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SUBJECT
PERMIT NO.
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
ZCEIPT
NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1
f�;
1 -"1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
j 612-660-3450
910-F15
7/21/77.
JOB ADDRESS 1491 Rice Creek Drive N.E.
1 LEGAL
LOT NO:
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
2
1
Heather Hills 3rd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Robert Helerg
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Commercial Erectors 5298 Filmbre Street N.E., Fridley 571-8865
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
C�A NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 261 x 321 Dwelling and a 201 x 241 Garage
SEEPERATE PERM"T EU.. FOR WIRING.
8 CHANGE OF USE FROM
HEATING, PLUMBING AND SIGNS.
STIPULATIONS Provide copy of truss design. Provide 45 square feet of window space
in recreation room or install adequate exhaust fan. Specify name and
approval of prefab fireplace unit before capping. Suggest eliminating full
wall brick in 2nd story frame construction. Provide a hard A)(f surface
driveway. Provide sod in the front and side yards. Provide a verifying
survey before capping.
AS BUILTS NOT AVAILABLE AT THIS TIME —REFER TO COMSTOCK & DAVIS AT
784-9346
DRIVEWAY DEPRESSION COST: N/A Existing Surmountable Curbing
`Con d+ttMg call local
.toC
o before
ft
aArA ► TxE YELEPHONE - ELECTRIC -
"FORMAWN AUlt AND �1flft$S
rrRSONS
USS RED p s
ff
No
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUM, WQFigawy Y OF CONST. OCCUPANCY GRO OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. d Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. 4800 Gar
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 1092 + 480 25,952 Total
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
$25.93
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $51,865
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTIVE PERFORM C F CONSTRUCTION. 9X$I Xn $123.01 $375.00
PLAN CHECK FEE TOTAL FEE
0.75 $554.69
SIG ATUREOF NTRACTORO AUTHORIZED AGENT (DATE) -VJHEN PROPS Y VALIDATED TIS IS YOUR PEERMIT
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) EILDG. WSP J DATE
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ENERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION
PLANNING AND TNSPEC'TION I1[:PAPTNIENT
CITY OF F'RIDLEY, MINNESOTA
This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE
AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING
OPPICIAL can determine that submitted plans comply with the ENERGY CONSERVATION
DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). It is the APPLICANT'S
responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA
in the plans; submit product specifications, if needed to support the "R" and "U"
factors used; and to assure construction is per.approved plans.
JOB LOCATION:
OR:
OWNER/CONTRACT
F-
ADDRESS: �'2 % PHONE: 5 y a
A. Determine the Total Exposed Wall -Area as follows:
1. Total wall window area
2. Total door area
3 Total sliding glass door area
4. .� Total fireplace wall area
55:-%1 Total wall framing area (average 10%)
6. Total net wall area above floor(average 900)
7. Total rim joist area
Subtotal: Total exposed wall area above floor
8. Total foundation window area
9. Total net foundation area above grade
Subtotal: Total exposed foundation area
GRAND TOTAL EXPOSED WALL AREA
ty I If
B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17 =
C. Determine the Total Exposed Roof/Ceiling Area as follows:
i�
10. Total skylight area
11. Total roof/ceiling framing area (10%) %/
12. Total net insulated roof/ceiling area
GRAND TOTAL EXPOSED ROOF/CEILING AREA
Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X .05
• t
�V
Item I
Item II -> ��
E. Determine the "U" value of
each segment
(1-9) and multiply by the area as
fol1�,W";
Code 6006 (c) 1..0001
I. Add Item I
,Ajrd + Item II
1..
.�2 2— Yi
teUll
+ Item IV
_Q
r.
2.
:, x
01
- l70 4t
4.
�, X
?full
, zoo
- :?
x
souls
-07
Z. JAA--0 W
2.
I X
"U"
P S 7`�
_ �►
9.
_ � x
��U��
o Ci
= 6
ye
ADD 1-9
FOR TOTAL WALL SEGMENTS
=
I//TEM III
F. Determine the "U" value
of
each segment
(10-12) and multiply by
the area as
follows:
10.
X
"U"
11.
g
fluff
_
12.
v x
,-UJ„
_
ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS = ITEM IV
G. If Item III is the same as, or less than Item I, you have met the intent
of State Building Code 6006 (c) 2.
H. If Item IV is the
same as, or less than
Item II, you have met the intent
of State Building
Code 6006 (c) 1..0001
I. Add Item I
,Ajrd + Item II
l/
���• 3 =�
+�
J. Add Item IIT
+ Item IV
_Q
r.
K. If the sum of Items III and IV are less than Items I and P -, -,-You h e met the
intent of the Code for total envelope system.
01
The undersigned, as applicant for a building permit, hereby affirms the above
information has been prepared and submitted by himself or under his direction,
hereby acknowledges the information to be correct and accurate, and hereby
presents the information with required plans in support of the building permit
application.
—f,/By: Y k�DATE: Ltj:l:
0
June ' 27, 1977
Page Six.
In conclusion, Mr. Chairman, members of the Board, I reiterate
my confidence in the recommendations. I feel it imperative
for Anoka County to move forward in the development of a
coordination capability which is separate from any individual
department. The first year of implementation will provide
for an integrated budget and program format for the three
departments. This will assure the policy makers that there
is no duplication of program effort without an absolute need.
Further, the policy makers will have the ability to develop
long-range goals and objectives for the total Human Services
System in the County in order to maximize the County investment
in scarce tax dollars for the delivery of very necessary
Social Services.
Finally, the afore -referenced recommendations will afford
Anoka County the flexibility which we will certainly need as
we approach major changes in the Federal and State administration
of Social Services programs. The County Board, with the
Acceptance of these recommendations, will be assured of
being in a position of being able to respond to change
rather than react after the fact to impositions of other
layers of government which may not conform to the needs at
this local level.
Ral h L. McGinley
Executive Secreta
RLMadf
V CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS.
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER BUILDER:
Address: '< l `
Address:
Tel. No.
No. / Street: ^
LOT:
BLOCK:
�_
ADDITION:
llct' " q
CORNER LOT:
INSIDE
LOT:
SETBACK:
SIDEYARDS:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
0
DESCRIPTION OF BUILDING
To BeeUsed As:
Y04��
Front: 0 Depth:
Square Feet: l d'
Front: 2z
Square Feet:
Type of Construction:
To Be Completed:
Height:
Cubic Feet: CY 0j two cow
Depth: - L 7
At bd Cubic Feet:
Height: /40
Estimated Cost: $
4j) A 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, 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
a e true and correct. See reverse side for ad itional inform ion.
DATE: z SIGNATURE: c''--✓�/
Stipulations:
P' y
s,— .ov
n.
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Surveyors Certificate
COMSTOCK & DAVIS, INC. Consulting Engineers and Land Surveyors
1446 County Road J, Mph., Minn. 55432, 784.9346
Lot 2, Block 1, Mr. Mike p!Bannon
Heather Hills Third Addition 5209 Fillmore Street N.E.
Fridley, Minnesota Mi=eapoli.s, PM xmesota 55421
l3.
ame(r9malo(ohlily easement-- _ ,
7500--1�
I
6',
� r
;:.0 C2iY OF FRIDLEY DOES NOT GUAR.4 , ° 4�
AC�WACY OF UTILITY LOCATIONS AND ELEVATIC .j
THIS DATA IS FOR INFORMATION PURPOSES ONLY AK
PERSONS USING IT SHOULD VERIFY( THE INFO TIQ�,
ON THE SITE,
O
" P
RICE CREEK DRE!� --
P
LEGAL DESCRIPTION;
Lot 2,. Block. 1, Heather $ills, Third Additigna AnpkaZCounty, Minnes.ota,
SCALE: / "- SDS
o de/ioles iron rrlonamenl
I hereby certify that this survey, plan or report was prepared by me or under my direct
supervision and that I am a duly Registered Land Surveyor under the laws of the State
of Minnesota. -
_� 13,2 iz/�o%6 36L�
Reg. No. .Fite Job No.
ar
gr
s re ate
Dom t -ors
m i- Wil - 9.7 V4
August 5, 1977
CITY (OF P t,
6431 UNIVERSITY AVENUE N.E., FRIULEY, MINNESOTA 55432
Mr. Joseph D. Ryan, Attorney at Law
3700 Central Avenue NE
Minneapolis, MN 55421
Dear Mr. Ryan:
TELEPHONE ( 6.12)571-3450
As discussed with you in a telephone conversation August 3rd, the
City of Fridley is in receipt of your correspondence indicating Mr.
Anderson's concern with the existing ditch on his property.
One of the items you mentioned was the possibility the City of
fridley did not have proper easements for the ditch construction.
Please note the attached quit claim deed which indicates a 25 foot
utility and drainage easement dedicated to Fridley.
As far as items pertaining to maintenance and the.hazardous con-
ditions of the existing ditch, perhaps a meeting at the site could
result in a solution.
After your review of the attached easement.and discussion with Mr.
Anderson, please contact me to arrange a meeting at your convenience
to further discuss the matter.
Thank you for your cooperation in this matter.
Yours very truly,
Richard N. Sobiech, P.E.
Public Works Director
RNS/jm
cc: Mr. Njalmer Anderson ,
1491 Rice Creek Road
Quit Ciaun ueen.
Individual to Corporation.
�1�, i-, , ifill:r-Davis Co., Minneapolis, Minn.
Minnesota uniform Conveyancing Wanks (1931).
ZS
.Made this ...... ....8 ..
**'*8th- ....... ..............day of.........January................................
between................I�almer Anderson (Husband) and Ruby A. Anderson,. (Wife...
of the County of..................Anoka........................................ and State of Minnesota
.............................................................................................
part?eS... of the fir8t part, and ....................................... City ...qt.Fridley................................................................:.............................
............................................................................................................................................................................................................................................................
a qlqt,�olqtW under the laws of the State of.....................MRRQ.aqta .................................. party of the second part,
municipal
Mane'qOetb, That the said part -ins.. of the first part, in consideration of the sum of
...... ....0ne...and.Nod.I00....(.$1...4.9.}...a ...otk�ox..va..t�es....re.c.eiued............ .......... .-........
-.-.-.-.-.-.-..DOLL.gItS,
to.....................them........................... in hand paid by the said partly of the second part, the receipt ar�hervof is
hereby acknowledged, do............ hereby Grant, Bargain, Quitclaim, and Convey unto the said party of
the second part, its successors and assigns, Forever, all the tract...... or parcel...... of land lying and being
in the County of..................... Ar&a................................................... and State of Minnesota, described as follozcs, to-urt:
A 25 foot utility and drainage easement described as follows:
The North 25.feet of Lot 2, Block 2, Spring Valley Addition.
All lying in the South Half of Section 13, T-30, R-24, City of
Fridley, County of Anoka, State of Minnesota.
NO STATE DEED TAX REQUIRED.
The City of Fridley hereby accepts this easement for utility
and drainage purposes.
M RVIIN C. BRUNSELL - City Clerk
To 3babe aub to olb the &ante, Together with all the hereditainents and appurtenances there-
unto belonging or in anywise, appertaining, to the. said party of the second part, its successors and assigns.
rOreUer.
5Ja urotgmoatp Wbereoi, The said part-i.es.. of the first part ha ... ve.... hereunto set.....theix................
hand S.. the day and year first abore u.•ritten.
lit Presence, Of ..........
..a .......... ...... q.
.................................
r
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TocAU7 i P,1ua ,`
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AW-wtate of inne!5ata, i
SS.
Anoka
...................................
I
On this ........... _.............8.th...............................day of. ..,.......... anuary....... .... ........ ........... .....
..., .1974......., before tree, I.
Notary............................................................zclitlt.izz• azzd for ?aid County, personally a.p>>ea.rrrl
Hjalmer Anderson (Husband) and Ruby A. Anderson (wife)
In tnc 7c71011M. to be the persozL...S..... ............................... described in, and ztlto executecl the fore6oin6 bmtrta.nzent,
_............. .................... .............................................................................................. .......... and aeknozeled! ed that ...th.e.y.. execidecl the
(See Note)
the
srattt.c cas.............................ir ......free act and, deerl............................................... .......................................
.....
/ (See ?Vote) 9r
9
L l 7 7 L/. ...
THIS INSTRUMENT WAS DRAFTED BY G. ........:.......... ... . r... � ...:. :..
City of Fridley_
6431 University Aven "N). E. Notary Publi.c................................ -'. ' " ....C'ounty, 111nn.
� MnM/�✓VvtM�\M.M/.•`.'�.'�MM.^ice: J�hA.'W`, n
ss) S ., ws; SS'AE`MrRA h9. BERRAY
Fridley, Minnesota 5� �- ., �� U'� �
.,lly cdi�%tzz sao, a tze ........
Hh ril C - 1'IIlidES'CTA"' ,
r2'• 4y3 Ar—o',@ County
Note: The blank lines marked "See Note" are for tts-e wlTCn thcdrtorney in fact.
et Vt��/VWVV: �t`VJt��.'V1NV�M:b'W�nfW\M.M/m
TQx Statements 46, _ffie Re��
PVOPe� desor',bed
ir�st�uvned�t he Son+ -to:
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PETER BARNA
JOHN W. TERPSTRA
ROBERT A. OL77Y
RICHARD A. MERRILL
GABRIEL D. OIANCOLA
ROBERT C. HYNES
GORDON L JENSEN
"JAMES D. OIBBS
CAUL E. QPDI,EWSKI
t
N A. RAETZES' W. REUTER
JOSEPH D. RYAN
DENNIS J. VAN ORDEN
BARNA. (SUZY. TERPSTRA, MERRILL & GIANCOLA. urD.
ATTORNEYS AT I.AW
3700 CENTRAL. AVENUE. N. E.
MINNEAPOLIS, MINNESOTA 06421
(812) 788-1044
FRIDLEY OFFLCE
COMMERCE PARK OFFICE BUILDING
7602 UNIVERSITY AVENUE N. E.
FRIDLEY. MINNESOTA 66432
(612) 788.9481
July 29, 1977
Mr. Nasim Qureshi
City Manager
City of Fridley
6431 University Avenue N.E.
Fridley, Minnesota 55432
Dear Mr. Qureshi;
Please be advised that I represent Mr. Hjalmer Anderson who
resides at 1491 Rice Creek Road, Fridley, Minnesota.
Mr. Anderson has retained this office as a result of the City's
maintenance and use of a rear portion of his property for
drainage purposes. In talking to Mr. Anderson and inspecting
this area being maintained by the City, it appears that a rather
dangerous condition exists with the potential of a youngster
being injured in falling into the rather steep bank, which
resulted when the City dug this property out.
I would appreciate your contacting me or your forwarding this
letter on to your City Attorney in order that I may discuss
this matter with yourself or your Counsel.
Your earliest attention to this matter will be appreciated.
Sincerely,
osGph D. Ryan ; 1�`"�
(/
JDR:mam
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
M
NO.
RATE
TOTAL
N
� x
d
$ 33, 0(3
U
_ x
k
O
New Fixture, Old Opening
Water
$2.00
$
Catch Basin
A
$5.00
$
�
C [+
$5.00
$-1-.(3 0
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
a
M
:.a
0
E7
$
Electric Water Heater
x
$5.00
N
o
4
w
2
w
x
'$3.00
Heater
u
-.i
4 0
.•-1
1
$
M
C
N
H
•.1 rJ
Y iJ
u
d
u.[
N
C
rz u
5 d
Q
$5.00
u
each adl. $100.00 or fraction
u
Q
U •7
C
•.�
.0
t1
•a
N
.0
N
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•.1 "a
3
Q
$�e
Op .0
Np
U
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13
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roroN
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kec
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l
lst
I
2nd
1
l
3rd
4 t.�
(n) = F,.ture Connection Opening
Connected with Sewer
(*) = N -_-:w Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUNIBI';G FIXTURE RATES:
NO.
RATE
TOTAL
Nu.:w,er Fixtures
� x
$3.00
$ 33, 0(3
Future Fixture Opening
_ x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
hater?eater - to 99,000 BTU
x
$5.00
$-1-.(3 0
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Ran Old Building
x
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITPl`G FEES:
Ist 3 fixtures
x
'$3.00
$ 3,
Additional Fixtures
x
$1.00
$
Gas �"ge to 199,000 BTU
x
$10.00
$
REPAIRS $ ALTERATIONS
First $,00.00
$5.00
$
each adl. $100.00 or fraction
$2.00
$
State Surcharge
$ .50
TOTAL FEE
$�e
REINSPECTION FEE
($10.00)
Job Address /'V-? Q " 1� &
Department of Buildings
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
���jy Fridley, Mn. - -3 iJ 19
OWNER / � A AAA —vi v ar
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT
ESTIMATED, ST
OLD NEW B ILDING PERMIT NO. , PERMIT NO. 7�
Company
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP.
' Date
APPROVAL FOR PERMIT 4z,
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
f�T,,�a'o.rn?n- g!R�a f?.n,,•..R eH „-.n. ••'/�� Y.�.N...--' . ►n ..ti -r1 hrn ?..r'e,-7
•J CL.;.:Ywr.O
.^ &w: �: LaWitis/ii _: `.v l•'i L..1 4 .tt-L
2e .o.�b•% v w�-•t.•4 •wo
y� mw+o':.1.'�y L'V,lwg Fay..=i. Jw'a
• �@3 `Y.•`•stl^a:,7:'Lvv+tee;• �
� � :,:i'v aLL.J •ax: .,�vr v H eea�.J -
��% ��w.l s ��;
PARTIAL QsA
VvIpt. oG
•
p �•
L •
P tet SfIr? I cc :iL`'t i70?k $1Q.00
v
City of F4:d% :
P.r>:are-ner.t o' 6.00
$
The urderrigc� hereby makc-application ;or a perr:it for Lie corm- he,
p c:p to 3`.34.40 E;�
c
specified arrc•c:r.b 'o do all work in strict acco-dance Wilh trhe Ci:? C>'Ccr
Ai•r•ra•:o :s each add. 5504.403L
$
and ruling -of the C^patt:r.rnt of _T3;,:1:and nd hereby dcci:::s that ail the 14c
and reUro:sFntatiu:�s statrd :n this app`c3Uon art true and ccr:ect.
S.he':t a Duct Work to I20,000 BTU -
$��
c
et -ch add. MC7J BTV .-3 tXJ-
5_..L._�
C?c+'- er
o: urrzcr 6.70
S
kind of Building
to MOM 6.00
i
i
P--ci-z & Altcratirz each add. $530.04 3.00
d
To be completed about' -
.eT'SAX ns F07 WA. i £YSTE?d,
'o
_%.: nact S` -etl &• L:res--to 4M sq. Lt FM? St:arn e10.00
Estimated Cos; S
FZ:r^ace S':61 do L;r.P-•te 640 sG ft. 'EDR ;TotWater I000
S.
91Jd
Old New. uildLng Perm;t No. -•---- F'®rmitNo.
Eac^ add :Cr) sq. rt EDD Strsm 3 on
$
Each add. 324 sq. ft EDR Hot "Rate: 3.00
$
OF
CSL :!a=2rin-to 3 gal. per hour 6.00
$.
TI ATING or POWER :s";L�ihzT,r-.Sizz.�, Fct Wa` �=Air No—
over 3 gal. per hour -See Fee Schedule
®®
Trade NameLlNo,
3V7,%-,RS_
GAS 3V7,% -,R (up :o 1^" .^•3.ETU) ,{ @�^
��
av:r IS3.C.00 b"'t`'.; £as roe sekrdvle
Capacity—_-- _ Sq. -PL F-D.R M_J Ej
G.Z iii I S'- :_'rte: ?:o RA i a TOTAL
1st 3 FZxtures. x;100
r.&_0
/Lj
Total Ccnnected La:d(v A ®O Kind of zLe
Additio- a1 iistures x 75
BURNER -- Trc4-- Ns:
Gas iL`rge � i�•G'� x? 8.00
S
State Surcharge
.50
Ca"City - Sq. m r -M -R BiJ '-
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City of Fridley
SU9JECT .
AT THE TOP OF TKE TWINS
SEWER STOPPAGE
INTERDEPARTMENT REQUEST
1 1i PUBLIC WORKS DIVISION
1 i 1 CITY MALL FRIDLEY 55412
NUMBER
R£V. DATE
PAGE OF APPRDY ' 8Y
612"360"8450-
SEWER STOPPAGE Q
ADDRESS
DATE"
CALL RECEIVED BY
AT��S"�} (AM) PM)
CREW LOCATION WHEN NOTIFIED
EQUIPMENT TAKEN TO SITE
CAUSE OF STOPPAGE
TIhtE STOPPAGE RELIEVED
At
DESCRIBE DAMAGE (IF ANY) /t
NOTE ANY STATEMENTS MADE BY CREW OR HOMEOWNER REGARDING DAMAGE OR POSSIBLE CLAIM'
c'
e` t �r
CREW AND HOURS
�--
I
0
SEWER BACK-UP:
DATE: December 17, 1977
ADDRESS: Hjalmer Anderson
1491 Rice Creek Rd. NE
Phone: 571-9756
TIME OF CALL: 5:50 AM
RECEIVED BY: C. Swanson - weekend duty man.
COMMENTS. & NARRATIVE:
I received a call at 5:50 AM from the Police Dis-
patcher saying I should call the Anderson's right away.
I did so, and ascertained that they had sewage in their
basement. I called Jim Brindley and left for the scene.
We arrived at 6:15 AM, discovered the location of the
problem in the City line and relieved the surcharge at
6:20 AM. It was not possible to tell what caused the
back-up, because of the volume of water that came when
the obstruction was relieved. After making sure the
lines were open to 64th and the 64th Lift Station, we
went into the residence affected and offered our help
to clean up the basement. We found.4 inches of water
on the floor. There were no rugs or other "soft" goods
that were wet.' The homeowner had done what he could to
get things up out of the water. Since it would take
some time for the water to drain away, we left and I
said I would be back shortly. We left at 7:30 AM. I
returned at 8:20 AM to catalogue damaged items and help
Mr. Anderson clean up, but he already had the basement
floor cleaned and had taken some small boxes outside.
I asked if there was anything I could do. He,said "no" -.
that he was going to let things dry up good and then
clean up a little more. I left at 9:15 AM after asking
Mx. Anderson for any items of value that were damaged -
he said he didn't think there was, but he was going to
sue the City for, "My time in cleaning up and all the
excitement it caused." He thanked me for coming back.
Notes: After relieving the backup (between the M.H.
at Kerry Lane and Rice Creek Road and the M.H. just
west of it. 133 feet from the west M.H.) Jim Brindley
and I cleaned a stick and other debris out of the "drop"
in the M.H. just east of 1491 Rice Creek Road.) After
leaving the Andersons at 9:15 AM, I again checked the
lines on 64th Ave. to be sure they were functioning
normally. Mr. Anderson did not have a ball -check in his
drain.
TIME: 2 men - 2 hrs overtime
EQUIPMENT: Jetter
December 2, 1977
Mr. Mike O'Bannon -
Commercial Erectors
814 - 9th Street South
Minneapolis, Mn. 55421
Re: Final Inspection at 1491 Rice Creek Drive N.E.
Dear Mr. O'Bannon:
A final inspection was made on December 1, 1977 of the above address and the
following items were noted which must be completed before the structure can
be finaled out;
1. Install closer on door between house and garage by December 15, 1977.
2. Install house numbers by December 15, 1977.
3. Call for plumbing and electrical finals by December 15, 1977.
We will expect the above items to be completed by the scheduled date when
a reinspection will be made to determine compliance. If you have any,
questions on these items, please contact me at 571-3450.
Sincerely,
RON HOLDEN
Building Inspector
RH/mh
CC: Mr. Robert Helberg
1491 Rice Creek Drive N.E.
OF FRIDLEY
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 66432
TELEPHONE ( 612)571.3450
October 17, 1978
L
Mr. Mike O'Bannon
Commercial Erectors Inc.
5298 Fillmore Street N.E.
Fridley, MN 55421
Re: Final Inspection at 1491 Rice Creek Drive N.E.
Dear Mr. O'Bannon:
A final inspection was made on October 16, 1978 of the above address
and the following items were noted which must be completed before the
structure can be finaled out;
1. Replace garage door closer with one that closes the door.
2. Add ventilation to remove moisture - open venting space over
tap plates on south and north side.
We will expect the above items to be completed by October 31, 1978
when a reinspection will be conducted to determine compliance. If
you have any questions on these items, please contact me at 571-3450.
Sincerely,
RON HOLDEN
Building Inspector
RH/mh
CC: Penny Hillberg
1491 Rice Creek Drive
CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 2001
6431 Univrsity Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
763-572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS I L I.] C Q �—
SCHEDULE
,SATE
OWNER m
Residential
Rate
TOTAL
Furnace Shell and Duct Work, Burner -
BUILDING USED AS
Also Replacement Furnace
$ 30.00
PERMIT NO. �S
(Side Vent . Fill Out Back)
ESTIMATED COST
Gas Piping (Needed with new furnace,
$ 10.00
$
but not replacement)
®ESCRIPTION OF FURNACE AND OR BURNER
Gas Range
$ 10.00
$
No. of Heating UnitsI —_ Circle One
(Steam) (Hot Water) arm Ai
Gas Dryer
$ 10.00
$
Trade Name-�� )I
Size No.
BTU I C 1�� HP
EDR
*Air Conditioning . All Sizes
$ 25.00
���
Fuel Total Connected Load
All Others/Repairs & Alterations (LIST ON BACK)
Burner Trade Name
Size No.
1%®•of Value of Appliance or Work
$
BTU HP
EDR
Commercial/ Industrial
1.25% of Value of Appliance or Work
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.
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 j 1
HEATIN
Approved Byl&4 Rough -In Date
TEL
1
Final Date
BACK SIDE MUSI`BE FILLED IN ON VENT SIZE, VENT CONNECTORS
AND COMBUSTION AIR VERIFICATION
COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions, Yes (JY No ( }
and is securely supported and firestopped where required.
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 1 Central Furnace Venting Tables for fan Yes No
assisted and natural draft appliances.
The existing combustion air is sized and installed to meet the current codes Yes (.-)No ( )
and manufacturer's specifications.
When required to Install a new combustion air, it will be sized and installed Yes (-'No ( }
to meet the current codes and manufacturer's specifications.
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA -LAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes (—�'No
Is the common vent and vent connectors sized and installed correctly after
an. appliance has been removed from the common vent and vented Yes (-No ( }
separately as per current codes.
Aopllance Ty and Size/Common Vent and Vent Connector Information
Appliance #1 Type B17U Input' U`Z`. an Assisted or Nat
Appliance #2 Type 8 Input ��an Assisted or Nat
Appliance #3 Type ETU Input Fan Assisted or Nat
Total Appliances Total Btu Input'
Common Vent Type Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type —
Appliance #2 Vent Connector Height ft Length ft Diameter min Type _
Appliance #3 Vent Connector height ft Length ft Diameter �in Type
ALTERATIONS: Describe
Signed By:
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY PERMIT2004-o
8 y
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 06/10/2004 ,
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 1491 RICE CREEK DR NE
PIN : 133024430052
LEGAL DESC : HEATHER HILLS 3RD ADD
: LOT 2 BLOCK 1
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 300.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A WATER
SOFTENER
# ELEC WATER HEATERS 0
# NEW FIXTURES (EXIST OPENINGS)
0
# GAS WATER HEATERS 0
# GAS DRYERS
0
# GAS RANGES 0
# OF NEW FIXTURES
0
# WATER TRMT APPLIANCES 1
APPLICANT
PLBG PERMIT MINIMUM FEE
PLBG FIXTURES (NEW OPENINGS)
0.00
0.00
SHILOAH WATER CO
7319 166 AVE NW
PLBG FIXTURES (EXIST OPENINGS)
0.00
RAMSEY, MN 55303-
WATER TREATMENT APPLIANCE
35.00
(763) 753-9244
WATER HEATER - ELEC
0.00
WATER HEATER - GAS
0.00
GAS RANGE FEE
GAS DRYER FEE
STATE SURCHARGE, PLBG FLAT
0.00
0.00
0.50
OWNER
HELBERG ROBERT E & PENNY C
1491 RICE CREEK DR NE
TOTAL
35.50
FRIDLEY, MN 55432
PAID WITH CHECK # 9905
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel a provisions of any other state or local law
re sting c to c ion or the performance of construction.
Applicant Date
Bldg Insp Da
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY, OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
Effective April 1, 2004
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT A
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS .11 L I
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas**
Gas Range**
$10,00
The undersigned hereby makes application for a permit for the work herein
$10.00
specified agreeing to do all work in strict accordance with the city codes
$10.00
and rulings of the Building Division, and hereby declares that all the facts
$10.00
and representations stated in this application are true and correct.
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$10.00
$10.00
$10.00
$35.00
$35.00
$35.00
$10.00
$10.00
$15.00
Reinspection Fee $50.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
DATE: —,20
�-� �� , 20
OWNER
BUILDING USED AS. Re6P.OI%
ESTIMATED COST r 6 c—
'O'
COMPANY
SIGNED
AApproved By Rough -In Date_
shn!/ AA D
PERMIT NO. C),7 (TUU
TEL N0.
Final Date
State Surcharge $
--tS� MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST
TOTAL FEE �r OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE.
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
i
COMMON VENTS VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
i
V1Vhen replacing an existing f�irnace, the undersigned hereby verified that the
vonting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No(
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and terminatian. Yes () No( )
i
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 No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No( )
When installing a new venting system, 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. Yes ( ) No ( )
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. Yes ( ) No( )
Appliance Type and Size/Common Vent and Vent Connector Information
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
Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date
CITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004
1431 University Ave NE - -rn�2&�49
fidley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
763) 572-3604, FAX (763) 571-1287
MARK NUMBER OF FIXTURES TO RF INSTAI I Fn nN r-ArN FI nnta
,is �
0
•
JOB ADDRESS 100 -Ar
Jew Fixtures
q t �
' „R�9 •
)Id Opening, New Fixture
$10.00
Yui
��
i
$10.00
and rulings of the Building Division, and hereby declares that all the facts
flow Off Basin _
$10.00
and repre -e and correct.
;atch Basin
$10.00
HELBERG, ROBERT
Iain Water Leader
$10.00
1491 RICE CREEK DRIVE NORTHEAS 4
ZO
FRIDLEY, MN 55432
iump/Receiving Tank
$10.00
(763) 571-3986
Vater Treating Appliance
$35.00
OWNER _
Vater Heater -Electric
$35.00
Vater Heater - Gas** —�
$35.00
BUILDING USED AS I 51 eyt�
:,as Range**
$10.00
Sas Dryer**
$10.00
ESTIMATED COST �� oto PERMIT NO.
lack Flow Preventer Required ( )Yes () No
'LUMBING FIXTURE RATES: NO.
RATE
TOTAL
JOB ADDRESS 100 -Ar
Jew Fixtures
$10.00
The undersigned hereby makes application for a permit for the work herein
)Id Opening, New Fixture
$10.00
specified agreeing to do all work in strict accordance with the city codes
leer Dispenser
$10.00
and rulings of the Building Division, and hereby declares that all the facts
flow Off Basin _
$10.00
and repre -e and correct.
;atch Basin
$10.00
HELBERG, ROBERT
Iain Water Leader
$10.00
1491 RICE CREEK DRIVE NORTHEAS 4
ZO
FRIDLEY, MN 55432
iump/Receiving Tank
$10.00
(763) 571-3986
Vater Treating Appliance
$35.00
OWNER _
Vater Heater -Electric
$35.00
Vater Heater - Gas** —�
$35.00
BUILDING USED AS I 51 eyt�
:,as Range**
$10.00
Sas Dryer**
$10.00
ESTIMATED COST �� oto PERMIT NO.
lack Flow Preventer Required ( )Yes () No
Type
$15.00
1_ ` `
PLUMBING COMPANY O C K0` OVA U✓w� Ifjt
teinspection Fee $50.00/Hr
SIGNED BY TEL N0. t (oI2) $27-033
kLL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
Approved By Ilt Rough -In Date Final Date
State Surcharge
$
TOTAL FEE
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST
OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE
.,OMBUSTION AIR SHALL BE PROVIDED
PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furnace, 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. Yes () No( )
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 () No( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes ( ) No( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes ( ) No( )
When installing a new venting system, 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. Yes () No( )
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. Yes O No( )
Appliance Type and Size/Common Vent and Vent Connector Information
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
Hent Heigbt Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :
Building
AND MATERIALS:
BUILDING
Permit No.: a
Inspections
TOTAL JOB VALUATION $
RESIDENTIAL APPLICATION
Received By:�AUI�3
763-572-3604
Permit Fee
CITY OF FRIDLEY
Date�,U
763-5024977 FAX
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
EFFECTIVE 1-1-09
.001 times the total job valuation
DATE C-3-1-0
OUR F.� MAILADDRESS /
G
uk �,
r o o OP
SITE ADDRESS
9 91-C. tree U r A
$5.00 (State Licensed Residential Contractors)
THIS APPLICANT IS:
JW OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: 51f LA o 4 --At v Cv
$
TENANT
ADDRESS: (�(� iQ �� CrK k 6, AJF CITY
EJ r STATE H4IP Zi $-
$
PHONE: C - 03ss iS
$450 Conservation Plan Review
CONTRACTOR
NAME:
SUBMIT A COPY OF
Sewer Main Charge
$
YOUR STATE LICENSE
STATE LICENSE #
EXP DATE
AND CERTIFICATE OF
ADDRESS:
CITY STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
XSINGLE 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
&MAINTENANCEIREPAiR ❑ REMODELING
DESCRIBE WORK BEING DONE:�yv e� ✓ l�ov
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT SQ FT
ROOFING ❑ HOUSE ONLY
7
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
I . Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING— -- _- — --
- _ -- - - - - -
_ FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
l . Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes [No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF. WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR
AND MATERIALS:
iJSIN
THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $
r
— OCCUPANCY TYPE
Permit Fee
$
p 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 (State Licensed Residential Contractors)
SAC Charge
$
$2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $22 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
/0
y Make checks payable to: City of Fridley Attach
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 plan in the case of w wli' requires review and approval of plans. �
SIGNATURE OF APPLICANT PRINT NAME SCO h ' /f C DATE b- �G