PRE 2010 DOCSCity of Fridley, Minn.
WELDING PERMIT
d
Date: ... 1 .... ....................
Owneri..a9t2 .� .... Builder
Address .. / J ..�. ��...... ..... .. t Address
NO. 300
LOCATION OF B�BUILDING
No. /. Street... . . ... ..5:........ Part of Lot ..
Lot ... ... Block ................. Addition or Sub -Division .. ......
Corner Lot ............ Inside Lot .... Setback 09 ...... Sideyard "........ ........
DESCRIPTION OF BUILDING
To be Use as:. OF
. tWaAj..... Front . !.... Depth �4..... HeightA. Sq. Ft. ........ Cu. Ft. ........
.................... Front ........ Depth ... Heigh .... Sq. Ft. ...... Cu.. Ft. ........
Type................... osY .�7®............ Completed ....................
of Construction Est. C To be Co leted . .
171 �e
consideration of the issuance to me of a permit to construct the building desribed above, I agree to do
e proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
__AQ,4.
-0
pO
In consideration of the payment of a fe of $......., t is hereby granted to ...................
......................... to construct the b ..�?.tion 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 regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. 1
. ....... Building Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
ATTENTION OF: y
To _,_ _._._GWEN SAMUELSON / n
SUBJECT COMPLAINT ON OUTSIDE BIFFY AT 1439 MISSISSIPPI ST. DATE JULY 22, 1966
ROBERT NELSON RESIDENCE
SIGNATURE
REPLY:
A COMPLAINT CAME IN TODAY WITH REFERENCE TO AN OUTSIDE PRIVY AT ABOVE CAPTIONED
RESIDENCE. THIS PRIVY IS LOCATED BEHIND A GARAGE AND IS BEING USED BY CHILDREN, ETC.
THIS RESIDENCE IS CONNECTED TO AN INSIDE SEWER AND WATER CONNECTION SO THERE WOULD
BE NO REASON FOR THIS CONDITION. A NEIGHBOR CALLED, COMPLAINING ABOUT THE ORORS
AND FLIES AND SO FORTH COMING FROM THIS BIFFY. KINDLY GIVE THIS MATTER YOUR PREFERRED
ATTENTION. LEGAL DESCRIPTION OF PROPERTY IS: LOT 5, REVISED AUDITOR'S SUBDIVISION #10
elo
DATE
CASSIS SAEFKE, INSPECTION
SIGNATUR
REPLIEWS COPY— RETAIN FOR YOUR FILES
ov_ _
tau-t...��-
ORIGINATOR — Extract PINK copy and Forward WHITE and YELLOW copies.
REPLIER — Return YELLOW copy and retain WHITE copy.
FORM G-1, MANUFACTURED BY HOLDEN BUSINESS FORMS. 607 WASHINGTON AVE. NO.. MINNEAPOLIS. MINNESOTA 0 FEDERAL 9-0241
ATTENTION OF:
James H. City Manager
TO Hens ey, Health Inspector
City of Fridley
5 600. -Benton -Avenue. --South------- 6431 University Avenue N.E.
Fridley, Minnesota 55421
L_Edinas -Minnesota
SUBJECT 1439 Mississippi Street Northeast DATE February 15, 1967
Enclosed is -,a.-,copy_ of -a'. letter. -written to Robert Nelson, 1439 Mississippi Street
--from-the Building Inspector-.--- Enclosed --also is -a copy--of--a--memo-which—I—received
--from--the Building- inspection Department on* July -22-#----1966#- -whish T—forwarded--to
July, 27, _1966. - The _enclosed copy ._has,. notations on it--that-might—be-.-of
--some-help to you. See your memo to the City Manager dated August 31,, 1966,
---Board of Health Activites,,_ Page__4._____
SIGNATURE
REPLY:
4• Now of Violator;
7. Nature of Complaint:
HEA.LTH' COMPLAINT
CITY -OF FRIDLEY, MINNESOTA
L. Aaareii:
S. Address:
as
3. Phone No.
41
6. Phone No.
0
0
8. Complaint received by: 9. Complaint Referred to: 0. Dote
7
11. Report of Action Taken: (Specify date of action)
Ll — ;�Zs ' 7
12. Report Made by: 3. Date
H E A L T H C O M P L A I N T
CITY OF FRIDLEY, MINNESOTA
1, Reported by: 2. Address: 3. Phone No.
