PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
Date: ...... �. � ..� ... !.............. .
Owner ..-0
L 460W-1� .....
Address ......:... ........
....................
N® 3913
Builder ... ...... (/,1,,�`�o�'o�..............
Address............................................
p LOCATION OF BUILDING
No. .6 JJJ// .?� t Street . �op .... Part o ....... ../.%.% ....... ... .
Lot .../!....... Block .................. Addition or Sub -Division C.'Y .� ..�
Corner Lot
............ Inside Lot X ........ Setback 3.Q !9.Sideyard ...........................
DESCRIPTION OF BUILDING
To be Used as:
e-4eW4 :F'Front . A/ -..P `Depth -. � Y Height AA...V "Sq. Ft. e*f. Cu. Ft.
.................... Front :....... Depth ...... Hei t ....... Sq. Ft ... Cu. Ft. .....
Type of Construction ................... Est. Cost. .. ... ....... To be Completed ..............:....
In consideration of the issuance to me of a permit to construct the building desribed above, I agreeto do
the proposed work In accordance with the description above set, forth and in compliance with all provisions of
ordinances of the city of Fridley.
. .............. ...... .. ........
a -a u
In consideration of the payment of a fee of $. ........... permit is hereby granted to ...................
......................... to construct the building or addition as described above. This ,permit Is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota 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.
Building Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Se sure to see the Bullding Inspector for separate permits for these items.
City of Fridley, Minn. N° 8248
BUILDING PER3nT
Date: July 22, 1965
Owner: Ambrose Espiritu Robert 0. Hale
Builder 5928 Oakwood Manor
Address 5928 Oakwodd Manor Address
LOCATION OF BUILDING
5928 Oakwood Manor
No...��_ Street Part of Lot
Lot _ Block Addition or Sub -Division .Aud. Subdivision 92
Corner Lot _ Inside Lot x Setback Sideyard
Sewer Elevation — Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Frontl8 Depth 24 Height 10 Sq. FL 432 Cu. Ft 43 20
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction frame Est Cost $1296.00 To be Completed
ew Detached Garage
In consideration of the issuance to me of a permit to construct the building described above I agree to do
=posed work in accordance with the description abov�-�e t forth and in compliance with ih provisions of
ordinances of the city of Fridley. V N A — A f n
4.00 Ambrose Espiritu
In consideration of the payment of a fee of $—, permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota .gg location, construction, alteration, maintenance, repair and moving of buildings
within the city limit Ous permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Allen G. Jensen Building Inspector
NOTICE:
V* perm* daces not cover the cemste dbn, testaiiatton for wiring, phmddng, gn heating, swrer or wafer. Be sane to nee
the Botldiog icor for separate rumifa for these *em
. ..
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME�i �l�� (' �"CZ • ° �Tr - BUILDER �v ��aC tt 1-S eq
ADDRESS., 6 y f wa IV.,, to ADDRESS aLC w n cl wa (Z
LOCATION OF BUILDING
No.STREET -711 �,�� �� )444- PART OF LOT S
LOT BLOCK .ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT_4!�_SETBACK SIDE YARD
SEWER ELEVATION FOUNDATION ELEVATION
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;
Gd Front (� Depth _Height
f
Sq. Ft._ � � !�- Cu. Ft. Al
Front
Depth Height
Sq. Ft. —Cu.. Xt.
Type of Construction Estimated Cost
To be completed —5 & r-7 A- -7- � n 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 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 �2'L r �' SIGNATURE .1, 0 1,-A _ g,
(Schedule of Fee Costs can,be found on the Reverse Side).
Tl�
O ;
City of Fridley
Application for Plumbing and Comas Fitting Permit
Dept. of Bldgs. Phone 860-3450
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures Locatiln-15�151'1-� 64A,<1
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ....... ............... �� x $1.50 $
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin .... x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $
New Ground Run Old Bldg. ....... .... x 3.25 $
GAS FITTING FEES:
1st 3 Fixtures ..........................
Additional Fixtures ....................
Gas Range to 200,000 BTU .............
REPAIRS & ALTERATIONS—Refer to Code
NO. RATE TOTAL
x $1.50 $
X .50 $
x 2.00 $
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct. 7
Fridley, Minn.
Owner /1 ®C &2-
Kind of Building
Used as / jT'
To be completed about
Estimated Cost, $
3
Old—New. Building Permit No Permit No. - q
ROUGH
FINALT
Description.............................................. $
TOTAL FEE -980-42
Signed
By
Business Phone No
3
;1
to
Y
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Z
N
<z
W
o
<
t
�U' °d
w
o
(V1
z
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O
•
F
.---
N
WATER HTR.
GAS
ELEG
Base
1st
2nd
3rd
4th
• Future Connection Openings
* New Fixture, Old Openings
Connected with
Sewer ❑
Cesspool []
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ....... ............... �� x $1.50 $
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin .... x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $
New Ground Run Old Bldg. ....... .... x 3.25 $
GAS FITTING FEES:
1st 3 Fixtures ..........................
Additional Fixtures ....................
Gas Range to 200,000 BTU .............
REPAIRS & ALTERATIONS—Refer to Code
NO. RATE TOTAL
x $1.50 $
X .50 $
x 2.00 $
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct. 7
Fridley, Minn.
Owner /1 ®C &2-
Kind of Building
Used as / jT'
To be completed about
Estimated Cost, $
3
Old—New. Building Permit No Permit No. - q
ROUGH
FINALT
Description.............................................. $
TOTAL FEE -980-42
Signed
By
Business Phone No
Application f�r Power Plants and Heating, Cooling, Ventilation, Refwigeraation and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATC TOTAL
Furnace Shell & Duct Work ................ .. $10.00 $
Replacement of Furnace 6.00 i
Repairs & Alterations—up to $500.00 6.00 $ _
Repairs & Alterations each add. $500.00
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ...... $10.00 L O
each add. 60,000 BTU .................... .. 3.W 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
9.(x1
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 188.000 BTU)
SAO
$
over 199,000 BTU See Fee Schedule
GAS FITTING FEES.
NO RATE TOTAL
1st 3 Fixtures
x$ 100
$'V� U o
Additional Fixtures
x .76
$
Gas Range to 199,000
x$ 5.00
$
AIR COHDITiONING
FAN HEATING SYSTEM
VSIITA.ATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
Fi NRL
See Fee Schedule
TOTAL FEE
Dept. of Bldgs. Phone 560.3480
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 truet,
lIand correcs�
Fridley, (Minn_ �P P+Wl P h- 18 (�
Owner D o n s*. ell)
Kind of Building .—F h a. is e
Used as - --- -- _.0`�-1�
To be completed about
�7 oa—
Estimated Cost,
Old—tLe)O. Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PI.ANTS-abeam, Hot Water, No
Trade Name_L f- YLe) X Sim Ne_ �D�3-1 I b
Capacity Sq. Ft. E.D.R BTU H.P
Total Connected Load Kind of Fuet 21 S
BURNER — Trade Naee9e Size No
Capacity Sq. FL E.D.R BTU
H
.
7 (REMARKS—OVEN)
We _
1 '4" Cv,vtr�?s�'Q"
CRONSTROMS HTG. & AIR. COND., INC. JoL Nam -
D.15 /
a
,j • `'$410 Excelsior Boulevard, Minneapolis T6, Minn. � ����d dO� �i7d
HEAT LOSS CALCULATIONS Job Address 4_
Weatherstrips A.S.H.V.E. Construction No.( Insulation r
Guide
Windows I Doors Reference I Out. Wall Int. Wall Ceiling Roof FloorI Kind How Applied
Yes—No Yes—No 19_.
/ F1.1 / t`, s ;z a Room I Length /L/ Width g n Height P II 1 F1.1 Room Length /,.2- Width e Height
Windows
Id Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane 11 to of crack sq. ft.
Width Height No. of Lineal ft. Area
No. of ppane of pane 1 hts of crack sq. ft.
% J r9i
ZO
Coef.
Coef.
Btu
Infiltration
P
_lD b
�2 Z jro
Glass
Glass
ft
p
Exp. wall
s �/
Exp. wall
Net exp. wall
Net exp. wall
?.a�O
D
-? D
Int. wall
//_0
%
/ 6 e
Ceiling
2�R
d
2 �d a
Floor
Ceiling
/G c,
Total Btu. I K
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
/ F1.1 Room I Length / > Width /-,/ Height 3" -
Windows and Doors--Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane 11 to of crack sq. ft.
2 2
Coef.
ICoef.I
Btu
Infiltration
P
_lD b
Glass
.S'e
Glass
ft
Exp, wall
v
D
Exp. wall
Net exp. wall
S
n
qr 0
Net exp. wall
//_0
%
/ 6 e
Int. wall
a
d
Floor
Ceiling
/G c,
/w e o
Floor
Total Btu. V
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
/ F7_I A"— -z-A Rmm I Lenath V Width He -At i
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft*Area
No. of pane of pane lights of crack sq. ft.
2 f/ fZ
Coef.
Btu
Infiltration
o
P
_lD b
Glass
.S'e
O
Exp, wall
v
..2
Exp. wall
Net exp. wall
S
n
qr 0
Int. wall
//_0
to
Ceiling
p
a
d
Floor
Floor
Tbtal Btu. I / L/ IT C,
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
2 f/ fZ
Coef.
Coef.
Btu
Infiltration
_S
Q
WD
.S'e
Glass
Net exp. wall
YAP
..2
Exp. wall
Int. wall
�Z
Net exp. wall
Int. wall
//_0
to
B
Ceiling
SO d
Floor
Total Btu. d _r
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
L9 1 r.n D___ If- o — VULZIt.
Windows and Doors—Crackage and Area
Width I Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
7
Coef.
Btu
Infiltration
_S
Q
Glass
Exp. wall
Z/ �
Net exp. wall
YAP
..2
6cy p
Int. wall
Ceiling
p
0
Floor
1rOD
SO d
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
Fl—Ill!) ...,..__e Rmm 1 Lenath.:2/_ Width 3/_ Height A
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
_S
_"'q D
Glass
Exp. wall
Net exp. wall
YAP
O 6
Int. wall
Ceiling
Floor
1rOD
SO d
Total Btu.
ft. E.D.R. or sq. ins. W.A. leader area
It
City of Fridley
App9catiOe for Fknblng and G= Fktbg Fomdt
Dept. of Bldga. Phone SW -34W
DESCRIPTION y
Number, Kind and Location of Fixtures•' 0 / ice." 1?_�!' �/
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures
i
N
z
Future Fixture Opening
x $1.50
riF
Z Z
New Fixture Old Opening
tZ
8
$
O
NN
ul Z
Z
7 u
®
e
WATER HTR.
x $3.25
$
Electric Water Heater
: $2.00
$.
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ...... .. .......
K
;�
o
Additional Fixtures ..... ..............
a[
�o
b;
Gas Range to 199,000 BTU ..............
c
cog
`
u�
coo
►
N
GAS
ELEG
Base
_�
-
—
--
-
--
—
ls^c
)
1
►
1
2nd
----
3rd
---
4th
- - -- --
Connected—
° Future Connection Openings
* New Fixture, Old OpeningsI
Sever
Ce"Podi
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures
x $2.00
Future Fixture Opening
x $1.50
$
New Fixture Old Opening
x $1.50
$
Catch Basin
x $3.25
$
Water Heater (Up to 99.000 BTU)
x $3.00
$
New Ground Run Old Bldg.
x $3.25
$
Electric Water Heater
: $2.00
$.
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures ...... .. .......
x $2.00
$ a C'J 0
Additional Fixtures ..... ..............
x $ .76
$
Gas Range to 199,000 BTU ..............
x $5.00
S
REPAIRS & ALTERATIONS—War to Code,
Description .................................. .............$
TOTAL FEE $.,2 3 �-
f
City of Fridley:
The undersigned hereby makes application for a permit for the work here!
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated In this application are true and correct.
/��jj Fridley, Minn-- ® 6 5� 19.1
Owner (�1'X
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old uilding Permit No.— _ --Permit No. _571
Signed
By --
Business Phone No_
ROUGH
FINAL
:W:_
C� -
City of Fridley, Mian.. L11 539
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT ,
Date:
July 11, 1972
Owner: Kenneth Baker Builder Lloyd's Cont.
Address _. 5928 Oakwood Manor _ Address 7870 Spring Lake Park
LOCATION OF BUILDING
5928 Oakwood Manor
No. Street Part of Lot
Lot — _. 11 _ __ Block _._.__.._..__ Addition or Sub -Division Auditor's Sub. #92
Corner Lot ----- _._.__ Inside Lot x _ Setback Sideyard
Sewer Elevation
t
To be Used as:
Foundation Elevation
DESCRIPTION OF BUILDING
Reside & rerog Front ._ Depth _ Height Sq. Ft. Cu. Ft.
Front .— Depth Height Sq. Ft. Cu. Ft.
Type of Construction Wood Est. Cost $1, 000.00 To be Completed 30 days
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
.56 State surchetzge
In consideration of the payment of a fee of $ 6.00 , permit is hereby granted toKenneth Baker
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects -to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
pyithin the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Building Inspector
CLARENCE BELISLE
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
.0;
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER IS NAM: ���%� �l r�� ��i� BUILDER: �^ / Ci � g Cd Cti � d
ADDRESS: � �' � two a � / ADDRESS : S 76
NO :,5 ,_5-? STREET • C' irk ��� o O� / ✓¢ �G�
LOT;_ BLOCK: ADDITION: Gf 14 C/�-
CORNER LOT: INSIDE LOT:_ 1� SETBACK: SIDEYARDS
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Veed As:
RIO �t
� tN vL Frt: —Depth: Height:
-41
-A�qt Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
L
Type of Construction: O L Estimated Cost: $
To Be Completed:
ae�• �
The undersigned hereby makes application for a permit for the.wQrk heroin
specified, agreeing to do all work in attict accordance with the City 4f
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this applic4tion
are true and correct.
*TA: SIGNATURE:
(See Reverse Side For Additional Information.)
a
50
SUBJECT
PEAM
City of Fridley
5920
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
REC
`- ______ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
30or
1 . �
�-"1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
9-9-66
JOB ADDRESS 5928 Oakwood Manor
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
11
SHEET
Aud. Sub, #92
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Kenneth._ Baker 5928 Oakwood Manor 571-898
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
Reroof House
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
9 CHANGE OF USE FROM TO
STIPULATIONS Roof can be 2nd but not 3rd roof. Install ridged galvanized
valleys:.
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
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
$700
$.SO
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$8.00
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI�yq
1
WHENPROPERLY VALIDA/T�ED��/jT/HIS IS YOUR PERMIT
C
, A///{���
,A `C/YW
,BLDG INSP f)A E
SIG RE OF O ER TI _FOWfi C99MLTILD C RI AT
50
CITY OF FRIDLEY
APPLICATIOid FOR RESIDENTIAL BUILDING PER4ITS
(New, Alterations, Additions, or Repairs)
OWNER:
TEL O rsi.
BUILDER: 50-11211 P—
ADDRESS:
TEL NO:
Construction Location
STREET NO: STREET:
LOT: l BLOCK: ADDITION: L2,
/
Corner Lot: Inside Lot: Setback.: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
, - -Y J Front:
7 141, Square.Feet:
Front:
Depth: Height:
Cubic Feet:
Depth: Height:
Square -Feet: Cubic Feet:
Type of Construction: ,
To Be Completed:
Proposed Driveway Width If New Opening Is Desired:
Estimated Cost: $
Alt. A Alt. B
SEE REVERSE SIDE OF SHEET
Mie 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
represen(:.ations stated in this application are true and correct.
DATE: V SIGNATURE:
Stipulations:
WELL DRILLING FOR FOUR GENERATIONS
1 ■ sons 15688 JARVIS STREET NX/ELK RIVER, MN 55330/(612)427-5100
INCORPORATED
Date: August 25th, 1987
MINNESOTA DEPARTMENT OF HEALTH
717 SE DELAWARE STREET
DIVISION OF ENVIRONMENTAL HEALTH
MINNEAPOLIS, MINNESOTA 55440
ATTN: Mr Jim Nye
(612) 623-5339
SUBJECT: WELL ABANDONMENT
RE: NOTIFICATION
Dear Mr Nye,
//
This letter is to notify you of a water well in your district that should
be sealed according to the Water Well Construction Code MCAR §4725.2500-2900.
E.H. RENNER & SONS, INC has been notified by the owner of this property or
an interested party and have subsequently submitted to them an estimate for
the sealing of this well under our LICENSE #71015. We have also included
a copy of the current code with our estimate.
In submitting our estimate, the owner may also receive additional estimates
and hire any number of Minnesota licensed water well contractors in the area
to seal this well. However, there is a possibility that this well may not
be properly sealed and thus jeopardize the ground water and Public Health.
E.H. RENNER & SONS, INC: -wishes to provide you this information for future
reference with the ,abandonment report when submitted.
PROPERTY OWNER: SYLVIA MCGUIRE
ADDRESS: Oa._aood Avenue
LOCATION: ��e �
Sincerely Submitted,
Raymond T. Renner, V -President
E.H. RENNER & SONS, INCORPORATED
STATE LICENSE #71015
333 -5811 -Ext. 24 Work
PHONE # 571-4886 H.
DATE 8-25-87
.WELL DIA. 3" & 1"411
DEPTH: UK
cc: City of Fridley
6431 University Ave. NE_
Fridley. !IN. 55432
ATTN: Darrel Clark 8r Don La rrigan--571-3450
�a WATER WELL ABANDONMENTS
FOR ANOKA COUNTY
LISTED BY CITY
NUMERICALLY BY ADDRESS
FOR THE CITY OF
*** FRIDLEY ***
6431 UNIVERSITY AVE. NE.
B.I. MR. DARREL CLARK & MR. DON 9AMCA14
574-3450
NO PERMIT FEE OR INSPECTION
DRILLER SIZE OWNER -CONTRACTOR SITE ADDRESS DATE SEALED
TORGERSON
1%
BORDEN
260 Longfellow.St.
Jan.
88
E.H. RENNER
2
SHARON ANDERSON
380 Longfellow St.
May.
86
MORK
3
ANOKA CO. COMM. ACTION
400 Osbornk;-Rd.
Sep.
87
MORK
3
ANOKA CO. COMM. ACTION
401 -76th Ave. NE.
Sep.
87
A -WELL
4
ELLEN KAKI
511 Ironton St. NE.
Mar.
88
E.H. RENNER
2
FRIDLEY SCH. DIST #14
611 Mississippi St.
Sep.
87
E.H. RENNER
1k
HARLIN & MAXINE SUND
776 -63rd Ave. NE.
Sep.
87
TORGERSON
3
Robert Knudson
1322 Hillcrest Dr.
Jul.
88
E.H. RENNER
1%
LOIS HLAVINKA
1500 Osborne Rd.
Apr.
88
E.H. RENNER
1k
LOIS HLAVINKA
1500 Osborne Rd.
Apr.
88
E.H. RENNER
2
OMAN CORP
1600 -71st Ave. NE.
Jul.
88
E.H. RENNER
2
ONAN CORP
1600 -71st Ave. NE.
Jul.
88
E.H. RENNER
3
JERRY McKNIGHT
4607 -2nd St. NE.
Nov.
87
E.H. RENNER
3
SYLVIA McGUIRE
„ 5928 Oakwood Ave.
Sep.
87
E.H. RENNER
1%
SYLVIA McGUIRE
5928 Oakwood Ave.
Sep.
87
E.H. RENNER
3
BINCKNER BUILDERS
5980 Stinson Blvd.
Apr.
88
E.H. RENNER
3
TIM FAHS
6105 Woody Lane
Feb.
88
E.H. RENNER
4
TIM FANS
���_�
6105 Woody Lane
Feb.
88
DON STODOLA
4
ENEBECK CONSTRUCTION
6222 Old Rd.
Aug.
88
MORK
2
CLARENCE GRAVES
6229 Sunrise Drive
Oct.
87
LUDWIG
2
CARL CHRISTENSEN
6509 East River Rd.
Jun.
88
E ". RENNER
lk
ANOKA COUNTY PARKS DEPT. 6666 East River Rd.
Jul.
88
E RENNER
1%
RICK MALACHEK
E., RENNER
1%
BOISE
CASCADE
CORP/BARB
E.H. RENNER
131
BOISE
CASCADE
CORP/BARR
E.H. RENNER
1%
BOISE
CASCADE
CORP/BARR
E.H. RENNER
1:j
BOISE
CASCADE
CORP/BARR
E.H. RENNER
1t
BOISE
CASCADE
CORP/BARB
E.H. RENNER
1%
BOISE
CASCADE
CORP/BARB
E.H. RENNER
1%
BOISE
CASCADE
CORP/BARR
E.H. RENNER
1%
BOISE
CASCADE
CORP/BARB
E.H. RENNER
1%
BOISE
CASCADE
CORP/BARR
E.H. RENNER
1t
BOISE
CASCADE
CORP/BARR
(10 WELLS..FP7, FP10, FP18, FP11,
FP13, FP9,
[ALL OF THE
ABOVE
10 WELLS FOR NATIONAL POLE
E.H. RENNER
1%
JAMES
L. SCHLEY
A -WELL
2
JIM HAM
ANOKA/018
END NOVEMBER 16th, 1988
NUMBER OF WELLS SEALED IN THIS CITY TO DATE:
2
7136 East River Rd. Aug. 87
7300 Block & Old Central Aug. 84
7300 Block & Old Central Aug. 84
7300 Block & Old Central Aug. 84
7300 Block & Old Central Aug. 84
7300 Block & Old Central Aug. 84
7300 Block & Old Central Aug. 84
7300 Block & Old Central Aug. 84
7300 Block & Old Central Aug: 84
7300 Block & Old Central Aug. 84
7300 Block & Old Central Aug. 84
FP1, FP8, FM8, FP3 Less Than 30')
& TREATING SITE/MEDTRONICS SITE]
7512 East River Road Sep. 87
7551 Alden Way NE. Jun. 88
35
SUBJECT
City of Fridleyl
4 `7 9
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
O.
i
COMMUNITY DEVELOPMENT DIV.
_______
�.
��
r , PROTECTIVE INSPECTION SEC
I
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
11/20/96
JOB ADDRESS 5928 Oakwood Manor NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1
1 Auditor's Sub. 492
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Carter/Rristi Carpenter 5928 Oakwood Manor NE
571-6930
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Custom Remodelers Inc 474 Apollo Dr STE A Lino Lakes MN 55014 784-2646
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
1748
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION p REPAIR
X
❑ MOVE ❑ REMOVE
6 DESCRIBE WORK
Reside House
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
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
$10,000
$5.00
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-
Sc $10.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$162.25
Fire
PLAN CHECK FEE
TOTALFEE
License SC
$5.00
$182.25
SIGNATURE OF CONTRAOR OR AUTH RIZED AG NT IDATEI
WHEN PROPERLY LIDATE THIS IS YOUR PERMIT
BLD INSP
DATE
SIGNATURE OF OWNER I IF OW NER BUILDERI TEI
NEW [ ] Effective 3/1/96
ADDN [ ] CITY OF FRIDLEY -
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 4��w
Building Permit Application
ConstructionAddress:
Legal Description:
Owner Name & Address: �ia��e� 9' 1� i2 �S i� CAA V Tel. # i L -
Contractor: S �� C r MN LICENSE #2_2 Y- $'
Address:�1-✓ ,�/A /4— Tel. #
Attach to ' app Catton, a Ce`&�61 of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF meROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: V15 / ,f-�'�, Estimated Cost:
Approx. Completion Date: /;2
(Cdst on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: //-020 —9, APPLICANT: ;fA- Tel.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Z5'�
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$900 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 [ ]
0
J
SUBJECT
P
City of Fridley
4 00
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
T NO.
�•
______ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC
r
CITY HALL FRIDLEY 55432
1`'
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
11/26/96
JOB ADDRESS 5928 Oakwood Manor NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
oEscR.
I 11
Auditor's Subdivision X692
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Christie Carpenter 5928 Oakwood Manor NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Walker Roofing 2701 36 Ave S M ls. MN 55406
729-23254229
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
x❑
8 DESCRIBE WORK
Reroof House 17 S 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
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
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
$1,402
$.70
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$48.50
Fire SC $1.40
PLAN CHECK FE
OTAL FEE
Li s SC
.00
55.60
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
P
RLY VA DATED THIS IS YOUR PERMIT
SIGNATURE OF OWNER OWNOWNER BUILDERI IDATEI
jafbG- INEP
GATE
0
J
NEW
ADDN [ ] CITY OF FRIDLEY
ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address:
Legal Description:
Owner Name & Address:
Tel. #
Effective 1/ 1/94
7(
Contractor: n*CA LICENSE #
as
Address: "--I- ( ` S f. cw(� Tel. # `7 X_L_
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:
Corner Lot [ ] 6ideLi.Side
Yard Setbacks
Type of Construc
f
D(� 4
ed Cost:
Approx. CompletionDa-
Driveway Curb Cut Width Needed:
DATE: 1-7- APPLICA
(Cost on Back)
+ 6 Et —= Ft x $
Tel. # 'oZfz ? 3
p /® g) CITY USE ONLY
01
Permit Fee $ Fee Schedule on Reverse Side
Fire Surcharge$ ' .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ ?0 $800 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee- Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
FAX (763) 571-1287
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
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/ Industrial
1.25/0 of Value of Appliance or Work
Rate
TOTAL
$ 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
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
01
L:ILeeLivC January t, _2003
BUILDING USED AS 2
ESTIMATED COST PERMIT NO.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units ` Circle One (Steam) (Hot Water)arm Air)
Trade Name _,T Size No. &/,-)-Tb7d---r
BTU Ot HP �EDR
Fuel _ Total Connected Load---'�r�����
Burner Trade Name_'_Z-,_' Size No. �i►'13b7�
BTU_ -7 U) bili _ 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
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE C, — 1/ ::�n3
HEATING CO
Signed TEL #3
FAX #
Approved B :� Rough -In Date Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
When rop acing an eYistin0 ftiraneg, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Y o ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination.
Yes( NO
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances.
Yes ) o ( )
The PY�g rnmh stien air is sized and installed to meet the current codes
and manufacturers specifications.
Yes () No
When required to onetali a new rnmhimfien air- it will be sized and installed
to meet the current codes and manufacturer's specifications.
Yes No( )
When iiostalling a new venfing _n stem, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances.
Ye ) o ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Ye No ( )
Anelnee Tyne and SizelCnmmen Vent and Vent Cnnn er infermatien
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances. Total Btu Input
Common Vent Type < nt Height Diameter inches
Appliance #1 Vent Connector Height' a ft Lengthft Diameter in Type
Appliance #2 Vent Connector Height ft Length 1 ft Diameter `� in Type �—
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
HEATING CO:
Signed By:
Date:✓
&0
CIIYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287
May 25, 2004
Ms. Tina Keeler
5928 Oakwood Manor NE
Fridley, MN 55432
Re: Final Inspection at 5928 Oakwood Manor NE
r Contractor: Anderson Heating & Air Conditioning
Dear Ms. Keeler:
A mechanical permit was issued on July 3, 2003 to install a furnace and an air
conditioner at your address. According to the 1991 Uniform Mechanical Code a final
inspection shall be conducted on the work authorized by this permit. As of this date the
inspection has not been requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your permit open for another 30 days and if we do
not hear from you within this time to set up the inspection, we will mark the permit "no
inspection called for by homeowner after notification" and the permit will be expired.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DJ/mh
Building
W W-Juw -
BUILDING
Permit Fee
Permit No.•
Inspections
See Back Page for Fee Schedule
RESIDENTIAL APPLICATION
Received By:
763-572-3604
65% of Building Permit Fee
CITY OF FRIDLEY
$
DateWCSoii ?0
763-502-4977 FAX
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
EFFECTIVE 1-I-08
-5—,00
$5.00 (State Licensed Residential Contractors)
DATE
YOUR E-MAIL ADDRESS CL
1 � 0
^^
SITE ADD SS 570
®6"A40—tjcoD "A0— p lE
ft + 6 ft = ft x $21 = $
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
$450 Conservation Plan Review
PROPERTY OWNER/
NAME: —r A KFC - —Z
Fee Determined by Engineering
TENANT
,,��QQ
ADDRESS: 50, LS (41L�a?t7a7D ANM �yCITY Fez �
D—LE
sSTATE ZII'
Total Due
PHONE: -7(o3— 50?, — (p93()
1
Make checks payable to: City of Fridley Attach Stipulations
NAME: 'f'
ADDRESS:—"9511? CO S► r4%L
PITY II01S - STA TF ZIP55323
CONTRACTOR
SUBMIT A COPY OF
PHONE Io a 613 10 FAX -763-574-3153
YOUR STATE LICENSE
-7 td,,5- EXP DATE
STATE LICENSE # 3
PROPERTY TYPE
INGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK _'SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR MODELING
DESCRIBE WORK BEING DONE: ?VE-: S,40C
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT SO FT
ROOFING
❑ HOUSE ONLY
BASEMENT
REMODELING SUBMIT:
NUMBER OF SQUARES
13 HOUSE & GARAGE
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:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING
inyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
[I Aluminum
❑Trim
1. Site
Plan/Survey showing the existing structures
13 Other
13 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:
11. _ (USING THE 1997 UBC FEE SCHEDULE)
I
TOTAL JOB VALUATION S
W W-Juw -
UUUUYANUY 7 YYL
Permit Fee
$
/39, '2-5;-
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
-5—,00
$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
$
1
Make checks payable to: City of Fridley Attach Stipulations
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 on site; that the work will be in accordance with the approved Ian in the case of all work which requires review and approval of plans.
SIGNATURE OF AP CMT PRINT NAME �(K —(� DATE
APPROVED BY
I D0
11 PLEASE NOTE: SEPA6kTE PERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK ' I