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AFf \yj - " SUBJECT PERM) . City of Fridley ® 3100 AT THE TOP OF THE TWINS BUILDING PERMIT ,r L RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. ; CITY HALL FRIDLEY 55432 NUMBER DATE PAGE OF APPROVED BY 612-560-3450 910-F15 7FV� 7-22-75 JOB ADDRESS 1445 NORTH DANUBE ROAD FRIDLEY MINNESOTA 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 3 1 INNSBRUCK NORTH ADDITION SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE LEE KUPCHO, 3713 FOSS ROAD N.E., MINNEAPOLIS, MINNESOTA 55421 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. SPRINGFIELD HOMES, INC., 3713 FOSS ROAD N.E., MINNEAPOLIS, MINN. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING RESIDENCE - SINGLE FAMILY DWELLING 7 CLASS OF WORK Rk NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK GARAGE 2418" x 29'4"x 8' 9 CHANGE OF USE FROM TO STIPULATIONS PROVIDE HARDSURFACED DRIVEWAY OD FRONT & SIDE YARDS ArtNIN SEE PERMIT ATTACHMENTS aiGASiEtc. BefOte diggin�Call SEWER: (APPROX. 8' DEEP) TELEpHOHELCTRtC of (Inv. 941.30) By LAW WYE'ELEVt 940x55 REQUIRED TOP OF FOOTING 943.80 (MIN.) WATER: 10' EAST OF SEWER SERVICE •$�S OIjBvin1d sitmi3d 3103 TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. FRAME THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. 25, 64O AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 5,784 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 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, WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERh(14 $41j600.00 $20.80 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- STRUCTIO OR THE PERFORM NCE OF $58.13 325.00 CQNSTCTION. AN CHECK FEE TOTALFEE Z /.f, 7 7- - 403.93 F A RA O IZ DAG T (DATE) WHEN PROPERL V LIDATE THIS IS YOUR PERMIT SAJULY 22, 1975 BLDG )NSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI f \yj - " •APPLICATION FOR RL•SI-DL'NTIAL., ALTERATION, OR ADDITION•BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNERS NAME • e, �J c-� �� BUILDER: v 41e, • ADDRESS u •� S LL,�,) ADDRESS: - STREET: l' I.OT :---- BLOCK • 3 ADDITION: CORNER LOT:^ _ _ INSIDE LOT: t1-1*"_SETBACK: SIDEYARD:,Z2�f,/v Applicant attach to this 'f ory.rTwo Certificates. -tf Survey of .,Lot and.proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As Front: Dep: Height• ' 2 I 1 Square Feet: Cubic. Feet: Q Front: 2 G�– Depth: ' -' eight: [� Square Feet; Cubic Feet': - Type of Construction: G Estimated Cost: ``° To Be Completed: —��a l '400,0 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: 7�2 SIGNATURE • 67, (See reverse Side For Additional Information.)' Db � �SIG 5a� �R��c& s►� �''�'®a 19,3 3 ' 'S' ►tom � sem- -3 10141— Cii-i o4 Fridley Applicatian forPlumthl�.9 am Gas ��a1� �� N �� Dept of Bl" Phono SM -3450 DESCRIPTION OF VlORr: ,/dw— j" NumSar, Kind and LocrKen of Fixtures I•oeIIti •'— • Fvtu:e CGaao:s. a Cr,+:iair..'s--------- — 'a Msw Flxturs, Old 0,"nirgs PARTIAL RATE SCHEDULE Savor rc=pGol 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 Cit? Ordin2ncv and ruling of the Department of Build.ngs; and hereby declares that all the fact and representations stated in this application are true and correct - .s Fridley, Minn Owner _ ��' 44�1 Kind of Building Used as To be completed about Estim'ated Cost. Old --New. Building Permit No. Permit No. LUMMING FIXTURE RATES: NO. RATE TOTAL l�LSO Signed Number Fixtures . . . . .. . . . . . ... • r x ✓2.00. �...�� Ll Future Fixture Opening ........... x $1.50 S. _. By -' -tiew Fixture Old Opening ......•.... x $1.50 Businu s Phune Catch Basin ................... e x $3.25 $ Water Beater °Up to 99.000 BTU1.... x $3.00 $_=3 New Ground Run Old Bldg....:..:. x $.3.25 S ROUQH Eloctrlo Wa:ar Heatar.....:........ s $2.00 $ FINAL AS 17TTING FEES: NO. RATE TOTAL Ist 3 Fixtures -- — x $2.00 =' y Additicnal Fixtures ..........:..... x $ 35 S Gas Range to 199.000 BTU ........... x $5.00 6 EMPA:RS & ALTERATIONS—Refer to Code .50 State Surcharge •De.:c�ipt+Cn .Y.. o.s0..0...i......e.0•..•••�•••e•�•� • TOTAL 1'*f..E • z.3s•�' r • r N wAr[a Mrx. �yy S •J ► N GAS ILM N u a u B3SZ 2nd 3rd • Fvtu:e CGaao:s. a Cr,+:iair..'s--------- — 'a Msw Flxturs, Old 0,"nirgs PARTIAL RATE SCHEDULE Savor rc=pGol 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 Cit? Ordin2ncv and ruling of the Department of Build.ngs; and hereby declares that all the fact and representations stated in this application are true and correct - .s Fridley, Minn Owner _ ��' 44�1 Kind of Building Used as To be completed about Estim'ated Cost. Old --New. Building Permit No. Permit No. LUMMING FIXTURE RATES: NO. RATE TOTAL l�LSO Signed Number Fixtures . . . . .. . . . . . ... • r x ✓2.00. �...�� Ll Future Fixture Opening ........... x $1.50 S. _. By -' -tiew Fixture Old Opening ......•.... x $1.50 Businu s Phune Catch Basin ................... e x $3.25 $ Water Beater °Up to 99.000 BTU1.... x $3.00 $_=3 New Ground Run Old Bldg....:..:. x $.3.25 S ROUQH Eloctrlo Wa:ar Heatar.....:........ s $2.00 $ FINAL AS 17TTING FEES: NO. RATE TOTAL Ist 3 Fixtures -- — x $2.00 =' y Additicnal Fixtures ..........:..... x $ 35 S Gas Range to 199.000 BTU ........... x $5.00 6 EMPA:RS & ALTERATIONS—Refer to Code .50 State Surcharge •De.:c�ipt+Cn .Y.. o.s0..0...i......e.0•..•••�•••e•�•� • TOTAL 1'*f..E • z.3s•�' r • r PARTIAL RATE SCHEDULE GRAVITY WARN AM: RATE TOTAL Furnace Shell & Duct Work ... ... ..$10.00 Replacement of Furnace 6.00 Repair-, & Alterations—up to $500.00 B.00 $ Repairs & Alterations each add. $500.00 3 W $ ST90L WARM pct. Furnace Shell & Duct Work to 120,000 BTU emch add. 60,000 BTlJ . ......... Replacement of Furnace Repairs & Alterations—up to $500.00 Repairs & Alterations each add. $500.00 STEAM or HOT WATER SYSTEM 3.00 a 6.00 6.00 $ 3.00 $ Furnace Shell & Lines --to 400 sq. ft. EDR Steam $10.00 $ Furnace Shell & Line ---to 640 sq. ft. EDR Not Water 10.00 $. Each add. 200 sq. tt. EDR Steam xon $ Each add. 320 sq. ft. EDR Hot Water 3.00 $ OIL BURNER—to 3 gal. per hour 6.00 $ over 3 gal. per hour—See free Schedule GAS BURNER (up to 180,0410 BTU) &00 $ J C7 6 over 10.9,000 BTi.1 Soe Fos Schodule GA.S FITTING FEES: NO RATE TOTAL 1st 3 Fixtures L_ x$ 200 $ 0 U Additional Fixtures x .76 $_ Gas Range to MWO x$ 6.00• $ State Surcharge .50 AR COMDMONMO a r FAN MZATLM STB Fes TEZG BVZTZN e ALTERATrO1 S & REPAM TOTAL rwV City of Fridley: The undersigned hereby makes application for a permit for the worm here i specified, agreeing to do all work in strict accordance with the City Ordinanct and ruling of the Department of Buildings, and hereby declares that all the fad and representations stated in this application are truenand correct. Owner _ /,/ C x� Kind of Building Used as To he corn Fridley. Estimated Costti $ C;� tl�' 0C Old ewBuilding Permit No. Permit No. �� 7 HEATING or PO *am Plot Water'Qj �No a.�� Trade Nam//e=� Size NoG I Z 0,L I �•� Capacity-l-�O_E_.,L.0_0Sq. Ft. E D.R Total Connected Load Kind of Tris¢ BURNER — Trede Nam Size N® Capacity Sq. IPL R.D--I VM 10 R V7 > •VAPA r r 00, CRONSTROMS HTG. & AIR CON D., INC. Job Name 04t, &M" . D-56 ` 4410 Excelsior Boulevard, Minneapolis 16, Minn. . EJ ��^ d NEAT LOSS CALCULATIONS .16b Address T !1� y y SHVE Weatherstrips A. . . . . Construction No. � ' I Insulation Guide Windows I Doors Reference Out. Wall Int. Wall CeilingF;Vimn4dowsarTd Kind How Applied es -No Yes—No 1Room Length Width Height %.r� oom Length idth Height Windows and Doors—Crackage and AreaWidth Helght No. of Llnealft. AresNo.fpaneof Dane lights of crack eq. tt. Coef.1 Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Floor oe „� S e Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area .I zA& oonn1Length Width -1 Heistht Windows and Doors---Crackage and Area ✓ pip Width Helght No. of Llneal ft. Area No. ofDans of Dans lights of crack eq.ftCoef. Wid h Helght No. of Llneal rt. Area No. of pans of pane lights of crack eq.[t.Coef. a 0i 1 �. j? z s L i Btu Infiltration o 7 �Glass Btu Infiltration I t fo t�/�GlassExp. tb Int. wall Glass Ceiling wall Floor j X 4 Exp. wall Net exp. wall 9 e � ' ,;, iL � ?.o ?-o Int. wallCeiling yr y ?.o /G • Int. wall Floor Floor lob Ceiling Total Btu. Required sq. h. E.D.R. or sq. ins. W.A. Leader area '. w%,. oom I L.enath / L Width Heiaht Windo s and Doors—Crackage and Area ✓ pip Width Helght No. of Llneal ft. Area No. ofDans of Dans lights of crack eq.ftCoef. WidthHelghtNo.ofLlnealtt.Area o. of Dane of pane Ifgbte o[ crack sq. [t. a 0i 1 �. j? z s L i Btu Infiltration o 7 �Glass Coef. Btu Exp. wall 3 3 Net exp. wall & � e tb Int. wall Glass Ceiling Lp' Floor j X 4 ! Tbtal Btu. I� Ifr, Doors—CrackageandArea ✓ pip Width Height of Lineal ft. Area No. of pane of pane lights of crack sq. it. lig WidthHelghtNo.ofLlnealtt.Area o. of Dane of pane Ifgbte o[ crack sq. [t. a 0i 1 �. j? z s L i Coef. Btu Coef. Btu Infiltration 3 3 Glass >S leo Glass Exp. wall Lp' 'O d -D Exp. wall .: • t v f�iP Int. wall Net exp. wall yr y ?.o /G • Int. wall Floor lob Ceiling Floor dp ktL / G Z Total Btu. t 3" Required aq. ft. E.D.R. o . ins. W.A. Leader area m north in Width / L Height 2 J -- Windows and Doors—Crackage and Area Windows ✓ pip Width Height of Lineal ft. Area No. of pane of pane lights of crack sq. it. lig -7 2 J-6 0� Coef. Btu Infiltration Btu Infiltration Glass ! dm Exp. wall -ft Net exp. wall l x .: • t v f�iP Int. wall Net exp. wall Or( y Ceiling ?ro Int. wall Floor lob 1 4 O Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area m 1 Linath / T Width / Z Height % Windows and Doors---Crackage and Area AP ,V Y OP Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. 2 J-6 0� Coef. Btu Infiltration Glass -ft Exp. wall Net exp. wall Or( y 20 ?ro Int. wall Ceiling Floor G Z Total Btu. Z Required°sq. h. E.D.R. or sq. ins. W.A. Leader area CRONSTROMS HTG. & AIR COND., INC. Job Nam D-56 ' 4410 Excelsior Boulevard, Minneapolis 16, Minn. /��.• /Vo ,/ /� NEAT LOSS CALCULATIONS Job Address l ✓ all- `� ° AS..V. Weatherstrips HConstruction No. � I Insulation . Guide.E WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor I Kind How Applied Yes -No Yes—No 19— Room I Lensfth /s Width ® Height II / Fl.l T Room I Length /G Widtly I Height Windows and Doors—Crackage and Area m ng Width Height No. of Dane of Dane Width Height No. of Lineal ft. Area No. of pane of p e lights of crack eq. ft. e ?.o i L Coef.1 Btu Infiltration Coef. Btu Infiltration Exp. wall Coef.1 Btu 7 F e Glass Int. wall ve p■p Exp. wall Floor ere -b Exp. wall Net exp. wall pX r s L 0 4e?.p Int. wall / S Int. wall Ceiling /* 40 to 4e to Floor a0upilif Ceiling Floor Total Btu. r I(. p Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / Fl. t4.. Room l Lenath / J. -Width 7 Height .r Windows and Doors—Crackage and Area m ng Width Height No. of Dane of Dane No. of Lineal ft. Area llghts of crack sq. ft. i i / — /o Coef.1 Btu Infiltration tip 1 9 ?.q Glass O 2-ar" Exp. wall Coef.1 Btu Infiltration yti Int. wall ve Glass 4. Floor ere -b Exp. wall Glass Net exp. wall Net exp. wall L.jxsi' / S Int. wall Irs Int. wall Ceiling I a feef't Ceiling Floor p �. j, 6 WS Total Btu. Z J S Z Required sq. ft. E.D.R. or sq. ins. WA. Leader area %ua M I m I Lenath7t Width Eleiaht A' Windows and Doors—Crackage and Area m ng WidthHeight No. of Lineal ft. Area No. of pane of Daae lights of crack sq. ft. 3O + 6 i i / — /o Coef.1 Btu Infiltration tip 1 9 ?.q Glass O 2-ar" Exp. wall e Net exp. wa k z t 1 7 - qo- awo yti Int. wall Glass Ceiling/'4c 4. Floor ere -b I tltal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area m ng Windows and Doors--Crackage and Area Width Height No. of I Lineal ft. Area No. of pane of pane lights of crack sq. ft. i i / — /o Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 2-72, — Coef. Btu Infiltration e /3 ob. ?A Glass Net exp. waU.Z JOSG. ere -b Exp. wall Glass Ceilin O•'If ! Net exp. wall L.jxsi' %/ = 1411 /o Irs Int. wall I a feef't Ceiling p Jl j, 6 WS Floor 0 / b % Qa Total Btu. I -T-&^ Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl Roo ii- tht I W.A H ' -Lb X''' Total Btu. Required sq. ft. E.D.R. or sq. itis. W.A. Leader area i r...._ i it rl.i a\WiY I A.'GAMNa ea — ...asau m ng Windows and Doors--Crackage and Area / el Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 2-72, — B►. lr Va- Infiltration L e Glass Coef. Btu Infiltration Net exp. waU.Z JOSG. Ov o Glass Ceilin O•'If ! Exp. wall Net exp. w - as Int. wall °7 / 6 0 / b % Qa Ceiling �I. 7G Floor Total Btu. Required sq. ft. E.D.R. or sq. itis. W.A. Leader area i r...._ i it rl.i a\WiY I A.'GAMNa ea — ...asau a ac.6uaCr Windows and Doors--Crackage and Area e Width Height No. of Lineal ft. Area No of pane of pane llghts of crack sq. tL Coef. Btu Infiltration L e Glass ep Exp. wall Net exp. waU.Z JOSG. (a /a /4 - Int. wall Ceilin O•'If ! Flo? 1 otal Btu. s(� Required•sq. ft. E.D.R. or sq. ins. W.A. Leader area f CRONSTROMS HTG. St AIR COND., INC. Job Nam aSb 1410 Excelsior Boulevard, Minneapolis 16, Minn. M . i NEAT LOSS CALCULATIONS Job Address Yy `r Weatherstrips A.S.H.V.E. Construction No. I Insulation Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes-s—No No I Ye19_ m ng . Le th /Si Width // g Hei ht 11 P1_I Roan I Length Width Height Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1AI& .I 5C Rnn.n I i.moth irlth—Irt 14.4.ht Ff Windows aM Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llghta of crack eq. ft. Windows and Doors—Crackage and Area G• — G 1. Z Ga Width Height No. of Lineal ft. Area No. of pane of pane Ilghte of crack eq. ft. Ga /r Glass Coef. Btu Coef. Btu Infiltration p Exp. wall Glass Floor Exp. wall Z (. p.. 2tplb f O Net exp. wa%1(. ,L Int. wall Ceiling 21rien Ceiling / 3 in Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1AI& .I 5C Rnn.n I i.moth irlth—Irt 14.4.ht Ff Windows aM Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llghta of crack eq. ft. Wid h Height No. of Lineal ft. Area No. of pane of pane 11=0 of crack sq. ft. G• — G 1. Z Ga Coef. Btu Infiltration Glass Coef. Btu Infiltration Glass Net exp. wall p Exp. wall Floor Net exp. wall Z (. p.. 2tplb f O dP* Int. wall Ceiling 21rien 1 Floor Total Btu. I zeb zy- Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 171.1 Room I Lenath Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llghta of crack eq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Tbtal Btu. Required sq. ft. E.D.R. _or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of Lineal It. Area No. of pane of pane lights of crack eq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. iis. W.A. Leader area F1.1 Rnnm I Lenath Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor II otal Btu. Required`sq. ft. E.D.R. or sq. ins. W.A. Leader area r, ADDRESS OCCUPANT C USE HEATING TEST RECORD APT. FLOOR— CITY_ OWNER HEAT LOSS DATE HTG. INST. GAS CO. METER BA GE SOLD BY INSTALLED BY Electrical Work By Gas Line By. TYPE OF HEAT G HW STEAM— SPACE HTR. UNIT HTR. O' DESIGN CONVERSION MAKE MAKE OF BURNER Model Model Serial Max. BTU Rating INPUT ®® MAKE OF FURNACE Model CONTROLS ,1 THERMOSTAT eat Plug / Vent Size Valve oa KIND OF LINE SUBURB Limit v(P Y1,07 Draft Hood bz`� egulator Limit Setting D 17.$ Filters Size Number Fan Setting 4w Chimney Location Insid ` Outside Pilot Type Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tag Ir I L.W. Cut Off Door Pressure Li Ming Inst. Pressure Percent CO2 Date Tested c2 AVS — Input CFH Percent 02 Company Testing Stack 7empa Percent CO ® Name of Tester W- 44 ' - + STATE OF MINNESOTA '� J Rev. 74 DEPARTMENT of NATURAL RESOURCES Division of Waters, Soils $ Minerals APPLICATION FOR PERMIT TO WORK IN PUBLIC WATER - t:' ^ the owner of land is Government lot(s) , print or type �app ic=t s name quarter section(s) section(s) township no. (s) , range(s) L015 fire ;o-., x no. or asof r,- blosk A &,Wdzvzsfon) county(ies) ft