4. Name of Violator: 5. Address: 6. Phone No.
7. Nature of Complaint:
8. Complaint received by: 9. Complaint Referred to;
LL. report ox Action Taken: (Specify date of action)
. Date
12. Report Made by: 3. Date
lqk
10
X
X,
It
ATTENTION OF:
ro - -Mr•James H. Hensley, Health_Inspector
City Manager
- - ------ - --- City of Fridley
__5600- Rentt on__Avenues_%outb _._-_.__--_______— 6431 University Avenue N.E.
Fridley, Minnesota 55421
Edjma_x._M:_Lnnesota 55424
SUBJECT 1439 Mississippi Street Northeast DATE February 15, 1967
Enclosed is_a _copy of a letter written to Robert Nelsons 1439 Mississippi Street
--f-rom-the-Bald-ing--i-nspector.. -Enclosed--also--is--a--.ropy--o-f--a-memo whi-ch I-r-eeeived
from-In-spectionm-pawtment---on-_July-22 r-1966 -0-whl-eh to -
you on_July_27.x_966_�he-enclosed copy_ has,-_nctatis__o _itat__might be of
some help to you. See your memo to the City Manager dated August 31, 1966, _
--Board--of---Health.--Activite s r--1?age __4._______ --
SIGNATURE
REPLY:
�Ib tecl .
DATE 2-28-F% SIGNATURE
REPLIER'S COPY -RETAIN FOR YOUR FILES
ATTENTION OF: f
-- ------ - ;3
TO -_ . GWEN SAMUELSON _--
_ - - .1`'
� ry1
- -�
SUBJECT COMPLAINT ON OUTSIDE BIFFY AT 1439 MISSISSIPPI ST.
DATE JULY 22, 1966 "
ROBERT NELSON RESIDENCE
SIGNATURE
REPLY:
A COMPLAINT CAME IN TODAY WITH REFERENCE TO AN OUTSIDE PRIVY AT ABOVE CAPTIONED
RESIDENCE. THIS PRIVY IS LOCATED BEHIND A GARAGE AND IS BEING USED BY CHILDREN ETC.
THIS RESIDENCE IS CONNECTED TO AN INSIDE SEWER AND WATER CONNECTION SO THERE WOULD
BE NO REASON FOR THIS CONDITION. A NEIGHBOR CALLED, COMPLAINING ABOUT THE OEIORS
AND FLIES AND SO FORTH COMING FROM THIS BIFFY. KINDLY GIVE THIS MATTER YOUR PREFERRED
ATTENTION. LEGAL DESCRIPTION OF PROPERTY IS: LOT 5, REVISED AUDITORS SUBDIVISION #10
CASSIE SAEFKE. INSPECTION
r � �
DATE �s SIGNATUR
REPLIER'S COPY -RETAIN FOR YOUR FILES
1. Reported by:
4. Name of Violator:
7. Nature of Complaint:
H E A L T H C O M P L A I N T
CITY OF FRIDLEY, MINNESOTA
2. Address:
S. Address:
3. Phone No
6, Phone No.
8. Complaint received by: 9. Complaint Referred to: 110. Date
L1. meport of Action Taken: (Specify date of action)
N.
12. Report Made by:
3. Date
M
Q
ATTENTION OF:
TO __ GWEN SAMUELSON
1'
3
COMPLAINT ON OUTSIDE BIFFY AT 1439 MISSISSIPPI ST.
SUBJECT DATE JULY 22, 1966
@ R NELSON RESIDENCE
1
A COMPLAINT CAME IN TODAY WITH REFERENCE TO AN OUTSIDE PRIVY AT ABOVE CAPTIONED
RESIDENCE. THIS PRIVY IS LOCATED BEHIND A GARAGE AND IS BEING USED BY CHILDREN, ETC.
THIS RESIDENCE IS CONNECTED TO AN INSIDE SEWER AND WATER CONNECTION SO THERE WOULD
dJ BE NO REASON FOR THIS CONDITION. A NEIGHBOR CALLED, COMPI,A]NING ABOUT THE OBORS
AND FLIES AND SO FORTH COMING FROM THIS BIFFY, IQNDLY GIVE THIS MATTER YOUR PREFERRED
ATTENTION. LEGAL DESCRIPTION OF PROPERTY IS: LOT 5, REVISED AUDITORS SUBDIVISION #10
SIGNATURE 42 CASSIS SAME INSPECTION DEPARTMENT
REPLY:
8• • 6 Survey :indicated no evidence of a Pit privey. Old shacks
awl—s lL.- el --sheds sibz:9 chilidor -map-awe--fir M�e- fetl® _
FRI�DI�EY
CIVIC CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 - PHONE (612) 571-3450
MARCH 25, 1985
Mr. Robert 0. Nelson
1439 Mississippi Street N.E.
Fridley, MN 55432
Re: Noncompliance of the Fridley City Code at 1439 Mississippi Street
Dear Mr. Nelson:
At present your property at 1439 Mississippi Street does not meet the minimum
standards necessary to maintain a pleasant and healthy suburban environment.
It is through the compliance of the City Code that the City can attain those
values so essential for continued growth and development. The City has
established codes to control the accumulation of debris and refuse, the
storage of materials and equipment, the storage of unoperable or unlicensed
vehicles and the proper maintainanee of buildings and property. While mayor
code requirements are satisfied at your property, the following items do not
comply with the performance standards of the City code:
1. Store all materials and equipment in an enclosed building or remove them
from the site.
2. Remove all unoperable vehicles from vier and obtain current licensing.
An inspection will be conducted on or about April 15, 1985 to verify that the
appropriate action has been taken to correct these deficencies. If you have
any questions or concerns regarding this matter, please contact me at the
Fridley Civic Center, 571-3450.
Sincerely yours,
Philip S. Dommer
Planning Assistant
JK -1
3/5/18/6
GNOF
FRIDLEY
CIVIC CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 - PHONE (612) 571-3450
February 18, 1986
Robert Nelson
1439 Mississippi Street N.E.
Fridley, MN 55432
RE: Noncompliance of the Fridley City Code at 1439 Mississippi Street N.E.
Dear Mr. Nelson:
At present, your property at 1439 Mississippi Street N.E. does not meet the
minimum standards necessary to maintain a pleasant and prosperous suburban
environment. While major code requirements are satisfied, the following item
does not comply with the performance standards of the City Code:
1. Store your daughter's blue car in the driveway or garage, not on the'
front lawn.
I understand that there may have been some extenuating circumstances for this
to have occurred, however, your quick action to correct this situation would
be a great improvement for your property and the entire community as well.
An inspection will be conducted on or about February 28, 1986 to verify that
you have taken the necessary action to correct this deficiency. If you have
any questions or concerns regarding this matter, please contact me at the
Fridley Civic Center, 571-3450.
Sincerely,
Richard W. Wiersma
Code Enforcement
RWW/ dm
C-86-44
SUBJECT
City of Fridley
24382
AT THE TOP OF THE TWINS
BUILDING P E R M
r
�
NO.
i L _ ---� COMMUNITY DEVELOPMENT DIV.
�
PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
7/22/96
JOB ADDRESS 1439 Mississippi St NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt 5
1
1 Revised Aud. Sub. 410 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Robert 0 Nelson 1439 Mississippi St NE, Fridley 571-8116
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 (j ALTERATION JJ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside House; Build entry roof
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
WARNING
Before digging call for
all utility locations
REQUIRED BY LAW
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
1
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,300
$.65
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-
$43.00
Fire SIC $1.30
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$44.95
SIGNATURECONTRACTOR OR AGENT iDATEi
HEN PROPERLY VAL IED THIS IS YOUR PERMIT
�JITIRIIZED
BLDG INSP r)ATE
SIGNATURE OF OWNER OF OWNER BUILDERS 4DATE)
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress: �'7 -� f `�/ ,cd
0
Effective 3/1/96
V
Legal Description:
Owner Name & Address: Tel. # L ^%/ F j/
Contractor:
Address:
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Grround Sq. Ft.
OTHER: �GC�C Si/J GQi��
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: V,41� Estimated Cost: $
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
CITY USE ONLY
Permit Fee
$ % eD
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ ,
$.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
f
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
9
TOTAL
STIPULATIONS:
I
aim
CINOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287
May 6, 2002
Robert & Doris Nelson
1439 Mississippi Street NE
Fridley MN 55432
Re: Paved Driveways
Dear Mr. & Mrs. Nelson:
In 1997, the City Council adopted an ordinance declaring gravel driveways a public nuisance.
They were declared a public nuisance for a number of reasons, such as: they can cause
erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the
City's storm sewers and detention ponds. When gravel driveways were declared a public
nuisance, the City Council gave property owners five years to have their gravel driveways
paved. The five-year deadline is quickly approaching, which means all gravel driveways within
the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002.
If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at
the Anoka County Courthouse. A misdemeanor citation is a criminal offense and is punishable
by up to 90 days in jail and/or a $700 fine.
If you've already paved your driveways, Thank you! Please call me at 763-572-3595, so I can
update our files.
For your convenience, a brochure on the City's loan program has been enclosed. You can use
this loan program to acquire financing for your driveway improvement project. Please call Jim
Hesnik at 612-335-2651, if you have any questions regarding this program.
Thank you for your cooperation! As you successfully complete your driveway improvement
project, please call me at 763-572-3595, so I can do an inspection of your property and update
our files. If you have any other questions, please feel free to call meat the above number.
Sincerely,
Stacy Str mberg
Planner
C-02-53
rJAW
GiYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287
July 2, 2002
Robert & Doris Nelson
1439 Mississippi Street NE
Fridley MN 55432
Subject: Paved Driveway Reminder
Dear Mr. & Mrs. Nelson:
This letter is a friendly reminder that all driveways within the City of Fridley need to be paved by
December 31, 2002*.
As you are aware, the City Council adopted an ordinance declaring gravel driveways a public
nuisance. They were declared a public nuisance for a number of reasons, such as: they can
cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in
the City's storm sewers and detention ponds. When gravel driveways were declared a public
nuisance, the City Council gave property owners five years to have their gravel driveways
paved. The five-year deadline is quickly approaching, which means all gravel driveways within
the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002*.
If you've already paved your driveways, thank you! Please call me at 763-572-3595, so I can
update our files.
For your convenience, a brochure on the City's loan program has been enclosed. You can use
this loan program to acquire financing for your driveway improvement project. Please call Jim
Hesnik at 612-335-2651, if you have any questions regarding this program.
Thank you for your cooperation! As you successfully complete your driveway improvement
project, please call me at 763-572-3595, so I can do an inspection of your property and update
our files. If you have any other questions, please feel free to call me at the above number.
Sincerely,
Stacy S mberg
Planner
*If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Anoka County Courthouse. A
misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail and/or a $700 fine.
C-02-83
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
BUILDING PERMIT
P - .
33771
r
�
� `� ______ COMMUNITY DEVELOPMENT DIV.
r : PROTECTIVE INSPECTION SEC.
i -__•� I•� CITY HALL FRIDLEY 55432
1 763-571-3450
RECEIPT NO.
NUMBER
910-F15
REV
DATE
8/6/03
PAGE OF
APPROVED OV
JOB ADDRESS 1439 Mississippi Street NE
1 LEGALLOT
DESCR.
NO.
Pt 5
BLOCK
TRACT OR ADDITION
Revised Auditor's Sub. X610
SEE ATTACHED
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Robert & Doris Nelson 1439 Mississ'_ppi Street NE
763-571-8116
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Grayhawk Builders 3020 Centerville Rd, Little Canada, MN 55117 651-486-9888
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
20174611
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Ij REPAIR
O MOVE ❑ REMOVE
8 DESCRIBE WORK
Rerooi House & Garage `21 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
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
ZONING
SO. FT
CU FT.
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO DWLG. UNITS
OFFSTREET PARKING
T I HAVE READ AND EXAMINED THIS APPLICATION
I HER�RDINANG
1
STALLS
GARAGES
AND K O BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND VERNING THIS TYPE OF WORK WILL BE COMPLIED
W H WHETHER SP IFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION
@
$2,431
SURTAX
$1.22
OES N PRESU E TO GIVE AUTHORITY LATE OR CANCEL THE
ROVI ONS OF Y OTHER STATE L LAW REGUL TING CON•
RU TION OR E PERFO AN F TRUCTIO
PERMIT FEE
$83.25
SAC CHARGE
Fire SC $2.43
PLAN CHECK FEE
TOTALFEE
®
Lica SC $5.00
$91.90
4ruRE OF N- CTO Au ORi2E PGENT iO�TE�
HEN PROPERLY VALIDATED
THIS IS Y UR P RMIT
BL Ofa �h5�at
S.Ganru QE OF OWNER��c OWNER Bu4 DERi iDATE.
HUI -[ it C9t�1 11:41 FPON C-1 TY OF FP I DLEV TO
NEW [j
ADDN [ j CITY OF FRIDLEY
ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Namer & Address:
Contractor: I '1 CA A 1An i
651486EE3 P. 01;'02'
Effective 1/)12007
(763) 672-3604 Bldgs Inap
Y
)qA Tel.#
A-,�3 MN LICENSE# L
ti Tei.
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 W,id�thHygt/Ground Sq. Ft
OTHER: 44 AC, f
_ -
00r -
Estimated Costt�
Construction Type: S : $
r✓..�eway Curb Cut Width Needed: Ft + 6 Ft = Ft x s = $
DATE.' APPLICANT: Tet. #
CITY use ONLY - Call (763) 572-3644 for Permit Fees if mailing in apprication
Permit Fee Fee Schedule on Reverse Side
Fre Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ /• o`Z�2 $.50/$1,000 Variation
SAC Charge $ $1150 per SAC Unit
License Surcharge $ 06 $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt "A" or Aft. "B" Above
Erosion Corftl $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary 4 ]
RAWR
F- ILATIONS:
131 University Ave NE
idley, MN 55432
63) 572-3604, FAX (763) 571-1287
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
eewov kl aenco ns c1YTl IoCe 771 RC IAICTAI 1 Fn PNU FOC_H FI (')(iR
LUMBING FIXTURE RATES: NO. RATE TOTAL
ew Fixtures
►Id Opening, New Fixture
eer Dispenser
.low Off Basin
:atch Basin
,aln Water Leader
;ump/Receiving Tank
Vater Treating Appliance
Vater Heater -Electric
Vater Heater - Gas**
Sas Range**
;as Dryer**
Sack Flow Preventer Required ( )Yes () No
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
Type $15.00
teinspection Fee $47.00/Hr
\LL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
JOB ADDRESS l
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.
20
•
Owner
Building Used At
t
i >
Estimated Cost PERMIT NO. 6A
PLUMBING
SIGNED
Approved By
Rough -In Date
$__54-1
��! v) MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
$ PLUS THE $.50 STATE SURCHARGE
'aOMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
Urinal
•+.:::;.:: •.:.:: Wash
0 r:: ' Shower Tra
.::':•:�. )���-::�
: �'.: f�-,:>:>;>>:
.......................
'Drain
Floor
r
....•.�>�<I:.:
' <`:..
Auto. GaS
•�••'
Ran e
Wa sher�a
>..........
ater Heater
•: C•{::::4:
'i?CCS •i::•: is ii:•i
Stones �:>:::
EI
- Gas ec
e:A:::?Gii:C: i:•
Base
Floor
`:
Floor 2
:::
E..,,
Floor 3
itiF•::::}?i:::
Floor or 4
LUMBING FIXTURE RATES: NO. RATE TOTAL
ew Fixtures
►Id Opening, New Fixture
eer Dispenser
.low Off Basin
:atch Basin
,aln Water Leader
;ump/Receiving Tank
Vater Treating Appliance
Vater Heater -Electric
Vater Heater - Gas**
Sas Range**
;as Dryer**
Sack Flow Preventer Required ( )Yes () No
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
Type $15.00
teinspection Fee $47.00/Hr
\LL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
JOB ADDRESS l
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.
20
•
Owner
Building Used At
t
i >
Estimated Cost PERMIT NO. 6A
PLUMBING
SIGNED
Approved By
Rough -In Date
$__54-1
��! v) MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
$ PLUS THE $.50 STATE SURCHARGE
'aOMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
SuBjECT
P
City of Fridley
11139��4�
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
0 /
r PROTECTIVE INSPECTION SEC.
� b7
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
'�
1 763-571-3450 1910-F15
10/6/03
JOB ADDRESS 1439 Mississippi Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt 5
Revised Auditor's Sub. #10
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Robert & Doris Nelson 1439 Mississippi Street NE
763-571-8116
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Gr&yhawk Builders 3020 Centerville Rd, Little Canada MN 55117 763-571-8116
d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION ❑ ALTERATION ❑ REPAIR
%
O MOVE ❑ REMOVE
B DESCRIBE WORK
Replace 4 windows within existing openings; wrap & soffit & Fascia
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels
of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk
and flash all
exterior openings.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST
OCCUPANCY GROUP
OCCUPANCYLOAD
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
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$5,000
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2.50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHE STATE OR LOCAL LAW REGULATING CON-
$111.25
STRUCTIO P F ANCE OF CONSTRUCTION
Fire SC $5.00
PLAN CHECK FEE
TOTAL FEE
Licen a SC $5.00
$123.75
SIGNATUREC&TAACTOR OR AUTHORIZED AGENT (DATE,
EN PROPERLY VALIDATED THIS IS YO RIpPE MIITT
v 0
SIGNATURE OF OWNERoF OWNER BUILDER. IDATE.
BL G INS
TIATE
NEW [ J CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572.3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 5714287 Fax
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address:c �, -�a'fv /; r �� Tel. # 76 3 �%/
Contractor. /'-eS :�''� ��! i��r�_�/�rs _ MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA:
Length
Width Height
Sq. Ft.
GARAGE AREA:
Length
Width Height
Sq. Ft.
DECK AREA:
Length
Width Hgt/Ground _
Sq. Ft.
OTHER:
ai Lvr�� �5 v Sv v'c�
�
Construction Type. Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x
DATE: 161 -3 � APPLICANT: / � � Tel. # � ��- 336-
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ 16B, �S�
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering ,
Agreement Necessary [ ] Not Necessary [ ]
STIPULATIONS,
w