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEI
COMMUNITY DEVELOPMENT DIV.
r L PROTECTIVE INSPECTION SEC.d��s
1 � �
"1 CITY HALL FRIDLEY 55432
j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
8/26/85
JOB ADDRESS 290 Longfellow Street N.E.
1 LEGALLOT
NO. BLOCK
E. 95.5' f Lots 211,
TRACT OR ADDITION
13, Block 3, Spring Brook Park SEE ATTACHED
DESCR.
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP PHO
Erast Winiarczyk 290 Longfellow Street N -E-
786-0029
3 CONTRACTOR MAIL ADDRESS
ZIPON LICENSE NO,
Chris's Construction 240 Longfellow Street N.E.
784-P7H145
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW 3J ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 22' x 24' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS provide a hard surface driveway.
WAKNIN
SEPARATE P
Before digging call local Utilities
WIRING) HEAT GATS RE FOR
QUIRE®
TELEPHONE - ELECTRIC - GAS Etc.
PL UMBI�� RREQUIRED
BY LAW
4 N, Sler
�M
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
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
6 436.32
$3.22
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-
$62.50
TRUCTION OR THE ERFORMANCE F CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$65.72
SIG ATUREOFCONT AUTHOR1Z DAGENT (DATE)
e
WHEN PROPER ALIDATED THIS IS YOUR PERMIT
BLD INf)ATE
-)&koS ,
SIGNATURE OF OWNER OF OWNER BUILDER) )DATE)
NEW [ ] City of Fridley Effective 4/1/84
ADDN. [ R-1 AND R-2
ALTER. I ] Building Permit Application
Construction Address: e;�of dL�/l%E���eCO
Legal Description: �• 9S� �-f a -F L a f pz._/�? . 3 6vock 3 S�iOrv/ &®®k
Allk
Owner Name & Address: C05t / Tel. # 24F6 0 15 -
Contractor: h r ; S 'S C_ a a < Y6 Tel. # � Address: ':P ':P 6/7 g Te //a W_
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, With the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width
Length a ` Width L✓
Length Width
Height
0
Height_
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [ ] Inside Lot ['�j" Ft. Yd. Setback Side Yard Setb�c Z
Type of Construction: .6 ,9M I` Estimated Cost: $
Approx. Completion Date: �nJD O �,
6L, -
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired:
DATE:
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
See Back Page for Explanation
APPLICANT: (I-
i^�i`4 _PS CC Tel. #
CITY USE ONLY
$ Fee Schedule on Reverse Side
$ 25% of Building Permit Fee
$ �� Z $.50/$1,000 Valuation
$ $425 per SAC Unit
$ Fee Determined by Engineering
$
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS:
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133815 M0113A 9NOrl
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STATE OF MINNESOTA
DEPARTMENT OF HUMAN SERVICES
444 LAFAYETTE ROAD
ST. PAUL. MINNESOTA $5101
Date
reet Address
S
City State Zip Code
DHS -2722 (9-85)
PZ -02722-02
RE: ZONING NOTIFICATION OF APPLICATION FOR LICENSURE
Subject:pe of License:
ame f Day Care Home Applica FA Idamily Day Care
Street Addr Group Family Day Care
/� Licensed Capacity
1
-City State Zip Code Phone No. %��--
This is to inform you that we are in receipt of an application for
licensure under Minnesota Rules, parts 9502.0300 to 9502.0445 (formerly
Rule 2), Family Day Care and Group Family Day Care Standards. Issuance of
this license is subject to compliance with the provisions of Minnesota
Statutes, Sections 245.781 to 245.812 and 252.28, subdivision 2, known as
the Public Welfare Licensing Act and the rules of the Department of Human
Services.
You should note that under Minnesota Statutes, Section 245.812, Subvision
3, a licensed day care facility serving 12 or fewer persons shall be
considered a permitted single family residential use of property for the
purposes of zoning. Subdivision 4 of the same section indicates that a
licensed day care facility serving from 13 through 16 persons shall be
considered a permitted multi -family residential use of property for
purposes of zoning.
If we do not hear from you within
will consider the above-mentioned
your local zoning code.
Sincerely,
JVA9 W1
i
LicensingWorker
Street Address
30 days after receipt of this letter, we
dayP$1�' to., bei:. Clpliance with
SERVICES D_rARTf-.1ENT
COUNTY OF ANOKA
COURTHOUSE, FOURTH FLOOR
ANOKA, MINNESOTA 55303
Name of Agency Organization
City State Zip Code
AN EQUAL OPPORTUNITY EMPLOYER
V U
SUBJECT
P RMI
City of Fridley
212 3 5
AT THE TOP OF THE TWINS
BUILDING PERMIT
i •
REC
COMMUNITY DEVELOPMENT DIV.
_
PROTECTIVE INSPECTION SEC.��
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-115
3/25/92
JOB ADDRESS 290 Longfellow. Street. NE
1 LEGAL
LOT NO. BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
E 95.51 o Lots 1,2,
Block 3, Spring Brook Park SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Erast/Jacqueline Winiarczyk 290 Longfellow Street NE 786-0015
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
6 DESCRIBE WORK
Reroof Dwelling (Tear -off) 23 Squares
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing must comply with. State.underlayment code,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. 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
7-
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
$1,27-9
$061
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-
$ 31.00
Fire SC $1,22
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$32.83
SIGNATURE OF CONTRACTOR OR AUTHORIZEGENT? IDATEI
WH N PROP RL iLl AT THIS IS YOUR PERMIT
Y
4,_ATURE
Zoe-
OG INSP DATE
OF OW NER IIF OWNER BUILDER IDATEI
V U
NEW (] Effective 3/1/92
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: rM Lnrr f / I d(A) -) ! /U t_-,
Legal Description:
Owner Name & Address: 9 JaC 21 lie I i lel e, Lo ( Y) i dL4Te1. v-7 j 5
Contractor: G W iULP-- MN LICENSE #
Address: ice. ML a OWL 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 Sq. Ft..
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length . Width Hgt/Ground Sq. Ft.
OTHER: Z 3
Corner Lot [ ] Inside Lot [ ] Ft. Yd . Setback _
Type of Construction: G C. ttLL
0
Approx. Completion Date: 12w ,
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
DATE: APPLICANT: -�JU
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Park Fee
$ 31.00
Sewer Main Charge $
TOTAL
STIPULATIONS:
$ ,3�2-&3
Side Yard Setbacks _
Estimated Cost: $ i aI9
(Cost on Back)
Ft x $ = $
CITY USE ONLY
Tel. # -00
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$700 per *SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary ( ] Not Necessary [ ]
Building
BUILDING
Permit No.: ftke ,I
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604CITY
OF FRIDLEY
Dat W Va.
DATE I Z •Q 3- DOUR
-MAILl in t r1(i SSU ., �"(,l S C V C O m
SITE ADDRESS
/ADDRESS
OG. I / Y C
THIS APPLICANT IS:
OWNER CONTRACTOR
PROPERTY OWNER/
NAME:
TENANT
ADDRESS: " ` ' CITY
STATE—ZIP
PHONE: ID3 ' I • (� IOS
CONTRACTOR
NAME.
SUBMIT A COPY OF
STATE LICENSE # EXP DATE -319115b
mw
YOUR STATE LICENSE
ADDRESS: SS�b CITY ZME-4 - STATE ZIP 5531,3
WITH APPLICATION
PHONE qSZ - 935 • -74AP 9 FAX -?6Z-,?-R5- 9571f4/
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
Q ADDITION ❑ GARAGE/SHED ROWS
❑ BASEMENT FINISH ❑ ROOF DRAINTILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
0NEW 13ADDITION
ANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1. Existing Floor Plan
PROPOSED SIZE:
PROPOSED HEIGHT:3.
❑ DETACHED GARAGE
2. Proposed floor plan
List of structural members to be used
SIDING
q Dower
FOR NEW CONSTRUCTION
INCLUDING DECKS,
13 Vinyl
❑Soffit //// /1nA �I'
ADDITIONS. & PORCHES SUBMIT:
❑ Alumirnkin
❑ Trim I (%
1. Site
Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project
WINDOWS
2. Two sets of construction plans
IN EXISTING OPENINGS Yes
ONo LOCATION OF WINDOWS
3. Energy Calculations
OR FOR NEW OPENINGS -DESCRIBE SIZE OF All
OPENING CHANGES &
,
t0
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE TOTAL JOB VALUATION S 48,5 9mv .B.0 FEE SCHEDULE)
OCCUPANCY
TYPE
Permit Fee $ a710
Plan Review $
Fire Surcharge $
Surcharge $
License Surcharge $
SAC Charge $
Curb Cut Escrow $
Erosion -Control $
Park Fee $
Sewer Main Charge $
Total Due $
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks oavable to: Citv of Fridlev Attach
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 which equiresFT
and p oval of plans. - /j
SIGNATURE OF APPLICANT PRINT NAME DATE /Ci% •t/,3 0