no i? , which is riparian to tl and • name 0,r = or stream applies pursuant to Minnesota Statutes Chapter 105 and other applicable statutes for a permit to work in the public water(s) named above, in accordance with all data, maps, plans, and other information submitted herewith and made a part hereof. PROPOSAL IT IS PROPOSED TO: Q excavate,= fill, Q construct, Q remove, (check) = install, Q abandon, or Q other(specify) rmTM %aro -ant f'isll., tr•►xrt THE FOLLOWING: Q dam, Q shore -protection, L= shoreline, Q harbor, Q channel, Q bridge, (check) Q culvert, Q wharf, Q obstruction, or Q other(speoify) ..*at.l �•+ri JUSTIFICATION Explain why this project is needed: y0 —ke 1.7t "i v'lliC3 l? 1�7r Si'rl`;1 �a("i) tr ;2:,+•rad, ENVIRONMENTAL IMPACT 1. Anticipated changes in water and related land resources: oroxirmte_1.1 wO,, 0f the exist•i n -r i'.lr'f.-v!e :• ati,"id area ?•Til.; be fill ee. t0 acco;7 .-ldnte c,)nS`,r-,i.ction 7f 2. Unavoidable but anticipated detrimental effects: —inin l red,lCt o i in l rn ter Storn -e P 11 acre Prep aonroxi--ately 10-)j' 3. Alternatives to the action proposed: Cc'1': ennn -u ion CPna-,it,r. Loss *,Till be diverted to feet from the locntiori in O'Je3tion. PROJECT SITE DATA 1. Describe the type and amount of aquatic vegetation present: 2J,- ,e^«e ?^."1 J', c-ttails. 2. Describe the nature of the material beneath the water: 1,enr 3. Describe the nature of the upland area: 13,. �>n,,d a.1d Cr);•, C1 -.r rvi QCT 11137? W & T 4. Describe type and amount of nearby shoreland development: '' ),);'^ :1r 1`?l�' 1 •: i.)T feet '''=!' is an 11 nc—e non4i-i -nd: wetlo ?d area .�_1 , a,2di will bA c-)nnec<•ec3 by st0r^ nine. S. ENCLOSE SKETCH DESCRIBING WATER LEVEL FLUCTUATIONS. (see instruations) ATTACH EXTRA SHEETS IF NECESSARY (continued on reverse side) - Channelling Existing Total length (feet) - - - - - - - Length in lake/stream (feet)- - - Bottom width (feet) - - - - - - - Side slopes (ratio) - - - - - - - Average depth (feet)- - - - - - - Gradient (S)----------- w-S4 CONSTRUCTION DATA (aZao attach sketch or drairtg) Proposed Alterations along shore Proposed 1. Describe type of excavation -equipment to be used, if known j-lpckhoe and- cat Distance along shore (feet)- - - - --- Distance .- Distance waterward (feet)- - - - - Thickness .of fill material (feet)- - - 7 Depth of excavation (feet) 2. Describe location (ineZude map) and characteristics of spoil disposal site proposed: )est will be st)c-niled on 1,1ew Br'_.-hton D-nd pint l 3.3 comnlete. Then it Ndll be bro,ii '!t b--'- to yn—T o ;s %Itei as to-+soi 1. 3. Would maintenance excavation be necessary? (check) Qj 'YES CV,( N0 Explain: 4. Volume of material to be removed initially (cubic yards): Muck or silt W)1,11!1 Sand or gravel Rock or stone ATTACtMNTS Q a1S.00 filing fee, L7 photographs, Q other (specify) Applicant declares that information submitted herewith and statements made herein are a true and correct representation of the facts, and that the filing of this application and information with the Commissioner of Natural Resources is prima facie evidence of the correctness thereof. COMPLETE APPLICATION SUBMITTED TO: (1) None of dity or township street a post off -ace (2) Name of watereW aistrict (3) Shoreland Management Administrator of County Dated this 7� day of t},;{- 19 '7 '"Ye Signed 7,P? arra r,r-srnn, 3f'i^ (appUcant) aaAA Address 220.3 Silver Lake Road City °''?;•r Rri77-tton State 1-1 Zip code S el1 1 7 State of Minnesota ) County of ss. AFFIDAVIT phone � on this day of , 19 before me personnally appeared who being first duly sworn and to me known to be the person who executed the foregoing application, acknowledge(s) that executed the same as own free act and deed and that the statements, maps, plans, documents, and other supporting data are true and correct according to best knowledge and belief. Notary Public County My commission expires 19 Rev. 14 STATE OF MINNESOTA