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PRE 2010 DOCSCity of Fridley, Minn. BUlOLDING PERMIT N? 3129 Date: .../.....�i. ' ............... Owner ''� ..... Builder�,�n,-.. ................... Address .. (a . / ... ...... ..... Address .... . b 0.. .. • ® LOCATION OF BUILDING No. .3 /.. Street .� .... . 1 ............ Part of Lot .. �. Lot ... �.' .. Block ... �....... .... Addition or Sub -D ivision ... ...2. .. Corner Lot . Inside Lot ..... .. Setback . J. P .... Sideyard 4P .� DESCRIPTION OF BUILDING To be Use as:,7 o Front �.. Depths Heights��G Sq. Ft. .���Cu Ft. ........ .................... Fr t ........ Depth ........ ??Height ...... 4b� Sq. Ft. ........ Cu. Ft. ....... Type of Construction Z ...... Est. Cost.. 1.3-j. I � .. To be Completed .. � . . . r In consideration of the issuance to me of a permit to construct the building desribed 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. !®In consideration of the payment of a fee of $. ...... permit is hereby granted to A20 ...................... 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. _-�? V.A . V. .......... g Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for thea® Items. M City ®f Fridley, M.nne BURDING PERMIT N® 7306 LOCATIO F BUILDING No. Street Part of Lot Lot __ Block Addition or Sub -Division Corner Lot Inside Lot Setback ®--____ Sideyard f Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING be U Front --- Depth Height Sq. Ft Cu. Ft Depth Height �____ Sq. Ft Cu. Ft Type of Constructs Fit To be Completed _ 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 f rth and in ce with all p ons of ordinances of the city of Fridley. In consideration of the payment of a fee of $-7= , 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 reg location, construction, alteration, maintenance, repair and moving of buildings ante city limits and permit may be revoked at any � o of any of the provisions of said Building %nspector NOTICE 'fids permit does not ewer the eondroallon, fnata Wen for vikkg, plembing, gas heating, sewer or Water. Be wre to see the Buddhas ingmmr for mparato perndts for these itenm APPLICATION FOR BUILDING FEP11IT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME LOCATION OF •BUILDING, No. Street. Fart of Lot Lot Block Addition or Subdivision Corner Lot Inside Lotetback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of. Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: ' P �s w dolFront ® ® ® Dapth Height Sq. Ft. 'Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction.. �/�A-M Estimated Cost /,2 ®® 01 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 and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. (Schedule of Fee Casts can be found on the Reverse Side). •+a. s % . .. a. SUBJECT R City of Fridley 1802-4 AT THE TOP OF THE TWINS BUILDING PERMIT ECEIPT NO COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �� 911fr CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j 612-571-3450 910-F15 6/4/85 JOB ADDRESS 6351 Quincy Street N. E, 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 8 Christi Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michael Panning 6351 Quincy Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO, 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION M ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling 9 CHANGE QF USE FROM TO STIPULATIONS )MM Roof can be the. 2nd layer but not the.3rd. Install ridged galvanized valleys.. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Asphalt 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 $8Co $� r�0 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- $15.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. P AN CHECK FEE TOTAL FEE $15,50 SI E TUREOFCONTRA UTHORIZEDAPENT (DATE) rVVUEN PROPERLY L DATED THIS IS YOU PERMIT r BLD SiGNATUREO WN RtIFO NER BUILDERI (DATE! NEN [ ] ADDN. [ ] ALTER. [ J Constructii Legal Desm Owner Name Contractor Address City of Fridley R-1 AND R-2 Building Permit Application Effective 4/1/84 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Corner Lot [ ] Inside Lot Ft. Yd. Setback Side Yard Setback Type of Construction: Approx. Completion Date: gr Estimated Cost: $ 9 0Q• Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: fa � rr APPLICANT: Tel . f 5 '7/ CITY USE ONLY Permit Fee $ ® Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sever Clain Charge $ TOTAL $ �,�,� Agreement Necessary [ ] NoX Necessary [ ] STIPULATIONS: SUBJECT PERMIT NO. City of Fridley ® 18962 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 ` i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/26/87 10B ADDRESS 6351 Quincy Street N. E, 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 8 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michael Panning 6351 Quincy Street N.E. 571-8524 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 j] ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a, 161':x 161 (256 sq, ft) Deck. 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan, W AR;NING Before digging call local u TELEPHONE - ELEGTRiCG_ E PFE PSM11, . ,�,,,,,-, QUIRED BY LA O. i l t V,.ii3 *Q SIGN& SEPARATE PERMITS ARE FIEIQUIRED 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 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 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 COMPLI9D $11750 $188 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMfT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $29150 STRUCTION OR THE PERFO MANCE OF CONSTRUCTION. 1 PLAN CHECK FEE TOTALFEE $ 7.38 $37.76 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGE IDATEI WHEN PROPERLY TED THIS IS YOUR PERMIT rVI* SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI BLDG INSP ATE NEW ADDN. ] ALTER. [ ] Construction Address: City of Fridley R-1 AND R-2 Building Permit Application Effective 4/1/86 Legal Description: Tel. # Owner Name & Address: v� Contractor: Address: 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. F DECK AREA: Legth n Width / Hgt/Ground Sq. Ft OTHER: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback vo �,� Estimated Cost: $/� Type of Construction: Approx. Completion Date: _,p loe Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation DATE: 5 ,.�- 2 _ff 7 Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: APPLICANT: s''/AAi.� Tel. CITY USE ONLY $ 50 Fee Schedule on Reverse Side $ 0 25% of Building Permit Fee $ .�n $.50/$1,000 Valuation $ $ 525 per SAC Unit $ Fee Determined by Engineering r +n Y • V, Necessary [ ] Not Necessary [ 7 CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Job Address RESIDENTIAL RATE TOTAL Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 $ 'L� Department of Buildings, 6431 University Ave. N.E., Fridley, NN 55432 City of Fridley Gas Piping $ 10.00 $ Tel. #571-3450 (piping needed with new furnace) Gas Range $ 10.00 $ 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 Gas Dryer $. 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. • Air Conditioning (all sizes) $ 10.00 S /y Fridley, Minn. All Others/Repairs and Alterations / % OWNER / , 41 e- It of Value of Appliance or Work $ ,/ KIND OF BUILDING f7a+Gs S COMMERCIAL/INDUSTRIAL USED AS L •'�: ' 10 of Value of Appliance or Work $ TO BE COMPLETEDUT ESTIMATED COST d C) U State Surcharge $ .50 OLD - NEW BUILDING PERMIT NO. PERMIT NO. TO'T'AL FEE $ Reinspection Fee ($15.00) $ Rough Insp. Date Final Insp. / Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS PLUS $.50 STATE SURCHARGE $15.00, *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water Warm Air No. Trade Name P,' Size No. Capacity Sq. Ft. EDR BTU OBc, HP Total Connected Load Kind of Fuel "".-9 BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company Signed By Tel. No. Fill out back side for stack verification on replacement furnaces CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; I. 'Has .been_ careful ly. _ exami ned Yes (; ) 2. Is free from.rust or deterioration Yes ( ) 3. Has no foreign objects lodged within Yes ( ) 4. Is securely supported Yes ( ) 5. Meets all current Code requirements for size and total BTU connected Yes ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Remarks A�- "/ & 4, Company Signed By Date No ( ) No ( ) No ( ) No ( ) No ( ) CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL Furnace Shell'and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer RATE TOTAL $ 20.00 $ $ 10.00 $ $ 10.00 $ * Air Conditioning (all sizes) $ 10.00 $ All Others/Repairs and Alterations li of Value of Appliance or Work $ l COMMERCIAL/INDUSTRIAL 19 of Value of Appliance or Work $ State Surcharge S .50 TOTAL !EE $ IL To Reinspection Fee ($15.00) $ Rough Insp. S t 5 Date Final Insp. 146--91 - � Date� Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00• PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Job Address e 36-/ av I n C 4/ SK /I& -- Department of Buildings, 6431 University Ave. N.E., Fridley, NN 55432 City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application !!1% are true and correct. rr Fridley, Minn. TO , 19& OWNER rA ( K -e PCt,hh , n , A _ n KIND OF BUILDING USED AS TO BE COMPLETED ABOUT t/ ESTIMATED COST 7' O� OLD - NEW BUILDING PERMIT NO. PERMIT NO. ,q- DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Not Water, Warm Air- No. Trade Name Size No. , Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR T� BTU/ HP Company e /�7� 1 . Signed By Tel. No. ` S 7 — is Fill out back side for stack verification on ,replacement furnaces CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. 'Has .been_ carefully examined Yes (,) -No ( ) 2. Is free from.rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU connected Yes ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s Company Signed By Date 0 -''I SUBJECT City of Fridley 2 912 AT THE TOP OF THE TWINS BUILDING PERMIT r RE COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE 1 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 2/11/99 JOB ADDRESS 6351 Quincy Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 8 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ,ADORES$ ZIP PHONE Mike Panning 6351 Quincy Street NE 571-8524 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Solomon & Sons 12211 Olive St NW, Coon Rapids, MN 55448 754-5875 20055664 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW Q ADDITION ❑ ALTERATION Ck REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house & Garage (25 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S0. 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 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@ 142 f $1.,07 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2, DOES PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE OF ANY OTHER STATE OR LOCAL LAW REGULATING CON -IO F -re SC $2.14 OR TME PERFORMANCE OF CONSTRUCTION $74.75 r/11111ON 8��� PLAN CHECK FEE TAL F (% License .00 $ .96 SIGNATURE OF CON'RACTOR Op AUTHORIZED AGENT IOATEI PRO r.ATE4rWS IS Y UR/PER IT S-GNATURE OF OWNER, -F OWNER SUILDERI IDATEI - BLDG -NSA!!! QAtE -''I NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 63s-, Legal Description: Owner Name & A Contractor: Address: A4 (AmC-bf S� - A) iL- 55vl Effective 1/1/99 Tel. #57/- j -T MN LICENSE #4222LL6 Lt4-- Tel. # 7�Li �f 0?_ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. STIPULATIONS: DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/G Sq. Ft. OTHER: : — r Estimated Cost: Construction T e: YP (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 2- APPLICANT: (-2Tel. #7�� S CITY USE ONLY Permit Fee $ ' . �,S Fee Schedule on Reverse Side Fire Surcharge $ o! J 7 .001 of Permit Valuation (1/10th%) State Surcharge $ f (�'% $.50/$1,000 Valuation SAC Charge $ $1050 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: SUBJECT PE City of Fridley 426 AT THE TOP OF THE TWINS BuILDINV DC"vI t � NO. ►v ______ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. ���✓ r � � PROTECTIVE C,hJ 1 = ' /".I CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY . 612-571-3450 910-F15 5/10/99 JOB ADDRESS 6351 Quincy Street 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 8 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Mike Panning 571-8524 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Builders by Design Inc. 18963 Jewel St. Wyoming NN 55092 612-434-0631 20026555 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 20' x 24' addition (Interior finish by owner) 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. NUNN 8ef01e digging call for all utility locations 454- TE pkRMITS .REQUIRED FOR REQUIRED002 By �% RNVV G6 HEA.TING, PLUMBING AND. SIGI , 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 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 ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $27,434.00 $13,72 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS PERMIT FEE SAC CHARGE $27.43 OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $421,55 Fire i$x� PLAN CHECK FEE TOTALEE � LJ', S_ $5.00 $ 7.70 SIGNATURE OF CO TRACT O AGENT ID TEI R ENOP LIDAT IS IS YOUR PERMIT S,GNATURE OF OWNER,; OWNER BUILDER) IDATEI 41 BL7INS OAtE NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �p BUILDING PERMIT APPLICATION ConstructionAddress: 6. ^-c s 1 Legal Description: Owner Name & Address: M% V F P A"r,, �Lc4 Tel: Contractor: u ; lc�� v '�� 1��s �� , �� MN LICENSE # 7 Cc -z(,5;-5S' Address: [ Sq 3 '� q Lj<- I fd W �N z Tel. # c- 12- - 143 4'-64c;3� / Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DATE: APPLICANT: �A� �c��, �`tZ �� t isi3y Tel. # q34 �-0fs3I DESCRIPTION OF IMPROVEMENT CITY USE ONLY Permit Fee $ /• Fee Schedule on Reverse Side Fire Surcharge LIVING AREA: Length 2 Q Width 2-L( Height Sq. Ft. 1490 GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER:v�Su Alt. "A" or Alt. "B" Above Erosion Control $ Construction Type: O o -n Estimated Cost: $ ®ems Sewer Main Charge $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APPLICANT: �A� �c��, �`tZ �� t isi3y Tel. # q34 �-0fs3I CITY USE ONLY Permit Fee $ /• Fee Schedule on Reverse Side Fire Surcharge $ ji, i .001 of Permit Valuation (1/10th%) State Surcharge $ / %Z $.501$1,000 Valuation SAC Charge $ $1050 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: WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring WELL AND BORING SEALING RECORD Sealing to Minnesota Unique No. Minnesota Statutes, Chapter 1031 or W -series No. blank if not known) q x H "�j County Name , Anoka(Leave Township Name fridle Township No. Range No. Section No. Fraction (sm. -s Ig.) % 4 ja Date Sealed 3-24-98 Date Well or Boring Constructed Numerical Street Address or Fire Number and City of Well or Boring Location .gqncy gyp.Fridley 6351 Depth Before Sealing 1. ft. Original Depth 13 ft• Show exact location of well or boring Sketch map of well or boring in section grid with °X°. location, showing property lines, roads, and buildings. N -Y- -Y- -1-- --1-- W - 'r- -i - - - --i-- E - r- - -- -� - --�-- Na mile --�- -�-- - i - -i-- qfr---• rmNe die II AOUIFER(S) H Single Aquifer ❑ Mulbaquifer STATIC WATER LEVEL El Measured ❑Estimated' ft. below ❑ above land surface WELL/BORING ❑ Water Supply Well ❑ Monit. Well ❑ Env. Bore Hole ❑ Other_ CASING TYPE(S) Steel ❑ Plastic ❑ Tile ❑ Other CASING Diameter Depth Set in oversize hole? Annualar space initially grouted? �-;I�M .in. from -Q to 13 ft. ❑ Yes No ❑ Yes ❑ No 0 Unknown in. from to ft. ElYes ❑ No ❑ Yes E]No E]Unknown in. from to ft. ❑ Yes ❑ No - ❑ Yes ❑ No ❑ Unknown PROPERTY OWNER'S NyryAME Property owner's mailing address 9 different than well location address Indicated above. SCREEWOPEN HOLE Screen from to ft. Open Hole from to ft. OBSTRUCTIONS ❑ Rods/Drop Pipe ❑ Check Valve(s) ❑ Debris ❑ Fill :K] No Obstruction Type of Obstructions (Describe) Obstructions removed? ❑ Yes ❑ No Describe WELL OWNER'S NAME Well owner's mailing address ff different than properly owner's address indicated above. PUMP Type ❑Removed] Not Presets ❑ 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 CASINGS, OR CASINO AND BORE HOLE: No Annular Space Frits ❑ Annular space grouted with tremis pipe ❑ Casing Perforation/Removal In. from to ft. ❑ Perforated ❑ Removed in. from to ft. ❑ Perforated ❑ Removed Type of perforator ❑ Other Sane, tan soft 0 3 GROUTING MATERIAL(S) Grouting Materia at cementfrom � to. 13ft. yards bags from to It. yards bags from to ft. yards bags from to it. yards bags REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING r OTHER WELLS AND BORINGS Other unsealed and unused well or boring on property? ❑ Yes [NNo How many? LICENSED OR REGISTERED CONTRACTOR CERTIFICATION This well or boring was sealed in accordance with Minnesota Rules, Chapter 4725. The Information contained in tie report is true to the best of my knowledge. Hadden Well Co., Inc. 02657 Contractor Business Name License or RegWreibn No. 3-24-98 Authorized Representative Signature Date r4ark 'Hadden 3-24-98 LOCAL COPY S ® JH 3 Name of Person Saafing Wei or Boring HE -01434-03 2197 R CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES 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 dor Work 0'. �,Y- 4/., i /o �e�lct, d 1''a5." Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 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. Effective On May 10, 1999 Air I"b JOB ADDRESS 0/'55-Z (2,a, , a)4 OWNER �i c s� �.� TOTAL BUILDING USED AS //o $// ESTIMATED COST /Oct ®fes PERMIT NO. , 6 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 0-�Z) L)) It Signed i`% DATE Approved By Rough -In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Inas 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: