PRE 2010 DOCSMEMO FROM:
RICHARD N. SOBIECH
Public Works Director
SUBJECT:
❑' See attached
MEMO NO. TC 151
DATE 7-17-75
REPORT BY: 7-24-75
Fitting in o f Low Axea South o4 M,iAa"aippi Stceet
❑ Review & take appro-
priate action
❑'JC Review & comment
❑ Note & discuss with me
❑ Work with
f— Rush, immediate action
desired
REMARKS:
There hp been 4U placed an pjiapeniez aj 1340
a 135k Mis.a. 6.6ippi Street; .th" is the area
into which the out$a t goer,. Check into the
.6 ttuWon and contact the tcu iddents and .indicate to
them. any 6itX,i ng wilt have to be OK'd by the City.
Make reports, w/background
material as complete as poss-
ible.
oss- COMMENTS:
i bl e. Make interim report if c�ra.a D
necessary.
CD
� Action completed, no
z further review needed
❑ Further action necessary
❑ See attached letter
❑ Interim report o-����20 a'4�..
DATE: -712: L1;tS— SIGNATURE
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
i �• COMMUNITY DEVELOPMENT DIV.
______
PROTECTIVE INSPECTION SEC
,
NUMBER
REV
DATE
PAGE OF
APPROVED BY
/�"1 CITY HALL FRIDLEY 55432
�---- �" ��' 612-571-3450
910-F15
4/4/97
JOB ADDRESS 1340 Mississippi Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
15
1
Spring Valley Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Russell Prior 1340 Mississippi Street NE
571-4364
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
x❑
B DESCRIBE WORK
Reroof House & Garage (27 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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 I 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
$2 227
1.12
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$74.75
Fire SC $2.23
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
8.10
SIGNATURE OF CONTRACCTOORROORAUTHORIZED AGENT IDATEI
N P OPE ALID T THIS IS YOU P R T
/
TNATUREOFpWNERiIFO NE ILDERI (DATEI
LDG INSP
r)ATE
NEW [ ] Effective 1/1/97
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATIONf-�
. _ _,—
ConstructionAddres s :
Legal Description: _
Owner Name & Addr
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
��(J /• 111 �.: '
_Tel. #
LICENSE #
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EUPROVEM ENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. ,Ft.
Driveway. Curb Cut Width Needed: Ft. + 6 Ft =
Estimated Cost: $ S�
(Fee Schedule on Back)
Ft x $ =$
DATE:
APPLICANT:
Tel.
CITY USE ONLY
17499
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$950 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
$ C • �%%
STIPULATIONS:
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to -wit:
TOTAL VALUE ;: FEES -
$1 to $500 $21 (Minimum Fee is $21 _plus surcharge)
$501 to $2,000
$21 for fust $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000
$62.25 for fust $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$25,001 to $50,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $1()0,-000
$100,001 to $500,000
$887.25,for;first.$100,000 plus $5-00 for, each additional
$1,.0W or fraction: thereof, to and including .$500,000, .
{, T 1r,♦ .. 1 `F. i.J4
$500,001 to $1,000,000
$2887 25 forahe fust$500,000rplus. $4 25 for each additional.-
$1, 000.or:fractton:thereof to and includuig $1;000;000
$1,000,001 and up
$5012.25 for the fust $1,000,000 plus $2:75 for each additional
$4000 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 it has been constructed
will be required before proceeding with the framing.
HOUSE -HEATING TEST RECORD
ADDRESS %A 7 Cs1 ��1� �ii�ao2 APT. OOR CITY SUBURB '
OCCUPANT AZ OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY
Electrical Work-
By4 '' Gas Line By
TYPE OF HEAT GA FA HW L STEAM SPACE HTR. UNIT HTR. OTHE
GAS DESIGNCONVERSIO
MAKE MAKE OF BURNER.
Model Model
Serial Max. BTU Rating % 2 C
INPUT MAKE OF FUR ACE
Model
CONTROLS
THERMOSTAT M /4 Heat Plug
Valve
Limit
Limit Setting
Fan Setting
Pilot Type
Pilot Make
Pilot Model
Pilot Timing
L.W. Cut Off
Pressure 3 -6 -
Percent CO -
2
Input CFH / F'Percent 02--L�z
Stack Temp. Joe Percent�" ---
Form 235
Vent Size
KIND OF LINER NONE
Draft Hood ®r RegulaTor
Filters Size dumber
Chimney Location Inside Outsi e
Chimney Construction -
Smoke Bomb
Draft
Wiring
.Test Tag _rte
Door Pressure Lighting Inst.
Date Tested '
Company Testing
Name of Tester
WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring
County Name WELL AND BORING SEALING RECORD Minnjesota Unique Well No.
Minnesota Statutes, Chapter 1031 °�;tepe�s No.
,�nelfa
H263598
P; j-OPERTY OWNER'S NAMEICOMPANY NAME
CASING(S)
Township Name
Township No.
Range No.
Section No.
Fraction (sm. Ig.)
Date Sealed
Date Well or Boring Constructed
Frid e
ods/Drop Pipe ❑ Check Valve(s) ❑ Debris E] Fill ❑ No Obstruction
10/10/07
Unknown
COLOR
HARDNESS OR
FORMATION
FROM
GPS Latftude degrees_ minutes_ seconds
Depth Before Sealing ft.
Original Depth 19 ft.
LOCATION: Longitude_ degrees_ m1hutes seconds
AO ER(S)
Single Aquifer ❑ Multiaquifer/
STATIC WATER LEVEL
easured ❑ Estimated Date Measured 'J' 6
15 ft slow ❑ above land surface
Numerical Street Address or Fire Number and City of Well or Boring Location
1340 Mississippi St
ORING
Water -Supply WeII ❑ Monit. Well
❑ Env. Bore Hole ❑ Other
Show exact location of well or boring Sketch map of well or boring
in section grid with °X" location, showing property
N Ifnes, roads, and buildings.
CASINGTYPE(S)
1 feel ❑ Plastic ❑ Tile ❑ Other
WELLHEAD COMPLETION
W E i `
Outside: Well House ❑ At Grade Inside: ❑Basement Onset
Mile ' ❑ Pitiess Adapter/Untt ❑ Burled ❑ well Pit
r — ❑ Buried
1 WRu Pit .R
—1 Mile --I
❑ Other ce
P; j-OPERTY OWNER'S NAMEICOMPANY NAME
CASING(S)
.Marge Prior
Diameter Depth Set in oversize hole? Annular space initially grouted?
1,/ in from to� ft. ❑ Yes ,� ❑ Yes Pfvo ❑ Unknown
Property o ner's mailing address if different than well location address Indicated above
15523 - 95th Circle NE
Otsego, MN 55330
in. from to ft. ❑Yes ❑ No E] Yes ❑ No El Unknown
,
in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown
WELL OWNER'S NAME/COMPANY NAME
Same
Well owner's mailing address if different than property owner's address Indicated above
SCREEN/OPEN HOLE
Screen from 15 to--19_tt. Open Hole from
OBSTR ONS
ods/Drop Pipe ❑ Check Valve(s) ❑ Debris E] Fill ❑ No Obstruction
Type of Obstructiona (Describe) Suction Pimp - -
Obstructions removed? s ❑ No Describe
GEOLOGICAL MATERIAL
COLOR
HARDNESS OR
FORMATION
FROM
TO
PUMP
Type
❑ Removed of Present ❑ Other
If not known, indicate estimated formation log from nearby well or boring.
Sand Brown
0
20
C
D USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE:
o Annular Space Exists ❑ Annular Space Grouted with Tremae Pipe ❑ Casing Perforation(Removal
Fine Sand Gray
1.90-
In. from to ft. ❑ Perforated ❑ Removed
-60-
Shakopee Doloyrfi-+-
90
2.11-5-
In. from to ft. ❑ Perforated ❑ Removed
Type of Perforator
❑ Other
GROUTING MATERIAL(S) (One bag of cement = 94 lbs., one bag of bentonite - 50 lbs.)
/
Grouting Material Neat Grout from 0 to 18 ft. yard§ Z bags
from to fL yards bags
from to ft. yards bags
OTHER WELLS AND BORINGS
Other unsealed and unused well or boring on property? ❑ Yes ❑ No How many?
REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING
LICENSED OR REGISTERED CONTRACTOR CERTIFICATION
This well or boring was sealed in accordance with Minnesota Rules, Chapter 4725. The Information contained in this report
is true to the best of my knowledge.
Geology From: 1314 Mississippi St
Water Level in Above Well: 45'
Date Water Level Taken: 03/22/1946
E.H. Renner &Sons, Inc. 1431
Contractor Business Name License orRegistration No.
Unique 206665
10/23/07
Certill d e res Slgn Certified Rep. No. Date
Kevin Scheiterlein
LOCAL COPY
H 263598
� � 5 � 8
Name of Person Sealing Well or Boring
HE -01434-09 ICH 140.0423 6106R
:r
MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring I (� (�7:�::]
[�Sl
(�
WELL OR BORING LOCATION ng No. �1 V
WELL AND BORING SEALING RECORD
County Name MinnSealie ota Unique Well No.
or W -series No.
Anok-a Minnesota Statutes, Chapter 1031 n m i
PR OW R'S NAME/COMPANY NAME
Farr `
Township Name
Township No.
Range No.
Section No.
Fraction (sm. — Ig.)
Date Sealed
Date Well or Boring Constructed
in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown
Fridley
1 30
23
1 13
, NW, SE
10/23/07
Unknown
15
15
GPS Latitude degrees_ minutes_ seconds
Depth Before Sealing ft.
Original Depth ft
Type of Obstructions (Describe)
LOCATION: Longitude_ degrees_ minutes_ seconds
AQUIFER(S)
STATIC WATER LEVEL
COLOR
gle Aquifer ❑ Muittaqu'rfer
Qrl-asured ❑ Estimated Date Measured U
Numerical Street Address or Fire Number and City of Well or Boring Location
PUMP
1340 Mississippi St
WELLBORING
Sand Brow
2
L�MterSupply Well ❑ Monit Well
15
2
Show exact location of well or boring Sketch map of well or boring
In section grid with "X." location, showing property
F] Env. Bore Hole ❑ Other
ft. -slow ❑ above land surface
CASING TYPE(S)
6
19
N lines, roads, and buildings.
E] Plastic El Tile ❑ Other
I I I
--i--- -- r-- ---h-- ---f-- ' WELLHEAD COMPLETION
F$'O'L
.Outside: ❑ Well House ❑ At Grade Inside: E] Basement Offset
W EI tIMileess Adapter/Unk ;? uded Well Pit
❑Pik ! ❑
❑ Buried
i—Kwan vn
S
F 1 Mile I
u ❑ Other
❑ Other
PR OW R'S NAME/COMPANY NAME
Farr `
CASING(S)
Marge nor
g
Diagtqr Depth Set in oversize hole? Annular space initially grouted?
1 �- 4 In. from to 12 ft. ❑ Yes LAORo ❑ Yes eNo ❑ Unknown
Property owner's malling address k different than well location address Indicated above
15523-95 Ih Circle NE
Otsego, MN 55330
in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown
In. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown
WE OWNER'S NAME/COMPANY NAME
ammailing
SCREEN/OPEN HOLE
Screen from 12 to,15 ft. Open Hole from to ft.
Well address it different than property owner's address Indicated above
OBSTRUCTIONS
❑ Rods/Drop Pipe ❑ Check Valve(s) ❑ Debris ❑ Fill o Obstruction
Type of Obstructions (Describe)
Obstructions removed? ❑ Yes ❑ No Describe
GEOLOGICAL MATERIAL
COLOR
HARDNESS OR
FORMATION
I FROM
TO
PUMP
If not (mown, Indicate estimated formation log from nearby well or boring.
Sand Brow
2
TWO
❑ Removed Not Presets ❑ Other
Clay Brow
2
6
METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE:
Fine Sand Gra
6
19
No Annular Space Exists ❑ Annular Space Grouted with Tremfe Pipe ❑ Casing Perforation/Removal
In. from to ft. ❑ Perforated ❑ Removed
Shakopee Dolomite
19
21
In. from to ft. ❑Perforated ❑Removed
Jordan Sandsto
Type of Perforator
❑ Other
GROUTING MATERIAL(S) (One bag of cement - 94 lbs., one be of bentonfte - 50 Ibs.)
Neat Grout 0 1 ! V2
Grouting Material from to ft yards bags
from tc ft_ yards bags
from to ftyards bags
OTHER WELLS AND BORINGS
Other unsealed and unused well or boring on property? ❑ Yes No How many?
REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING
LICENSED OR REGISTERED CONTRACTOR CERTIFICATION
This well or boring was sealed in accordance with Minnesota Rules, Chapter 4725. The Information contained in this report
Geology From: 1314 Mississippi St
Water Level in Above Well: 45'
Is true to the beat of my knowledge.
E.H. Renner & Sons, Inc. 1431
Date Water Level Taken: 03/22/1946
Liven Name License or Registration No.
Unique 206665
10/23/07
Certified Represen five Signature Certified Rep. No. Date
Kevin Scheiterlein
LOCAL COPY H 26520
Name of Person Sealing Well or Boring
HE -01434-10 IC# 140-0423 5 o7R