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PRE 2010 DOCSi` weAir ftr Purer Pkm t: and Heali ft Cooling, Ventilation. Refrigeration and Air Conditioning System and Devices PARTIAL RATE SCHEDULE GRAYrTY WARM AIR: NATE TOTAL a Furnace Shell do Duct Work ................ .. $10.00 $ Replacement of Furnace .... . ..... .. ..... . 6.00 $ Repairs & Alterations—up to $500.00 600 $_ Repairs & Alterations each add. $500.00 3.00 $— - — MECS. WARM ADI Furnace Shell & Duct Work to 120,000 BTU ........ ..$10.00 each add. 60,000 BTU .................... .. 3.00 i Replacement of Furnace .. .... .. .... 6.00 Repairs & Alterations—up to $500.00 .. 6.00 $ Repairs & Alterations each add. $500.00 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 $. Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam 3.00 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 Fee Schedule GAS BURNER (up to 199,000 BTU) . ...... 6.00 $ 5.00 over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures .. . .... x$ 200 $ 2.00 Additional Fixtures x .76 $ Gas Range to 199,000 =$ 5.00 $ AIR CONDPriONING WEST: S36 0 ton) $ 18.00 FAN HEATING SYSTEM Soo Fe't`1M>dsm) V ITILATING SYSTEM $ .50 SURCHGE ALTERATIONS & REPAIRS TOTAL FEE $ 35.50 ROUGS FINAL _5- F - 7 52'� Dept. of Bldgs. rl.om 560-3480 Lente 1479 No. Innsbruck Drive City of Fridley: -, The undersigned hereby makes application for a permit for the work herein 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 facts and representations stated in this application are true and correct. Fridley. Minn- Aug. 14. 197 it -- owner Robert Laugen Homes KInd of Building - frame Used as - - ---- -. --residential To be completed about --9-/30/73- Estimated Cost, $1.-665.00 Old—New. Building Permit No. Permit No. -4r17W "/ DEdCBI>r'TION OF WORK HEATING or POWER PLANTS- Ste=6 Not Water, Warin Air—No 1 Trade Name LEW01S Na- G11s137 Capacity 110.000 Sq, Ft, E.D.R BTU S.P Total Connected Load- 66 s 284 Kind of F1iet Gas BURNER — Trade Name SAME AS ABOVE Size No Capacity Sq. Ft. E.D.R BTO MIR. HEAT LOSS ATTACHED. SAIESNAN: Don Bell (REMARKS -OYER) Sim Business P'h� V T 8e [` ATR CM HONING 3260 C-ftm Are. ' 924-6767 AL laab Park, M"' -fa 55425 Windows and Doors --trackage and Area 1coef. Btu Area sq. ft. JV, Infiltration 14 Infiltration coef. Glass Infiltration HEAT LOSS CALCULATIONS Glass Exp. wall Glass Exp. wall -4 Exp. wall Net exp. wall[%1,2 Net exp. wall f- �' -Z Net exp. wall— Weatherstrips, A.S.H.V.E. va Construction No. Int. , vall Insulation Guide Poor Total Btu. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. Win,doivs Doors Reference Out. Wall Int. Wall Ceiling Roof Kind How Applied Yes—No —Yes—No 19— Room I Length/ Width Height 2 Fl., Room I Length Width Heiaht7l� 'Windows and Doors—Crackage and Area Windows and Doom—Crackage and Area* Width Height NO. of Lineal ft Area No. of pane of pane lights of crack sq. ft. I No. Width of pane Height No. of Lineal ft. Area of pane lights or crack sq. ft. r�7 7 Windows and Doors --trackage and Area 1coef. Btu Area sq. ft. Co1 Infiltration 14 Infiltration coef. Glass Infiltration c. Glass Exp. wall Glass Exp. wall -4 Exp. wall Net exp. wall[%1,2 Net exp. wall f- �' -Z Net exp. wall— Int. wall va Int. , vall Ceiling CedingFloor Poor Total Btu. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room Length Width Height 171.1 --Room (Length Width Windows and Doors --trackage and Area Width Height N% * of Lineal ft No. of pane of pane ,ff is of crack Area sq. ft. -7 coef. Btu Infiltration Coef. Btu Infiltration Glass Glass Exp. wall -4 Net exp. wall[%1,2 6 f- �' Inc. wall Net exp. wall Int. wall Ceiling Ceiling 1 7, Floor RM Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane of I =9 Ifghta of crack sq. CL -7 coef. Btu Infiltration Glass r"I(V Exp. wall 6 Net exp. wall Int. wall Ceiling 1 7, Cily of Fridley APpl�c�t%n for Pkmbbe aud Gas F!"big Pwmtt DE8C nrnoa of WORK Numbm. ltd and l.ocatim of tom" PARTIAL RATE SCHEDULE IMVM IXC. illrrg= RATM NM "TZ TOTAL. Num zxbrM ................ . _ FUtomaadweOpraft....:...... :sflao deo b 2ftw� 711dure am Opening .......... / Basra.............!!•!!.a —Ram f Water Raster RTp to lUjw BT't .... s = jW g 3-01 New' Gratmd Rua OM Bldg:........ z SM ; zieatde Watmueawr ............. a am i ew" iT Tll G rccL_ W06 RATE TOTAL lot � (. IM j a - o o .............. L. s +' an Ra,* to 110.00 Brea ..........a z 85.W 6 State Surcharge $ .50 ZIT it A&T=ATXWW-AatW lot Cala •..►a... ...\i s.laps... spa.. a....l.a.� jja11i •1 8� 32-L' City of T idiom: The undersigned hereby makes application for a permit for the sorb hen&- - specifted. agreeing to do all Boric in strict aceaadame with the (3ty Ordvumwr- and nding of the Department of Buddin^ and hereby declares that all the fad---- and representatIons stated to this appHestim are frac and correct may. lam ? �- Kind of Building Used as To be cued. about Estimated coat„ i 361& OM--Nes►. Building Primit into ?man lu L BY— Business phuse l- 5-Y,5- -e a 0,7 FlbfltL O® - ez < - i i ��eii�i.■.weW e■.. ................ PARTIAL RATE SCHEDULE IMVM IXC. illrrg= RATM NM "TZ TOTAL. Num zxbrM ................ . _ FUtomaadweOpraft....:...... :sflao deo b 2ftw� 711dure am Opening .......... / Basra.............!!•!!.a —Ram f Water Raster RTp to lUjw BT't .... s = jW g 3-01 New' Gratmd Rua OM Bldg:........ z SM ; zieatde Watmueawr ............. a am i ew" iT Tll G rccL_ W06 RATE TOTAL lot � (. IM j a - o o .............. L. s +' an Ra,* to 110.00 Brea ..........a z 85.W 6 State Surcharge $ .50 ZIT it A&T=ATXWW-AatW lot Cala •..►a... ...\i s.laps... spa.. a....l.a.� jja11i •1 8� 32-L' City of T idiom: The undersigned hereby makes application for a permit for the sorb hen&- - specifted. agreeing to do all Boric in strict aceaadame with the (3ty Ordvumwr- and nding of the Department of Buddin^ and hereby declares that all the fad---- and representatIons stated to this appHestim are frac and correct may. lam ? �- Kind of Building Used as To be cued. about Estimated coat„ i 361& OM--Nes►. Building Primit into ?man lu L BY— Business phuse l- 5-Y,5- -e a 0,7 FlbfltL O® - ez < - i i SUBJECT IT City of Fridley oRM13664 AT THE TOP OF THE TWINS BUILDING PERMIT L. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 IL NUMBER REV. DATE PAGE OF APPROVED BY L•"'J4�' r I.J 612-560-3450 910-F15 7/23/76 JOB ADDRESS 1479 North Danube Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 3 Innsbruck North SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gary R. Samuel 1479 North Danube Road N.E. 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 C. ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 20' x 16' Addition onto Dwelling SEPERATE PERMITS REQUIRED FOR 9 CHANGE OF USMEATING 1 IG q STIPULATIONS WARNING Before diaing call local utilities TELEPHONE - ELECTRIC • GAS Etc. REQUIRED BY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ] 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. $6,000 $3.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT ESUME TO GIV UTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISION OF ANY OTHE ATE OR LOCAL LAW REGULATING CON- $23.90 STRUCTIO OR THE P O ANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE `% Z3-7"a $26.90 SIGMA EO CONT CTOR OR AUTHORIZED ENT (DATE) WHEN PROPERLY ALIDATEO THIS IS YOUR PERMIT 1 -BLDG INSP DATE SIGNATURE OF OWNER (IF OWNER BUILDERb (DATE) 4U'1'L1 CA11UN 1•Ulc KCJ1 u1:,vt IJ+L., J1LiA iA%1% iv•I, OR ADDITION - BUILDING PERMIT (rLL (,•�/y-%6� • CITY OF FRIDLEY, MINNESOTA • L -l� �i To , S M,1.1 I>: r Y (`� BUT R: A , O14N ► ' ADDRESS :,14 a �� t° ADDRESS STREET • I) A, q 1�,4__ i.OT : BLOCK • ADDITION :� { INSIDE LOT SETBACK: SIDE -YARD: COMTER LOT: f - Applicant attach to this fora. Two Certificates �.,f Su Ve .of Lot and .proposed s ' building location diswn on these Certificates. DESCRIPTION*OF BUILDING ; a To Be Used As: @ tie red .-Aro • - - Depth: • Front: � _0 p �6 D Height • . - Square Feet: Cubi e . Feet : 14A 6 • Front.' Depth: Height: Square Feet; Cubic Feet: Type of Construction: d.i Estimated Cost: $ To Be Completed: 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 anrulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. r� • A4TE: �'-9-.-- 7.h SIGNATURE. (See 4leverse Side For Additional Information.) • r ,� F � �, � � : �6• - ,S�/ �u t ATS vrJ S • . lowly a amu: r I. MAT a�! r r , -10: d,. r r , -10: h d,. Y t qq { r �iRtt /y lit t ryim tt , -tkASO ,t at - r r r tai r!c i Act t �� 4t 2 Lc>t 4 • F� J p C1K ,S r F Cl aB�,UCK xi49" r r , -10: Y t qq { r �iRtt /y lit t ryim tt , -tkASO ,t at - r r r tai r!c i Act t �� 4t 2 Lc>t 4 • F� J p C1K ,S r F Cl aB�,UCK xi49" qq { r �iRtt /y lit t ryim tt , -tkASO ,t at - r r r tai r!c i Act t �� 4t 2 Lc>t 4 • F� J p C1K ,S r F Cl aB�,UCK xi49" u SUBJECT PERMIT City of Fridley 2492-91 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. L -_---_ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC jZ4eZ7_ CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 3/28/97 JOB ADDRESS 1479 North Danube Road NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 4 3 Innsbruck North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Terry Reyes 1479 North Danube Road NE 571-8335 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 Xf] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (25 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,062 $1.03 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- $74.75 Fire SC $2.06 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $77.84 S NATURE OFCONT RACTOR HORIZEDAGENT IDATEi WHEN PRO ALIDATED THIS IS YOUR PERMIT _ 3-0200, ,` B NSP DA7 SIGNATURE OF OWNER OF WN UILDER� ,DATEi u NEW [ l ADDN [ ] ALTER [ ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: /-179 & Ll �a41/ � e leal Effective l/ 1/97 =0 Legal Description: Owner Name & Address: err eS 1V,0a,,1jt 61 Tel. # s7/ X 335- Contractor: DGvn ie*- MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length DESCRIPTION OF IIVIPROVEN[EnNT` Width Width Height Height Tel. # Sq. Ft. Sq. Ft. Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x. $ DATE: Ah. APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ 001I/:1I STIPULATIONS: $o" CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $950 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 [ ] 5 2 / 5-.335 CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, 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 Rate TOTAL $ 30.00 $, $10.00 $ $10.00 $ $10.00 $ $ 25.00 $ All Others/Repairs & Alterations (UST ON BACK) 1 % of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work State Surcharge TOTAL FEE JOB ADDRESS I `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 and correct. — o C . ,1997 OWNER BUILDIN ESTIMATED COST J 9 D ® PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) Air Trade Name_ A mcm(� Size No. U � 9� BTU 1 HP EDR $ Fuel Total Connected Load $ 50 Burner Trade Name Size No. BTU HP 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. EDR VORT WAPNQ & AIR CONOIYIONING 3260 GORHAM AVE HEATING COMPANY s7. LOUIS PARK, MN 5w6 WES 929-M SENCE 92M1 I pp Signed By415a O'v� Tel No. Approved By�O Rough—In Date Final Date FILL OUT BACK SIDE FJ STACK VERIFICATION ON REPLACEMENT FURNACE r�o�v�rnrr<-� � ,•, � ,oy 0 3 3 � rn 3 r • X o o x H i� QQZv5< Iii I A, z 3 3� x0H o d r co:� �I >I SII m:H r • r � o Remarks: . List ALTERATIONS .Being Done: HEATING CO: Signed By: Date: CHD04EY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (L� No 2. Is free from rust or deterioration Yes WNo ( ) 3. Has no foreign objects lodged within Yes ( ) No 4. Is securely supported Yes WNo { ) 5. Meets all current Code requirements for size and total BTU's connected Yes MINO ( ) 6 Has total heating BTU's of All other BTU's 1�9 0710 TOTAL BTU's /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: HEATING CO: Signed By: Date: W- 54' STATE OF MINNESOTA RS V.. 74 DEPARTMENT of NATURAL RESOURCES Division of Waters, Soils & Minerals - APPLICATION FOR PERMIT TO WORK IN PUBLIC WATERS n �Ja �+A . r�+n ^t= , the owner of land is Government lot(s) , prmnt or type app aeant s none quarter section(s) section(s) , townshipnono.(s), range(s) , Lot 5 � . 7 , -d1nC's I. fire no., s no. or address)�(%t, bsubdiviewn) county(ies) -q no ,P , which is riparian to ?=ratlind , ncmre of Lake or stremn 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, YL2�7 fill, /77 construct, = remove, (check) Q install, Q abandon, or Q' other(specify) �n*-tnvr� Haat _ f 1 1 THE FOLLOWING: Q dam, Q shore -protection, Q shoreline, Q harbor, Q channel, Q bridge, (check) Q culvert, Q wharf, Q obstruction, or = other (speoify) 1;T,,t l and JUSTIFICATION Explain why this project is needed: rn io -n-ke lot3 b�iildable for single family hnries. ENVIRONMENTAL IMPACT 1. Anticipated changes in water and related land resources: tiny^roXl:'.1ate1'r i,.Oiu of the existi-17 :3'lrf'n,7e wetlp:1.'j nrei krill be filled to c_cc7;lcdate construction 01"si'1;1Ze farai_ly, ''norges. 2. Unavoidable but anticipated detrimental effects: `•`ininal reduction in stora.;e c2racity. joss i.11 be diverted to P 11 acre area annroxinately 10JJ' feet From the location in c•yeftion. 3. Alternatives to the action proposed: rcn�i e�tna tion PROJECT SITE DATA 1. Describe the type and amount of aquatic vegetation present: 20,- Sed RA anti �0 U cattails. 2. Describe the nature of the material beneath the water: r` e t• . 3. Describe the nature of the upland area: 1,3- ;--nd a id 90 •u cl-Nr -nd r,vooded. 4. Describe type and amount of nearby shoreland development: '1'l',^^ilr:iatnlV 1.330' feet is an 11 ?c'_^e that is c':.rr-nt1v and will be c,innected by S. ENCLOSE SKETCH DESCRIBING WATER LEVEL FLUCTUATIONS. (see inatruetions) (continued on reverse side)- 11,977. ide) 11977Nil AX nondinm Pnd wetland area storm nine. ATTACH EXTRA SHEETS IF NECESSARY Channelling. Existing Total length (feet) - - - - - - - Length in lake/stream (feet)- - - Bottom width (feet) - - - - - - - w-54 CONSTRUCTION DATA (also attach sketch or drawing) Proposed Alterations along shore. Proposed Distance along shore (feet)- - - - -. -,, Distance waterward (feet) - - - - Side slopes (ratio) - - - - - - - Thiekness of fill material (feet)- - - 7 Average depth (feet)- - - - - - - Gradient (5)- - - - - - - - - - - Depth of excavation (feet) - - - - - -mow 1. Describe type of excavation equipment to be used, if known:. "ackhoe and cat 2. Describe location (incZude map) and characteristics of spoil disposal site proposed: ,)eat will be stoc ,-piled on New Bri -hton land Tintil constriction is comrlete. Then it will be bro,i?'it b C^,C to virnzS SiteS PS tonSo 1. 3. Would maintenance excavation be necessary? (oheck) = YES ZZ& NO Explain: 4. Volume of material to be removed initially (cubic yards): Muck or silt �,O, Sand or gravel Rock or stone ATTACHMENTS Q $15.00 filing fee. Q 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) Name of city or township street' d post o aoe (2) Name of GFershed diatzwl6t: I (3) Shoreland Management Administrator of County Dated this 7� day of(fit - ' 19 � Signed DpVerre Cnrnnrnti n (appticant) l ease Address 2200 ilver Lake Road City "T ew Rri "Nton State i l n n r— Zip code 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 l 19 W-221 - ' Rev.�74 STATE OF MINNESOTA 07 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 APPLICANTO TO: A) Chief executive officer of the (check) ,K city, Q township of F.elloG� 7Mnt or B) Secretary of the board of managers of the watershed district. print or type name C) Administrator of the shoreland management program of county. Co"CAAnow print or type name FROM: zZoo SmsrFA LOAW%Z4d Al, -Aa &o&*07vN SS//Z Date: ocr % 1922— print or type name &&address of app zcant INSTRUCTIONS FOR THE LOCAL GOVERNMENT 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 a 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 15 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 55155 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 bb4.3Z ITY OF FRIDLFY . a.zj i7 Q, Ral � y7 1.0 °`ri?s3 � 9 0 s '6 i, I yi 77 5� y.1454 � '. meg, ► s• ee OUTLOT re - mo. 03 fiR q(4k3 CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE \ES I DZ%T IA L Furnace Shell and Duct Mork, Burner (Also replacement furnace) Gas Piping (Piping needed with new furnace) Gas Range Gas Dryer a Air Conditioning (all sizes) RATE TOTAL $ 20.00 $ $ 10.00 $ S 10.00 $ S 10.00 $ $ 10.00 $1060 All Others/Repairs and Alterations It of Value of Appliance or Mork S COMMERCIAL/INOUSTRIAL 10 of Value of Appliance or Ifork S State Surcharge .SO 'i10M P'Et. Reinspection Fee (S15.00) S Rough Insp. Date Final Insp. Date Approval for Permit 1 MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS 5.50 STATE SURCHARGE Attach stack verification form with replactvont furnace permits *Air tu+nditionern can not kis- placed in •ad.• yard without written pn rmissmon from admuung trt.11d■.r. Job Address •...r��.,. ^. #. . 6'1111 11-479 Noah'b Q1,i rtibt M, ,VF- Oeh.artment of Buildings. 6111 University Ave. N.C., rridley, NO SS432 City of Fridley Tel. IS71-34SO The undersigned hereby wake/ application for a permit for the work heroin specified agreeing to do all work in strict accordance with the City Cados and rulings of the Department of Buildings. and hereby declares that all the facts and representations stated In this application are true and correct. rridley. Minn. a-1 . 19 OWNER I �r t L -J RIND OF BUILDING Q6�cde&j l 4 ll it USED AS (,�` TO BE Cd—3V IPLETED ABOUT ��.��"� ESTIMATED COST 'PaRc o a � c OLD - NEW BUILDING PERMIT NO. pawl? No. DESCRIPTION OF ruwACE/BUiWtlt HEATING or POWER PLANTS. Steam. not Mater. Nam hit- No. Trade Name Gl rr i �e r Size No. Capacity Sq. Ft. CDR BTU H► Total Connected toad Rind of Fuel BURNER - Trade Name site No. capacnty V� Sq. Ft. EDP 01M RP Company UJ Si7ned By ,NiinQ.,d . /t L��1f✓L�- Tel. No. �� d �� 3 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Effective On January 1, 1995 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Urinal �Tu ::I Shower NO. RATE Water Heater — Gas —� Gas Range Gas Dryer Back 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 $5.00 Wash A Floor tch r Auto. Gas Mi Water Heater Tray Fa.._. Drain I asirt T Washer App�a ='t Range .Fixe., .*11a� Gas Else TOTAL Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS / /U 1 % of Value of Fixture or Appliance State Surcharge .50 TOTAL FEE 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. ,199.5 Owner O G n ri Building Used As v � Estimated Cost ® PERMIT NO, �� PLUMBING COMPANY LIZ ,r SIGNED BY �� TEL N0. 97 �U L Approved.By) ugh—In Date Final Date I MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY INSPECTION DIVISION L?` 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, 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, but not replacement) Gas Range Gas Dryer mains *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 Effective On May 10, 1999 JOB ADDRESS A/ ? &!,bz,,a&IZe_ ?J, ^cZ OWNER Rate TOTAL BUILDING USED AS $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr $ %/d/_� ESTIMATED COST �el®1 `70 PERMIT NO. $ DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name Size No. BTU HP EDR $ Fuel Total Connected Load Burner Trade Name Size No. $ BTU HP EDR $ 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 an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are*true and correct. $' HEATING CO *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. zd X/ D.s a &01 o'l 5339 Signed/G� DATE Approved By Rough -In Date Final DaAC�3� CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () 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: HEATING CO: Signed By: Date: SUBJECT City of Fridley 3383 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. 1 a: ------COMMUNITY DEVELOPMENT DIV. 9 r E PROTECTIVE INSPECTION SEC. 1111 l �-, `F�' E � NUMBER REV DATE PAGE OF APPROVED BY E _ .."'1 CITY HALL FRIDLEY 55432 ....... I.J 763-571-3450 910-F15 8/27/03 JOB ADDRESS 1479 North Danube Road NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 4 3 I Innsbruck North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Terry Reyes 1479 North Danube Rd NE 763-571-8335 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal By Andersen 1920 Co Rd C W Roseville MN 55113 651-264-4777 20130983 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 ❑ ADDITION ❑ ALTERATION ❑ REPAIR X ❑ MOVE O REMOVE 8 DESCRIBE WORK Replace two patio doors within existing openings 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. PermitInspection Cards Will Be mailed To Homeowner To Pem 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 SO. 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 ISTALLS 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 $4,290 $2.15 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- $111.25 Fire SC $4.29 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE -bkcen SC $5.00 1 $122.69 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATE, EN PROPERLY VALIDATED THIS IS YO R PERM S-GNATURE OF OWNER of OWNER SUILDERI - JDATEi OG NSP f A E NEW[ ] Effective 5/10/99 ADDN [ l CITY OF FRIDLEY ALTER [ ] SINGLE FANULY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: ' �l��lGl �, •r1� . �CQ : (�(,� Legal Description: Owner Name & Address'. V -t f P r c, Tel. #I L92).6al I . t5 �j Contractor.;•woo' MN LICENSE # �013098'� Address: 19 a o Coffin 'c Dod C W est: ► ; 11t mt� SS a Tel. # (ceal • alo4.4�i- . 1 Attach, for this application, a Certificate of Survey -of- the lot, with the proposedconstruction drawn-hn it to scale. DES.CRI ON OF "--X0VE111ENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: �/µLength Width Hgt/Ground Sq. Ft. OTHER: T \�� r0 r P , iY r'\r. -i 0 n l 4fh on n Construction Type: Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # �j a •34S • loot{ CITY USE ONLY $ II . Permit Fee "-' Fee Schedule on Reverse Side Fire Surcharge $ �{ • .001 of Permit Valuation (1/10th%) State Surcharge $ 1-5- $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ .00 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Sewer Main Charge TOTAL $ «c STIPULATIONS: Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 01 SUBJECT P City of Fridley 1�?12246 AT THE TOP OF THE TWINS PERMIT i � BUILDING � t U. COMMUNITY DEVELOPMENT DIV, g J 7 I&U.3 r PROTECTIVE INSPECTION SEC. 1 � i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-580-3450 910-F15 7/20/73 JOB ADDRESS 1479 North Danube Road N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 3 Innsbruck North; Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gary Samuel 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Robert Laugen Homes, Inc 6866 East Fish Lake Road 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 EX NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 8 DESCRIBEWORK ConstrucL 54' x 38.6' & 24' Dwelling and 30' x 24' Garage 9 CHANGE OF USE FROM TO 1 STIPULATIONS Provide a hard surface driveway. Provide a verifying survey before capping. SEWER LOCATION: "Y" 88' East of Manhole WATER LOCATION: 10' East of Sewer (Approx.) SEPE.RATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 34,180 Total 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 $333,560 16.78 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT O VIOLATE OR CANCEL THE DOES NOT PRESUME TO GIVE AUTHFOCAL PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTH STATE LAW RGULATING CON- 64.00 275.00 STRUC N O THE P F MANCENSTRUCTION. PLAN CHECK FEE TOTALFEE G i - 23 ' 'Z� 6!S41NATURE 355.78 ' OF CONTRACTOR OR ALTTHORIZ GENT (DATE) ,' WHEN PROPERLY ATED THISISYOUR PERMIT. SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) .. . ^'6LOG INSP BATE 01 APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: UA2 Y P SAM UE BUILDER: _j�OASEZ /-A tv / me ADDRESS: ADDRESS: 6866 �A5; F-1sN l Oke )�z' . NO:. I LI71' STREET:_ /4627--j D14/) aA1 IhAQ LOT: BLOCK: 3 ADDITION :jS�iYS�,P/.lc�f CORNER LOT: INSIDE LOT:_SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: r Front:_ Depth: �' _`f Height: Square Feet: Cubic Feet: Front. ,I� Depth: Height: pp Square Feet; Cubic Feet: l Type of Construction: 001 �� AV`f�� . Estimated Cost: —$ E, To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict 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 SIGNATURE: V< (See Reverse Side For Additional Information.) 1 At CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 F63) 572-3604 FAX: (763) 571-1287 ADDRESS : 1479 N DANUBE RD NE PIN : 243024420023 LEGAL DESC : INNSBRUCK NORTH LOT 4 BLOCK 3 PERMIT TYPE BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 2,500.00 NOTE: REBUILD BRICK CHIMNEY FROM TOP 3 COURSES UP PER APPROVED PLAN. STATE LICENSED CONTRACTOR 1 APPLICANT BAC CONSTRUCTION SERVICES LLC 6015 LYNDALE AVE S 1VIINNEAPOLIS, MN 55419 - OWNER REYES TERRY J & CONNIE A 1479 N DANUBE RD NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Bldg PERMIT.:2004-01128 DATE ISSUED: 07/19/2004 BUILDING PERMIT FEE FIRE SURCHARGE STATE SURCHARGE, VALUE LICENSE SURCHARGE TOTAL PAID WITH CHECK # 6727 Permll Inspection Cards Will Be Mailed To HomeoWner To Post SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 83.25 2.50 1.25 5.00 92.00 NEW [ ] CITY OF FRIDLEY Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 - (763) 57.-1287 Fax BUILDING PERMIT APPLICATION j 0k)cVC1 Construction Address: 114-M V ®Wlh bayLda, Igen e,�, q��020' Legal Description: Owner Name & Address: Contractor. MN LICENSE # v;i Ok9 Q-O(P a Tel.#W-731-5SO® 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: R 4.buI 1A Bid ( f�' 0WArY% \Lj GtYn 3 C Construction Type: C�VY\(\� WCWk, Estimated Cost: $ .rJ� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: ( APPLICANT: 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. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - $ TOTAL $ Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) 4a $.50/$1,000 Valuation $1350 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: Building MECHANICAL Permit No.• - - Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604CITY OF FRIDLEY ' DATE 9-3-o_? YOUR E-MAIL ADDRESS SITE ADDRESS 14'1 c1 � c n ix h e_ RcO. _/v THIS APPLICANT IS: 0 OWNER CONTRACTOR PROPERTY NAME:Onn e- e e _ ADDRESS: lq-Ti,�� nic be CITY 6'i c� I e ✓ STATE�/6ZII��% OWNER/ TENANT PHONE: 2&3-4-9 �3 CONTRACTOR ` COMPANYNAME: a GaCl' CONTACT PERSON— PGC SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS:6R:;9 `/vim ;Je nn: 4 r L-a n e CITY�o r phS -�u u-i STATF�n.ZIP5�/O7 APPLICATION PHONE �-1 -`744t- &027 % FAX / -2 41a - � -2 di PERMIT TYPE VSINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: O NEW o REPLACEMENT 4TERATION/REMODEL _ DETAILED DESCRIPTION OF WORK PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) /�� Equipment Installed MFG: Pc, � Qr/L✓ 115,4094)MODEL: SIZEIBTU MFG: MODEL: SIZEBTU MFG: MODEL: SIZE/BTU A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $15 FIItEPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 FURNACE $35.00 GAS UNIT HTR $10.00 CHIMNEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 y x $15.00 = $ m v� TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .5p Total = $ ,� U 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 o all work which re uir review and approval of plans. p SIGNATURE OFAPPLIC Ci • PRINT N i't DATE PLEASE NOTE: SE_PAMTE PERMITS ARE REQUIRED FOR BUILDING ELECTRICAL AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 Building BUILDING Permit Ivo.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 $ 2 9 2008 Plan Review CITY OF FRIDLEY 65% of Building Permit Fee D404EP 763-502-4977 FAX y'1j .001 times the total job valuation Surcharge $ 2� .0005 x Permit Valuation Minimum $.50 EFFECTIVE 1-1-08 $ $5.00 (State Licensed Residential Contractors) � DATE q'� Cr YOUR E-MAIL ADDRESS r ](�Ji�f lCl� /E Cf n& • eft— ft-SITE SITEADDRESS 64""'J N Curb Cut Escrow THIS APPLICANT IS: ❑ OWNER CONTRACTOR ft + 6 ft = ft x $21 =$ PROPERTY OWNER/ NAME: / r $450 Conservation Plan Review TENANT ADDRESS: 1a -Z 4? CITY i V i �J (� ,� STATE &,J ZIP Sewer Main Charge r _ PHONE: (e o Agreement necessary ( ) Non Necessary ( ) Total Due NAME: Make checks payable to: City of Fridley Attach Stivulations CONTRACTOR ADDRESS: - ®( (/J d.�-I g �J7J� CITY S STAT kZIP.TJ qD3 SUBMIT A COPY OF PHONE (a la- 3? FAX (,/J. j44--3310 YOUR STATE LICENSE STATE LICENSE # z;�O Iv S 1 a IJ,? EXP DATE PROPERTY TYPE &SINGLE FAMILYINEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH(B ROOF 13DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: —?-.e- ro SJK SIZE OF IMPROVEMENT QENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES HOUSE &GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl []Soffit ADDITIONS & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING T,,H�1 BC FEE SCHEDULE) TOTAL JOB VALUATION $ 1.2 - �--{{ �� IOCCUPANCY TYPE Lid Permit Fee $ 5 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ y'1j .001 times the total job valuation Surcharge $ 2� .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks payable to: City of Fridley Attach Stivulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I ac o ledge that the ' rmation hove is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minneso onstruction C s; derstand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accor ap the case of all work whic7res revfii w and approval of plans. SIGNATURE OF APP IC RINT NA' p ?yA1 DATEV2!:�6 APPROVED BY DATE PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK