PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N° 4160
Date: - --............
'Ze4Owner--------------- --------------------------------------------- ---------- --------- -------- ------------------------ Builder -................._......_...._......._..._.... _..._..
Address.............. .................................. _.._................. _.... .... _ __......_ - Address ........---•-----.....-...... _.__.......__..._...__.._._
LOC�4TION F BUILDING
No....: f..- .. Street - «' - - .------------------------ Part of Lot
Lot ...... ................. ......... Block .--------------------........--- ............... Addition or Sub -Division .........................
Corner Lot .................................... Inside Lot ....................................... Setback ............................................. Sideyard
Sewer Elevation ... ................................ -.............. ............................ ......................... Foundation Elevation ..................
DESCRIPTION OF BUILDING
To be Used as: ® p
_!7WX1.... Gv�i Front .�._ Depth..�r�.. _ Height ......� Sq. Ft...._� Cu. Ft.
Type of Construction
Front ......................... Depth
....................................................... Est.
Height....................... Sq. Ft. ..... _................. Cu. Ft.
P --j_ C
........... To be Completed
GY-d&
In consideration of the issuance to me of a permit to construct the '1 ' de cri above, I a to do
the proposed work in accordance with the description above set forth in om an with all sions of
ordinances of the city of Fridley.
_........._.... ..._4 .....:... ......._ ... ..... ...._......_.....-.._......._....
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
tmnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
wcity limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinance
Building Inspector
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.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners Name � ��',���� ��Bii4l.der
Address 7��a-`�� Adtir'ess
LOCATION.'OF. BUIi?ZNC
Na. Street 'Part of
Lot Block Addition or.Sub.Div. S, s
Corner Lot Inside Lot "Set Back Side -Yard
SEWER ELEVATION FOUNDATIOI. ELEVATION
Applicant atta.g4 to this. form: Certificate'sof"Surve of Lot and o osed building,''*.
PP y pr P .
location. r...
DESCRI.PTION'OF BUILDING
To be used aoe�7,il ✓ > - �,,.
Sq. Ft. 5 6 r
_Front , -.� Depth C7 p Height
Cu. Ft.
Front Depth Height
5q. Ft. Cu. Ft.
Type of . Construction/�� `�� �� ��� Estimated Cost®�
To be completed _7Z2
The undersigned hereby makes. application for a permit for the work herein specified,
agreeing to do all worktin strict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions stated in this application are true and correct
DATE IGNATURE e R.
(A Scze4i4le of -Fee costs can be found on the Reverse Side.)
r-
j
CITY OF FRIDLEY
Effective May 1, 1990
APPLICATION FOR POWER PLANTS AND HEATING,:000LING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS.AND DEVICES
RATE SCHEDULE
RESIDENTIAL
RATE
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
S 20.00
Gas Piping
S 10.00
(piping needed with new furnace)
Gas Range •
S 10.00
Gas Dryer
S 1(1.00
Air Conditioning (all'si'zes)
$ 10.00
All Others/Repair's and Alterations
It of Value of Appliance or work
COMMERCIAL/INDUSTRIAL
is of Value of Appliance or Work
State Surcharge S .50
TOTAL !EE
Reinspection Fee ($15.00) S
Minimum Fee $15.50
Rough Insp.
Date /]
Final Inep. J r v
Date
Approval for permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00
PLUS $.50 STATE SURCHARGE
Job Address 7800 East River Road
Department of Buildings, 6411 University Ave. N.E., Fridley, MN 55432
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
Fridley, Minn. June 2 5 1990
OWNER L.W. Samuelson
KIND OF BUILDING
USED AS Residential
TO BE COMPLETED ABOUT June 2 5, 1990
ESTIMATED COST $3200.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Not Water, wart Air- No.
Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Total Connected Load Kind of Fuel
BURNER Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company Cronstroms HtgY_& A/C
Signed By
Tel. No. 920-3800
*Air Conditioners can not be placed in side yard without
written permission from adjoining 1r,►g1lx,r.
Fill out back side for stack verification on replacement furnaces
-73oo Elfj 6� f ` (-ia�
06 eE 6���`�-N WmeWme_a�(0-la-nc Z;/Uto/
WELL OR BORING LOCATION
MINNESOTA DEPARTMENT (YF HEALTH Minnesota Well and'Boring
WELL AND BORING SEALING RECORD Sealing No.
Minnesota Unique Well No.
Minnesota Statutes, Chapter 1031 or W -series No.
(Ecco Clamp it ncd iva ) lj
H '374 8
Courcy Name
Township Name
Township No. Range No.
Section No.
Fraction (sm. a Ig.)
Date Sealed
Date Well or Borin� Constructed
F D.�
-
-5V
I I 1211M
Ir
Nume Street Address or Fire r d i I r o n
rL��JJCf`�j
(
Depth Before Sealing 13 ft.
Original Depth ' ft.
Show a location of well or boring Sketch a or boring
AOUIFER(S)
I""
STATIC WATER LEVEL
in section gn wi oration, showing property
lines, roads, and buildings.
N
X Single Aquifer ❑ Mulfiaquifer
II
Measured (�, Estimated
40 ft. below ❑above land surface
WELIJBORING
Water Supply Well ❑ Monit. Well
❑ Env. Bore Hole ❑Other.
W E .
-�'-- ---- -i-- --i--
CASING TYPES)
Steel [ Plastic ❑Tile Other -
_-�- -'--
CASING(S)
Diameter Depth Set in oversize hole? Annular space Initially grouted?
1 f mxe— A�So
in. from to 1 ft. ❑ Yes ', !3R No ❑Yes E]No E3 Unknown
in. from to ft. 13 Yes 'i ❑ No ❑ Yes ❑ No ❑ Unknown
in. from to ft. ❑ Yes I' ❑ No ❑ Yes ❑ No ❑ Unknown
PROPERTY OWNER'S NAME
Propedy'owner's mailing address if different than well location address indicated above.
7806 T .Ety-. ROAD
FRIDLEY., SS432
SCREEN/OPEN HOLE
Screen from 130 to 1 ft. Open Hot. from to ft.
OBSTRUCTIONS
❑ Rods/Drop Pipe ❑ Check Valve(s) 0j Debris ❑ Fill E] No Obstruction
Type of Obstructions (Describe) MILLM OM
WELL OWNER'S NAME
AM
Well owner's mailing address g different than Property owner's address indl;ated. above..
Obstructions removed? ❑ Yes ❑ No Describe
PUMP
Type
❑ Removed Not Presort ❑ Other
GEOLOGICAL MATERIAL COLOR HARDNESS OF ° FROM TO
FORMATION
If not known, Indicate estimated formation log from nearby well or boring.
METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASIIVC;iS, OR CASING AND BORE HOLE:
� No Annular Space Exists
❑ Annular space grouted with tram le pipe
TAN
CLAY
(F] Casing PerforatiorJRemOval
in. from to ft. ❑ Perforated ❑ Removed
in. from to k. ❑ Perforated ❑Removed
4--
GI�y
HAND' PAIN
fill 11 F
g, I
J rt2kN
AM
Type of perforator
A
41 Other
GROUTING MATERIAL(S) (One bag of Conten a 04 On, one bag of bentonite = 50 Ibs.)
Grouting Material from to ft. yards � bags
from to ft. yards bags
from to � ft. yards bags
from to * ft yards bags
REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING
OTHER WELLS AND BORINGS
GEOLOGY FROM:SPRINGBROOKPARK
WATER LEVM Th ABOVE WLL.- 191
TE WATER LEVEL TAKEN: 9/ 23
Other unsealed and unused well or boring or property? ❑ Yes No How many?
LICENSED OR REGISTERED CONTRACTOR CERTIFICATION
I
fs well or boring was seated In accordance with Minnesota Rules, Chapter 4725. The information contained in this repo) Is
to the best of my knowledge.
ffi
E.H. , 71015
edore��n�at IberrsedrReglshaCoriJo.
SEALEU
#�..
According to MN State Regulations
_
Aed't°
u ®CAI COPw
H''
Namof ransom seating w� or Boring
f
OF
FRIDLEY
FRIDLEY MUNICIPAL CENTER -6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287
June 5, 2000
Manager
Fridley Branch Post Office
7440 University Avenue NE
Fridley, MN 55432
Re: Address Change in the City of Fridley (Effective Immediately)
Dear Manager.
The following address is being changed in the City of Fridley per the new owner's request:
NEW HOMEOWNER: Todd & Mary Christenson
OLD ADDRESS: 7800 East River Rd NE, Fridley, MN 55432
NEW ADDRESS: 7800 Pearson Way NE, Fridley, MN 55432
LEGAL: Lots 7 & 8, Block 6, Pearson's Craigway Estates 2nd
The City has notified the companies and departments listed below.
Thank you for your cooperation in this matter and if you have any questions, please call me at
572-3602.
Sincerely,
RON JU
Building
CC: Fridley Post Office Northern States Power Co Fridley Police Dept.
Anoka County Court House Reliant Energy/Minnegasco Fridley Fire Dept.
Paragon Cable Anoka Co 911 Other City Offices
94(� 44 , o2e
ITY OF FRIDLEY INSPECTION DIV.
r31 University Ave NE
Idley, MN 55432
63) 572-3604. FAX (763) 571-1287
MARK NUMBER OF
r-ReuOVe ^V1 II 1, 6uuv a /„A
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
Floor 1
Floor 2
Floor 3
Floor 4
.UMBING FIXTURE RATES: NO.
RATE TOTAL
.w Fixtures
$10.00
d Opening, New Fixture
$10.00
;er Dispenser
$10.00
ow Off Basin
$10.00
itch Basin
$10.00
An Water Leader
$10.00
imp/Receiving Tank
$10.00
ater Treating Appliance
$35.00
titer Heater -Electric
$35.00
later Heater - Gas"*
$35.00
as Range"
$10.00
as Dryer"
$10.00
ick Flow Preventer Required ( )Yes () No
Type
$15.00
3inspection Fee $50.00/Hr
-L OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
State Surcharge $ • 50
TOTAL FEE QJ.50
TO BE INSTALLED
Washer
JOB
Heater
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.
OWNER
BUILDING USED AS
ESTIMATED COST PERMIT NO
PLUMBING COMPANY
SIGNED
Approved By
TEL NO-'
Rough -in Date Final Date
OMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 544(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE
Building • BUILDING Permit No.- �7c�y1
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY Date Recd:
DATE /7-0 % YOUR E-MAIL ADDRESSi�L
SITE ADDRESS
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY OWNER/
NAME:
ADDRESS:
CITY —STATE—ZIP—
TATEZIPPHONE:
TENANT
PHONE:
CONTRACTOR
NAME:
STATE LICENSE # 5� EXP DATE O31-51 ��%
SUBIT A COPY OF
M
CITY STATl3'
STATE LICENSE
YOUR
ADDRESS:
WITH APPLICATION
�1
PHONE (oS/ / !Y C® FAX
f-®'f�
PROPERTY TYPE
❑ SINGLE 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 ❑ ADDITION
❑ MAINTENANCE/REPAIR REMODELIN
DESCRIBE WORK BEING DONE: �� PG
SIZE OF IMPROVEMENT LENGTH
WIDTH HEIGHT Sq. Ft.
ROQMGC c ❑ HQJAE ONLY
v
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES 17,O USE & GARAGE
1 • Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE: E3DETACHED GARAGE
3. List of struct ual members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl ❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum ❑ Trim
I. Site Plan/Survey showing the existing structures
❑ Other ❑ Fascia
and proposed project
2. Two sets of construction plans
VANDOWS
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
A T .T _ VV V Q A i2F R A CFiI nN VAT .YT A TTON_ YNC_LTJDTNG THE COST OF LABOR
AND MA
'OTAL JOB VALUATION 5
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
1997 UJLC FEE SCHEDULE)
70 OCCUPANCY
�/ 4 39
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
-7-&- 6 Q--,
Make checks payable to: City of Fridley Attach
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 of all work ch requires review and approval of plans.
SIGNATURE OF APPLICANT E %lt -t �1 /e4� � '' PRINT NAME 1'JCt � Cd V DATE -2V 7
42 '—