DEPARTMENT of NATURAL RESOURCES Division of Waters,.Soils and Minerals. NOTIFICATION OF PERMIT APPLICATION INSTRUCTIONS FOR THE APPLICANT Minnesota Statutes, Section 105.44, Subdivision 1, requires you to supply a complete copy and all supporting data of your water permit application to the following: A) The chief executive officer of the city or township within which the project is located. B) The secretary of the Board.of Managers of the watershed district, if any, within which your project is located or which your project may affect, You MUST certify having served the complete application on the above in the box on the back side of the application form W-54. IN ADDITION, if,your project is NOT located in a city, a complete copy and all supporting data of the application should be submitted to the Administrator of the Shoreland Manage- ment Program for the affected county. Complete this form for each notice served on a local government official. SECTION I (TO BE COMPLETED BY APPLICANT) TO: A) Chief executive officer of the (cheek) 2K city, Q township of 7Rn^ o t B) Secretary of the board of managers of the watershed district. print or type name) C) Administrator of the shoreland management program of county. (pmnt or type none FROM: zzoo 5/6&1EQ LOAWA"d Date: OCT /2 192-7— print or type nameaddress of app scant INSTRUCTIONS FOR THE LOCAL GOVERMENT This report from provides you an opportunity to submit input to the Department of Natural Resources to assist in deciding whether to grant, modify, or deny the requested permit. It is NOT absolutely necessary for local agencies to officially approve or disapprove the project -or make any recommendation, although this may be done if desired. It is requested that local agencies indicate the following, as applicable: A. The relationship of the proposed project to local plans for the affected water and related land. B. The relationship of the project to local land use controls including flood plain and/or shoreland regulations. (continued on reverse side) w-221 C. Any possible effects of the proposed project on the water resource, navigation, fish and wildlife, conservation, pollution, and the general public interest. D. Any recommended modifications in the proposal or other alternative way of achieving the desired objective which would reduce undesirable effects. E. Any pertinent factual data available concerning the water body or the proposed project. F. Reasons for any local objections. Please complete this form and return to the address shown in the lower left corner of this page within 1S days, if possible, or inform the department if additional time is needed. SECTION II (TO BE COMPLETED BY CITY, TOWNSHIP, WATERSHED DISTRICT OR COUNTY) The applicant named on the opposite side of this form submitted a copy of his water permit application on 19 It has been reviewed and the following comments are submitted for consideration by the Department of Natural Resources. P],atted properties are included in a storm sewer plan for the area. Properly developed, the lots in question should not be detrimental to overall development in the area. However, limits of fill should not encroach more than 20 feet into: the.:existing40' rear yard -drainage and utility easement, without appropriate extension of existing storm sewer system. (Attach additionaZ sheets if necessary) RETURN TO: DEPARTMENT OF NATURAL RESOURCES Division of Waters, Soils & Minerals Regulations Unit. Centennial Building St. Paul, MN SSISS Dated October 24, . 1977 19 Gov't Official's name Richard N. Sobiech, P.E. print or type) Signature Title Public Works Director Address 6431 University Avenue NE Fridley, MN bb432 m cic i COwO ,y . m cic COwO . SUBJECT City of Fridley MwTn�� 6 8 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIP COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC.CDC f r i NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7/13/93 10B ADDRESS 1445 North Danube Road NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 3 Innsbruck North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Darrel Gubrud 1445 North Danube Rd NE 574-1226 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Dube Construction 8609 28 Ave N NeWr Hoe MN 55427 593-1582 4497 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 ElREMOVE x❑ 8 DESCRIBE WORK Reroof Dwelling & Garage (:29. S uaresl Tear--off (_Cedar Roof) 9 CHANGEOFUSEFROM TO STIPULATIONS 7,nstall smoke detectors as per UBC 1210 adjacent to all sleeping areas and in basement. Provide ice and water protection at eaves and valleys, Provide adequate attic ventilation. 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 $8,500 $4.25 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- $108.00 Fire SC $8,50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $125.75 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEIP OPE ALIDATED THIS IS YOUR PERMIT BLDG WSP GATE SIGNATURE OF OWN ERIIF OWNER BUILDER] IDATEI NEW [ ] Effective 5/26/93 ADDIS [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ��l r} - Building Permit Application Construction Address:7a„ �.e, �J /vv// s Legal Description: 1 7 /a c 3 .L y n Xk- J c K / �0 �� Owner Name & Address: Tel. # s y -Z,2a 6 Contractor: �u cc � s �r� � },o�� MN LICENSE # 000 YY2 Address: 8� 7 ,�g/�/� /�! /��_.v 66-- 1412 Tel. # f9 '?- is -®a 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: Lengtpph ( �J Width Hgt/GroundT Sq. Ft. OTHER: 9t Ido 0 7, 17° vs L �jA, JL 9 59 1 e a s Corner Lot [ ] Inside Lot Ft. Yd Setback Side Yard Setbacks Type of Construction: 94o4,_l U2AL6, Estimated Cost: $ ffS-00, 00 Approx. Completion Date:/ JT Ce J a,- AD- j A C .- J y 9 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: r-2/9 9 3 APPLICANT: - �. Tel. # S i 3 - /s F,;?- CITY USEN� L -Y, Permit Fee $ f 616, tX) Fee Schedule on Reverse Side Fire Surcharge $ 0 .001 of Permit Valuation (1/10th%) State Surcharge $ - '�5 $.50/$1, {� Valuation 12M e $ $750 g � Ze��J SAC Char SAC Unit c l _ 3 License Surcharge $ 0 $5.00 (State Licensed Residentia Driveway Escrow $ Alt. "A" or Alt. "B" Above ��l�`• Erosion Control $ Conservation Plan Review $450.0 Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ S �-� STIPULATIONS: s Lf ,{ARCI IITEi - TELEPHONE �7d 7'K (H)'' Cd7:.9cYe1Fi �W) WORK TO BE j'ERFORAAED AT We propose to"furnish' all the materials aY►d perfprm all the Jabor;neceS,Sary for xFie completion Of _ ,.: Rt.�mnve+, 'r�ari Lat n� C�c"iar :` ��n��'� ris �7 avr+ca $Yid waf48i $fleet On fir$t r <- ti 3na] t nn Tama ni n4f` lniubin .tanks - °vents k'.' ._..420A All material is uaranteed to o as specified, and the above-wor g pec' k to be performed in accordance with the drawings andspecifications sub above work and completed in a substantial workmanlike manner for the sum of Fight thousand fivehWandred ----------------------------- Dollars ($ 8500.00 with payments to be made as follows: _ 50% on the start- 7/6/93 25% on or .before 8/15/93 ..25% on or before 9/15/93 Any alteration or deviation from'above specifications involving extra costs will be executed only 6pon written orders, and will become an extra charge over' and above the estimate. All agreements contingent upon strikes, accidents or delays beyond. our control. Owner to carry. fire, tornado and other necessary -insurance ytpon;above work - - Res II Submitted Workmen's Compensati6marid Public Liability Insurance on above P Y . work taken out by Jim Dube' ' Per Dube.. CdriStruC'tj on Five' year'.warrenty''onworkmanship ° ACCEPTANCE R OPOSA OF PL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to Accept -ed_ Signature do the work as specified. Payment will be made as outlined above. Date Signature DUPLICATE WHSO Jaaes . w USA 44-M •Owrsww ,es. IM 410 W. LAKE ST.1072 PAYNL- MINNEAPOLIS, MN 55408-2998 10 1 Mil ST. PAUL, MN 55% 612/824-2656 oNN612/772-2449Lc:AtNAR0 8c"ing nic 7WM Cities Since /930' ORSAT TEST RECORD ADDRESS CITY OCCUPANTS OWNER DATE HTG. INST. ^NSTALLED BY�� GAS LINE BY TYPE OF HEAT: GA FAHW STEAM SPACE HTR. GAS DESIGN MAKE MAKE MODEL JO q,MODEL SERIAL 01S f/ 2 MAX. INPUT //0,00-D MAKE UNIT HTR. OTHER CONVERSION R BTU RATING OF CONTROLS MODEL THERMOSTAT�-Iklt HEAT PLUG VENT SIZE. VALVEKIND OF LINER' SIZE �' NONE LIMIT � .� DRAFT HOOD REGULATOR LIMIT SETTING /,i CHIMNEY,t-,QNSTRUCTION 9 v FAN SETTING DRAFT 'o,) TEST TAG PILOT TYPE�LIGHTING INST._F" fi PILOT MAKE PILOT MODEL PILOT TIMING PRESSURE _ PERCENT CO2 t DATE TESTED �- INPUT CFH,/,j PERCENT 02 IS � STACK TEMP. d PERCENT `COAME. OF TESTER'S-=�` �.�- CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOUNG, VENTILATION, 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) 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 $ $10.00 $ $10.00 $ $ 10.00 $ $ 25.00 $ State Surcharge TOTAL FEE $ .50 MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 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. JOB ADDRESS l Ll 1-15 0' 04 n U b ,e-- U. I 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 ancorrect. ,1997 OWNER • J D e— BUILDING USED AS ESTIMATED COST ® L/' PERMIT N0.� DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water arm Air) Trade Name Orh Size No._3 S"_ BTU J / 0 � HP EDR Fuel vi ,-,('� Total Connected Load Burner Trade Name BTU HP Size No. EDR +-NDARD HEATING AND AIR CONDITIONING CO. 410 WEST LAKE STREET HEATING COMPANY FANNEAPOLIs.MN 654W2M Signed By Tel No. Approved By Rough—In Date Final Date FILL OUT BACK SIDE FOI STACK VERIFICATION ON REPLACEMENT FURNACE Remarks: . List ALTERATIONS Being Done: U HEATING CO: Signed By: Date: CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the. existin chimney or stack: T. Has been carefully examined Yes O No ) 2. Is free from rust or deterioration Yes O 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 other 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 Being Done: U HEATING CO: Signed By: Date: SUBJECT P"a� City of Fridley 336 AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. RECEIPT r PROTECTIVE INSPECTION SEC. � � 1 NUMBERDATE REV PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 ' 763-571-3450 910-F15 3/14/03 10B ADDRESS 1445 North Danube Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 7 3 1 Innsbruck North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joe Andert 1445 North Danube Rd 763-574-2420 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Standard Water Control 5337 Lakeland Ave N Crystal, MN 55429 763-537-4849 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 1522 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Draintile 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION Ck REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK 9 CHANGE OF USE FROM TO STIPULATIONS 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT THE GRANTING OF A PERMIT $6,200 $3.10 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS F ANY OTHER STATE OR LOCAL LAW REGULATING CON. TRUCTI N THE PERFORMANCE OF ONSTRUCTION $137.25 Fire SC $6.20 PLAN CHECK FEE TOTAL FEE �/ tiv) a vLic s SC $5.00 $153.55 SIGNATURE OF CON TRACTOR OR AUTHORIZED AGENT (DATE, NP ERLY V LIDATED THIS IS YOUR PE IT SIGNATURE OFOWNER .IFOWNER BUILDER, 'DATE' lOG SP DATE NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg lnsp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: j�jr Baq u 6 i�d Legal Description: Owner Name & Address: � � Tel. #��- Contractor: '5—tar,Q'ard Z�67 br MN LICENSE # /Jo7c Address:�y1�1L�-2.5�%agTel. # 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: Construction Type: dra-cr, bko-' Estimated Cost: $ /,a ezwz 4lJ Driveway Curb Cut Width Needed: Ft. + 6 Ftp= Ft x $ _ $ DATE: 3 �/ APPLICANT: % /lei k Tel. # -763 - 37 ye4 Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ A�3_ja CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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: