PRE 2010 DOCSCity Of Fridley, Mim. N° 8674
BUILDING PERMIT
Owner: Dan J. Sullivan Builder
Address L 61 Regis Me E* Vane Address
LOCATION OF BUILDING
No.- 6]61 _ _ Street Regis Ifille N • Part of Lot
Lot 8 _ Block Addition or Sub.Division Auditors Subdivision, No. 2�i
Corner . Lot _ Inside Lot Setback __ _ Sideyard
Sewer Elevation Foundation Mevation
DESCRIPTION OF BUILDING
To be Used as:
'ami1Z Room Front Depth Height Sq. Ft. Cu. Ft
Bath loom Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction - PARA -1 Est. Cost _00.00 To be Completed 311166
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 co`,m/p%liance with 21 provisions of
ordinances of the city of Fridley. �/ L
In consideration of the payment of a fee of __—, permit is hereby granted to
Dan J. Sullivan to construct the building or addition as described above. This permit IS granted upon
the expVd
tion that the person to whom it is granted and his agents, employees anworkmen, in all work
done inand upon said building, or any part thereof, shall conform in all respects to tine ordinances of
Fridley,ta within mits permit may be revoked at any time upon violation oY any of the provisions of said
ordinances.
NOTICE
ihls permN dos not sorer the aonstrosNoe, hat Dillon for wkbW phnabine, Ba heating, sewer or water. Be aro to m
tin Baildhis laspoator for apuah pormim for thea Nina.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME
I /A&I
BUILDER
ADDRESS /Ml l
/� `KGs! S
�.�T �cr� Alm'
ADDRESS
LOCATION OF BUILDING
/ Street. 1751„ Pari of Lo
Z .._ K _ ADDITION OR SUBDIVISION llvilm,_
Corner Lo` Inside LOT Setback Side -+Yard_
...SEATER I.EVATION FOUNbA±109 ELEVATION,
Applicant attach to this form xwo beki iii6ates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF.BUILDING
To be used as;
___ tea®e- �- 1em®a0 Front Depth Height
Sq. Ft.
Cu. Ft.
) ® Front Depth Height
Sq, Ft. Cu. Ft.
Type of Construction �s_� Estimated Cost _-5,00
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.
DATE_
(Schedule of Fee Costs can be found on the Reverse Side).
City of Fridley
SUBJECT
PE .
14'73
AT THE TOP OF THE TWINS
PERM
r
t `
BUILDING
ECEIPT N
`L COMMUNITY DEVELOPMENT DIV.
r 1 � PROTECTIVE INSPECTION SEC.
�t1 �7
t � �
CITY HALL FRIDLEY '55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
6/1/78
JOB ADDRESS 1161 Regis Lane. N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
Pt. 8
Auditor's Subdivision #25 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Dan J. Sullivan 1161 Regis Lane N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Camper City 9900 N.E. Hwy. #65 786-9430
4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
Ik NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 16' x 321 Above Ground Pool
9 CHANGEOFUSEFROM TO
STIPULATIONS
See stipulations on letter dated May 31, 1978 from Environmental Officer
Wom digging call local uttljUes.
-SEPERAYT PERMITS REQUIRED FDR VWFdN4 WNW • ROW • W Eta
l4EA'1 , UM81 G'mty:SUM REQUIRED BY LAW
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Steel/Vinyl
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
ISTALLS GARAGES`;
AND KNOW THE SAME TO BE_T,RUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
$2,100
$.60
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.
PLAN CHECK FEE
TOTAL FEE
$15.60
SIGNATURE OF CONT CTORAUTHO )ZED AGENT (DATE)
W EN PROPERLY VALIDATED IS IS Y7 PF-7RM1T
I
LDG. )NSP DATE
SIGNA URE OF OWNER IIF O ER BUILDER) (DATE)
CITY OF FRIDLEY
APPLICATION FOR Rl SII)ENTIAL hUILDING PLIMITS
GIEW, ALTL"RATIOI1S, AnITIONS, OR REPAIRS)
Oj•INER: ,JI 2-1 SU i I I UC,, j2 Qjtr1,, Qc:� r y
Address: : W,s6� Address:
Tel. No. _ "� � (� - 9 5�. � b L.
No.: Street:
E.X001 of - Q c
LOT: _ � BLOCK: ADDITION: A,5 � 5
COMER LOT: INSIDE LOT: SETBACK.: SIDEYARDS:
Applicant attach 'to this form 1ti10 Certificate_ of Survey of Lot- and proposed
building location dram on these Certificates.
To'Be Used As:
DESCRIPTION OF BUILDING
Front: / Depth: Height: _
Square Feet: Cubic Feet:
'Front.- Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: C��2c1� Estimated Cost: $
Tb Be Completed: Czt Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, zgrecing.to do all work in strict accordance with the City of
Fridley Ore-nances and rulings of the Department of Buildings, and hereby
declares that all the facts ana representations stated in this application .
-Ire true �vld correct. See reverse side for additional_ information.
DATE: 1-5�-13 % - 7 Y' SIGNATURt.: 1
Stimulations:
1 �,o
v
r I
F
May 31, 1978
4
�.0
6431 UNIVERSITY AVENUE N.E., FRI®LEY, MINNESOTA 55432
Mr. Dan J. Sullivan
1161 Regis Lane N.E.
Fridley, MN 55421'
TELEPHONE ( 612)571.3450
Re: Swimming Pool Construction at 1161 Regis Lane N.E.
Dear Mr. Sullivan:
This letter is to make clear this departments requirements for the swimming
pool construction at the above address.
1. As indicated, one (1) skimmer approved by the National Sanitation
Foundation will be provided.
2. As indicated, two (2) inlets of approved design for fresh and/or
repurified water will be provided.
3. The filter and pump shall be approved by*the N.S.F. and be of
sufficient capacity to provide a minimum turnover of at least two (2)
times in 24 hours. This department recommends a turnover rate of
6-8 hours.
4. A deck of at least three (3) feet wide,. measured from the pool water's
edge, shall be provided which extends completely around all private
residential pools. Above ground private residential pools may be
provided with decking of a minimum of 4 feet by 4 feet at pool entry
points and provided that such decking has the approval of the City.
5. Fencing or other effective means including but not limited to walls
or buildings, acceptable to the City, shall be provided to positively
control all access to public and private residential swimming pools.
Fencing shall meet the following criteria:
(a) The fencing shall prevent the entrance of children and be without
hand or foot holds that would enable a person to climb over it.
(b) The fencing shall be at least 6 feet high and entrances shall be
equipped with self-closing and self -latching gates capable of
being locked.
(c) Self-closing and self -latching devices shall be placed at the
top of the gate or otherwise inaccessible to small children.
(d) The opening between the bottom of the fence and the ground or
other surface shall be not more than four inches.
6. An automatic chlorinator should be provided with a suitable test kit.
7. All electrical and plumbing installations shall be inspected and
approved by the City Inspection Department.
8. All electrical lines must be 10-20 feet or more away from the pool
surface.
Mr. Dan J. Sullivan
May 31, 1978
Page 2
9. The,pool fill spout must be air gapped or protected by a vacuum
breaker.
10. Suitable safety equipment to include but not limited to a ring
buoy and rope that is 1� times the pool diameter, shepherds crook
pole must be provided and maintained with the pool at all times.
Furthermore, these and any other requirements must meet the provisions
of the Fridley City Code, Section 115, Swimming Pools. The building
permit is approved contingent on final inspections and approval by
the City.
If any questions or problems arise from this letter, please feel free
to contact me at 571-3450, ext. 170.
Sincerely,
SIMV J. OTS
Environmental Officer
SJO/mh
hand or foor holds tat would enable_ a
Original
PERMIT for Power Plants and Keating. Cool=
ing ventilation. Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of %� Heating Plants to be installed—attered—repaired
Make . T,e-,QeL-n 4L4 Q Ili , Size !��–
Oil fired ; Coal fired ; Gas fired ; Gas Authorization
Remarks
Approved
Final Inspection
19_
Inspector
aa®%
Peru N° 4742
Fes $ 16' 00
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn.
Owner F=. evnU v A-,; V–A
Location Ileo 4At;1)
Kind of Building -
e
How Occupied
Work to be Commenced—, 19
To be Completed - /S ,19.6
Estimated Cost,
Old- ew, Building Permit No.
Permission is hereby granted to to install—erect—use the material and devices described in the
above statement. This permit is granted upon the expressJcondition that tffe person to whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of the devices herein named, and to the specificatco setworth in the approved application for this
permit on file in the off ice o f the Inspector o f Buildings. °
Inspector of Buildings
4 z ane 11-67 v
MEMO TO: Ric �r V. Sobiech, Public Works Director
MEMO FROM: Clyde Moravetz, Engineering Admistration
MEMO DATE: August 1, 1979
SUBJECT: Proposed Property Trade-off Near Regis Lane and
Hillwind Road (See Attached Map)
Several months ago, Dan Sullivan at 1161 Regis Lane requested a trade-
off of property effecting Parcel 4900 in Section 24, Township 30,
Range 24 (10' strip of unplatted property west of Sheridan Acres -
designated "A" on map), and the City owned property designated "C".
Mr. Sullivan wants to acquire the excess public property adjoining his
land in order to provide area to accommodate an outdoor swimming pool
("C" on map). The City should acquire an easement from Mr. Sullivan
("A" on map) for utility and drainage purposes, as there are existing
public utilities on this parcel.
The Assessor's office has an evaluation of approximately $0.25 per
square foot on the property to be released ("C" on map). Using this
amount and taking into account the difference in sizes of the two
parcels, it would be suggested that the City should ask for $1,500.00
or $1,550.00 to consummate the trade-off of these properties.
Attached, also, is an ordinance which declares the'City property to be
surplus and authorizes the sale.
CVM: jm
Attach: 2
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Quit Claim Deed.
r Corporation to individual.
Form No. 30-M.
Miller -Davis Co.. Minneapolis. Minn.
Mlnneeota Uniform Conveyancing Ulanka (1831).
I
r ,
.Made this ......... 10th ..day of. ..September....... Ye 79
between......... G ty.sf „Fr dle.3'...................................................................................................................................................... .............
municipal
avcorporation under the laws of the State of......Hiltne-SQta....... ........ .................. ...... ...... , party of the fifst part, and
Daniel J..and Mary Kathryn Sullivan (husband & wife)
..........................................................................................................................................................................................................................................................
of the County of.. Anoka and State of .... .. a ................................................ .........,
part.ie ........of the seeand part,
Enftne0etb, That the said park of the first part, in consideration of the sura of
... F1f.WW... h4lndred...OQI ars .... ($1,,500,09,-and.other...val,ues.. received DoLLdBs,
to it in hand paid by the said parties... ..... of the second part, the receipt whereof is hereby acknowledged,
does hereby Grant, Bargain, Quitclaim, and Convey unto the said parli.ew%......... o of the second part ,... ......... _,......
heirs and assigns, Forever, all the tract ............ or parcel ............ of land lying and being in the Coun&j of
...... AnQka.... _ ................................................and State of .41innesota, described as follows, to -wit:
All that part of Lot 9, Auditorts Subdivision No. 25, lying Northerly of the
following described line. Commencing at the Northeast Corner of said Lot 9;
thence South along the East line of Lot 9:a distance of 49.4 feet to the actual
point of beginning. Thence deflect to the Right in a West -Northwesterly direction
along a line to its point of intersection with the North line of said Lot 9, said
point being 335.8 feet West of the Northeast Corner of said Lot 9, and there
terminating.
To babe anb to WIb the frame, Together with all the hereditaments and appurtenanm there-
unto belonging or in anywise appertaining, to the said part ... ies...... of the second part ,....... glair._ ...................
heirs and assigns, Forever.
i
In Presence of
In Zl O f nonp Wi bereof, The said first party has caused these
pr eats to be executed in its corporate name by its ....................................
3_ NXt: and its ...... C;Uy... Manager ...............and its corporate seal to
be hereunto affixed the day and year first above written.
William J. Ng'e f Mayor
Is...................... ......................... �?rese cfet
M..SGe...... ....................
Nasim M. Qureshi - City Manager
T................................. ......................
6tate of Alinneota,
ss.
( 'ozj n 1.71 of . Anoka . ....................................... ...............
On this. ................ lOtb ................................. day of ..................... September ............ .. .. ................... 19 .... 7.9..., before -nw, o
-Y ... Public ................................................................. with in and for said County, 7*r,,;onaZly appearedj, !.r
................. ., J-aM,J-...Nee ....................................................... and ....................... Nasim ... M-...Quresh.i ............................................
to -nwpersd"Zly, kiotw,i-A who, being each by me duly szvorn .............................. did sa,71 that tjge?. -vely
I I . Ire respeeti
L .1
Ithe .... MAY(?.F .......... ...... Pmidmrt and the ..... Ql.tY .. Xan.49er..................................................of. V municl d - the
Zn
fore,61ng imvtry , i meibt, rind that the seal aflixed to said instrument is the w.k%U91cal of saW=A&U94ty
ov-d that said.'instrun?ent;zvas signed and sealed in behalf of said ERAQ9410authortty of its --ar=d
'City.Counci
I
...................................../.....................and said ......................................................................................................................................... a'nd
.................acknowledged said instrument to be the free act and deed of said
... y***�,*,**,-*.,,
............. .................................... ...
THIS INSTRUMENT WAS DRAFTED BY
Cl-ty o�rldley am Notary Publics .................................. . ....................................... County, Jfinm.
..6431 University Ame.'-NN V.
Fridley. Mn. 554321 (Address)My bonnl8s*wn expires .................................................................. 19.. ........
-CME V. MORAVETZ
NOTARY PUBLIC —
MINNESOTA
ray ANOKA COUNTY
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CITY OF FRIDLEY
6431 UNIVERSITY AVE. N.E.
FRIDLEY, MN 55432
(612)571-3450
REZONING REQUEST ZOA #
VACATION REQUEST SAV #
PLATTING EQ�' ..
REQUEST FEE PARR FEE RECEIPT #
SCHEDULED PLANNING CDMMISSION MEETING DATE
SCHEDULED CITY COUNCIL MEETING DATE
PROPERTY INFORMATION
LEGAL DESCRIPTION:
per4-tdnS c -C
LOT . BLOCK TRAGI'/ADDITION kiters &,b d i vo�
W0 DNy k IT.
e; s� 1* `yy31
REASON FOR REQUEST: A site plan showing the proposed future use is required for all
^'j 2- /4-2 7- 6',z,
FEE
FEE OWNER INFORMATION 95Z7- dry=
NAME (please print) 69 -Al � ,�vLL •• �PHC7NE # %!-
ADDRESS // (o" Z' 4:: 6 1 5 L,A) �„ r� /=2. l c. rL -'r-
SIGNATUREDATE
******�°r*>�**************'*************
PETITIONER INFORMATION
NAME (please print) PHONE #
a.111111111111 1 0 ----
SIGNATURE DATE
PLANNING OOMt ISSION : APPROVED DENIED DATE
CITY COUNCIL:
STIPULATIONS:
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
CITY COUNCIL
ACTION TAKEN NOTICE
Dan Sullivan
1161 Regis Lane N.E.
Fridley, MN 55432
Dear Mr. Sullivan:
November 8, 1990
On November 5, 1990, the Fridley City Council officially approved
your request for a Plat, P.S. #89-01, Sullivan's Overlook, with the
following stipulations:
�. There shall be no grading below the 952 foot contour on the
northeast corner of Lot 2.
2. The access to Lot 2 shall be toward the westerly side of the
lot and shall be hardsurfaced.
If you have any questions regarding the above action, please call
the Planning Department at 571-3450.
Sincerely,
Barbara Dacy
Planning Coordinator
BD/dn
Please review the noted stipulations, sign the statement below and
return one copy to the City of Fridley Planning Department by
November 22, 1990.
Concur with action taken
STATE OF MINNESOTA DEPARTMENT OF HEALTH
ABANDONED WELL RECORD
1. LOCATION OF WELL MINNESOTA
TA UNIQUE
f not known) NO. H
County Name ANOKA
Township Name
Township N
Range Number
Section
4. WELL DEPTH (completed)
Date sealed
FRIDLEY
"E
7FrEaction
kof y
30 sr
23or
24NESW
155 ft'
EPT _ 8 , 3 -
Numerical Street Address and City of Well Location or Distance from Road
S. DRILLING METHOD (if known)
Intersection
Cable tool 40 Reverse 70 Driven 100 Dug
1161 REGIS LANE
20 Hollow Rod 50 Air 80 Bored 110
30 Rotary 60 Jetted 90 Power Auger
Show exact location of well
(in section grid with •X.) 19 Sketch map of well location
6. OBSTRUCTIONS
N
Weil obstructed 0 Yes jK No
Obstructions removed Yes 0 No If obstructions cannot be
removed, contact MOH
before sealing.
SI _ _ _ _ _ _I_ _ E K. 9a?
Q
SE
7. U Domestic 40 Monitoring B0 Heat Loop
_
20 Irrigation 50 Public 90 Industry
I.
30 Test Well 60 Municipal lq ] Commercial
S
�--i+iL—
70 Air Conditioning 110
2. PROPERTY OWNER'S MAKE
Mailing Address if different than
8. CASING(S)
DAN
property address indicated above
Black Threaded 70
1161 REGIS LANE
20 Gil v. 50 Welded
SULLIVAN
FRIDLEY MN. 55432
r
30 Plastic 60 Stainless Steel
3 in, to 152 ft.
HARDNESS OF
3. FORMATION LOG COLOR FORMATION FROM TO
If not known, indicate formation log from new well or nearby well,
in. to ft.
FINE SAND
RN/L
0
28
9• SCREEN
Greened wel l froul rft. tq�r ft.
(If known)
❑Open Hole from_ ft, to ft.
CLAY
3LUE
28
76
,r.RAVVT.
76
98
10. STATIC WATER LEVEL
land SuNaceow Datemeasured9— 8— 9 2
MUDDY GRAVEL
LUE
9$
111
SAND,GRAVEL
REE
111
128
11. WELLHEAD COMPLETION
10 Pitless Adapter 40 Found Buried
SHALE , SANDROCK
REE
128
153
Basement offset 50
SHAKOPEE ROCK
ELL W
153
270
3D Well Pit
16. REMARKS, ELEVATION, SOURCE OF DATA - CASINGS REMOVED, CASINGS PERFORATED, ETC.
12. GROUTING INFORMATION 8 BAGS �
GEOLOGY WAS TAKEN FROM THE WELL AT i
6000 W. MOORE ST.,FRIDLEY SR. HIGH
)KNeat Cement 2�pp Bentonite
Grout materiaiPORTLAND from to_ �.'eu. yds
N —
WATER LEVEL IN THE ABOVE WELL: 65'
— —
DATE WATER LEVEL WAS TAKEN: 9-24-68
13. N ST SOURCES CONTAMINATION
� r
feet direction CITY SEWER type
Well disinfected before sealing? WYes
14. PUMP XRemoved 0 Not Present
Type: 1Q Submersible 30 L.S. Turbine SQ Reciprocating
Jet 40 Centrifugal 60
Eept,. Q '���
15. EXISTING WELLS (Please sketch locations of abandoned and
0 1
active wells in remarks section or on back.)
Other unused well(s) on property? 0 Yes�No
hALr.0This
Abandoned: 0 Permanent 0 Temporary r] Not sealed
17. WATER WELL CONTRACTORS CERTIFICATION
well was sealed under my jurisdiction and this report
_ —
is true to the best of my knowledge and belief.
According to MN State Regulations
E.H. RENNER & SONS,INC. 71015
1568ceng JltlsjOp 1191r . N . W • License No.
Add R . V , 55330 427-6100
®3�
Signed Date 9-9-92 4 �."'
Date —8-92
Na of Driller
OF FICIAL ABANDONED WELL RECORD (May be used for Property Transfer)
Z"CRTA'= rzrB WZT$ DMW
KEVIN H O P P E
S
SUBJECT
PER
City of Fridley
4093
AT THE TOP OF THE TWINS
BUILDING
PERMIT
Ir
RECEIPT
� • _ _ COMMUNITY DEVELOPMENT DIV.
L INSPECTION SEC
r PROTECTIVE
(YJ
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE Of
APPROVED BY
612-571-3450
910-F15
4/24/97
JOB ADDRESS 1161 Regis Lane NE
1 LEGALLOT
NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
1
1
Sullivan's Overlook
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Chad Norgren 1161 Regis Lane NE
571-4241
3 CONTRACTOR MAILADDRESS
ZIP PHONE LICENSE NO.
Phalen Siding & Trim Inc 1528 Linc731-2092
6216
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 ❑x REPAIR O MOVE ElREMOVE
8 DESCRIBE WORK
Install soffit & fascia
9 CHANGE OF USE FROM TO
STIPULATIONS
Ventilation to meet 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
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,740
@@ 87
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
`I' •
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORI Y Tq VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE O LOCAL LAW REGULATING CON-
$56.75
Fire SC $1.74
STRU RFORMANCE O CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
License SC
5.00
$ .36
51 Tu EOFCONTRA ROR THORIZEDA T IDATEI
HEN P
ERL V IDATED IS YOU PERMIT
✓BLDG NSP
FATE
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
S
NEW [ ] Effective 1/1/97
ADDN [ ] CITY OF FRIDLEY
ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 114e;1 5 e
Legal Description:
Owner Name & Address: / U d"- .�-� ��� / , ° I �- Tel. # 5
Contractor:y '"�� R- F° �' -� 'f" �� -�^- LICENSE #�
Address: i�� '�' r :'� /"' �• ��-�- Tel. #
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
OTHER:
Construction Type:
Sq. Ft.
Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x. $ _ $
DATE: APPLICANT: P Tel. #7`�/�� c
Permit Fee
$ 56,,7f
Fire Surcharge
$ `7 tZ
State Surcharge
$
SAC Charge
$
License Surcharge
$
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $
45,
STIPULATIONS:
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 [ ]
Z
ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571.1287 Fax
BUILDING PERMIT APPLICATION ;Los
Construction Address:
Legal Description:
Owner Name & Address: 6= PAel. # nt- 90 /(0
Contractor (V—O—MN LICENSE #
Address:Tel. #
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRIPTIYN OF IMPROVEMENT !
LIVING AREA: Length Width Height Sq. Ft
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: �Zr ��e�. Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ $
DATE: A 2j APPLICANT: Tel. # 12-
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.
CITY USE ONLY -
Permit Fee
$ olS. S
Fee Schedule on Reverse Side
Plan Review
$
65% of Permit Fee
Fire Surcharge
$ , . 6
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50!$1,000 Valuation
SAC Charge
$
$1450. per SAC Unit
License Surcharge
.$ --
$5.00 (State Licensed Residential Contractors)
Curb Cut 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 [ J Not Necessary [ J
TOTAL
$
STIPULATIONS: