PRE 2010 DOCSBUMDING PERMIT
N?Yg
20,35
Villaa of bridle , Nlino .
g y
Date
fi"'
Builder 1!
Owner: ®� �.:..... .......
Address $°:. " ' `fa+i'r .. �.h . :.... Address ....
..............
LOCATION OF BUILDING,
,
y
No... a .:: ;': .... Street .":...:........:... .... ...... .. Part Lot .....
.............
Lot . 4........ Block..... ........... Addition or Sub-Division:ll
Corner Lot Inside Lot Setback ...... Sidey d.......
..............
DESCRIPTION OF BUILDING
To be Used as:
.... .Front- . �... Depth . ,Height .�..,,, . Sq. .......
. Ft. ........
.................... Front'........ Depth .... Height .... Sq. .....
Tq
Ft. ........
Type of Construction . ;� ...... Est Cost .. 4 .ez) ' To be C mpleted
�
J�j,({d�p
Y
5
In consideration of the issuance to me of a permit to constructthe building de cribed above,
agree to do
the proposed work in accordance with the description above set forth and in comp ce with allrevisions
of
ordinances of the village of Fridley.
... . ,... .....
........
In consideration of the payment of a fee of $.' .:permit is hereby granted ......... ............
....................... to construct the building or addition as described above. s permit U
anted upon
the express condition that the person to whom it is granted and his agents, employee and workm
in all work
done in, around and upon said building, or any part thereof, shall conform in all res ects to the o
dinances of
Fridley, Minnesota °regarding location, construction, alteration, maintenance, repair moving of b
' dings with-
in the village limits and this permit may be revoked at any time upon violation of of the prov
ions of said
ordinances.
o A�
s . ..r . Bull
g Inspector
NOTICE: 1.
This permit does not cover the construction, installation or:.aiteratian for wirin y plumbing,.ga
heating,
sewer or water. Be sure to see the Building Inspector for separate permits for thes items.
I
0,
PW0
Original
PERMIT for Power ants and Heating. Cool-
ing, Ventilation, Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of Heating Plants to b installs ltered—repaired
Make
Oil fired_ ; Coal fired , Gas fired--`'' ; Gas Authorization No.
Remarks
Approved
Final Inspection Date , 19_
Inspector
-Z/flok.�
Permit N° 4615
Fee $ f, 00
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn. Pj®,j -q , 19kQ
Owner L AEP -0 )5pl e-&f�
Location L�6 R20-6- 0 -ft -E e Kh
Kind of Building �R'q M -�'
How Occupied 6W it LL 10 Co
Work to be Commenced—,nn19_
To be Completed /V0 ✓ 16 ,19 (09
Estimated Cost, $ /,IS-. U
QNew, Building Permit No.
Permission is hereby granted to- v to install—erect—use the material and devices described in the
above statement. This permit is granted upon th press condition that the dm
n 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 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 specifications set forth in the approved application for this
permit on file in the office of the Inspector of Buildings. 1 x . � I- . , (_ _ A - ,
J 11- , _nspector of Buildings
4z 2M 11.67 b
5"-84-S915.51
City of Fridley
Apprifor
Dept. of Bldg*. Phone 3$0-3450
DESCRIPTION OF WORK 1.520 Rice Creek Rd
Number, Kind and Location of Fixtures
°
x $3.25
$
Water Heater :Up to 99,000 BTU) ....
x $3.00
WATER HTR.
GAS ELEC.
Base
x $3.25
$
Electric Water Heater . . ............
s $2.00
$
GAS FITTING FEES:
1stnt
1st 3 Fixtures . • ..............
slni raorousiB
;-
Additional Fixtures ..................
x $ .75
$
2nd
x $5.00
$
Gas Incinerator
5.00
3rd
4th
Future Connection Openings
I wanacxaa Wxm Sewer
* Now Fixture, Old Oysnings Cesspool Q
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................ x $2.00 $
Future Fixture Opening ........... x $1.50 $--
New_
New Fixture Old Opening .......... x $1.50 $
Catch Basin ....................
x $3.25
$
Water Heater :Up to 99,000 BTU) ....
x $3.00
$
New Ground Run Old Bldg.........
x $3.25
$
Electric Water Heater . . ............
s $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures . • ..............
x $2.00
;-
Additional Fixtures ..................
x $ .75
$
Gas Range to 199,000 BTU ....., .........
x $5.00
$
Gas Incinerator
5.00
REPAIRS & ALTERATIONS—Refer to Cede
Description ......................................... — . $
TOTAL FEE a
City of Fridley:
The .undersigned hereby makes application for a permit for the- work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that alt the fact
and representations stated in this application are true and correct
Fridley, Minn 7-2h– 70 19,
Owner L Friend -
Kind of Building frame
Used as Meg
To be completed about 7-29-70
Estimated Cost, $ 1Q100
Old—New. Building Pe it 9 o
Signed
By
Business Phone No
ROUGH
iINAL �i ®�
.
City of Fridley
r AT THE TOP OR THE TWINE
rL'------- COMMUNITY DEVELOPMENT DIV,
I PROTECTIVE INSPECTIOM W".
CITY MALI /RIOLEM U44
53=84-S-915.51
SUBI)EGT
PLUMBING PERMIT APPLICATION
Job Address
U 1 2115/73 1
1 1 800
1520
Rice Creek Rd
Owner
Address
Phone--
Lavern P. Friend Same
Contractor
Address
Phone
Kind of Building
Use
Frame
Res.
Completion DateEstimated
Cost
12/26/73
10.00
II
Plumbing Fixture Rates: NO.
RATE TOTAL
�J+
I
i l
Number Fixtures
x $2.00
3
n
i
I Future Fixtures
x $1.50
aflNra
srol
I
�
I
New Fixture -Old Open.
x $1.50
O
"1ddY
I
;
j
Catch Basin
x $3.25
CYOI
!
Water Heater -99,000 BTU
x $3.00
i
•78IMII
I
I
I �
i
small
Ii
!`
Ground Run Old Bldg.
x $3.25
CD
—i
I Elec. Water Heater
x $2.00
a.
SNIBYHI
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Gas Fitting Fees:
�O c
BNlraa
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3 °o
aoo,�I
•�
p,
lst 3 Fixtures 1
x $2.00 2.00
.w
0 y
'^
I saaMONS
�0,$
V
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I Additional Fixtures
x$
.75
1Nnc�
HNIaa
I
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I
Install (1) Gas Rn e
Gas Range 00�
3.00
-199, BTU
x $5.00
q�
HSYMI
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I
Repairs & Alterations
�o
See
S]IN,sI
I
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Description:
Code
SNIBYYI
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State Surcharge
.50
senjL
TOTAL FEE
ri $ 5.50
sIYNIan
!The undersigned hereby makes application for a permit
) I
I
I
for the work herein specified, agreeing to do all work
9
in strict accordance with the City Ordinances and rulin
aa�vM
I
of the Department of Buildings, and hereby declare that
all'the facts and representations stated in this
application are true and correct.
c�
M
'
s'�'�r`'�/
tr
Com' da'r�_
%3 •
Signature _
ate
• '
NO. RATE TOTAL
Cis, of
tI
r, iG ay
53—sty-991505.
Nw.ber Fixtures 0 0 0 0 .. • • •'• • • • • . • .�.--.-----
•
AppliCca'Han
f07 d 1tiEi'1 .P'.+od G'ns
'
-- x 51.50
'Dept. of B1dpi, phone SM -3m
DESC? IPTI02( 0:
17011%
CatchDisin.......•••••••••••••
Lo:Ad r ,
Numb -IT. l:'s d wid L,otr:lon of FIMh:res
Water ,liester 'L•p to 4:9,000 BTU) • • • •
x S3.00
$_--®----=
Nei+ Ground Run Old Bldg.: 4 4 0,0 4 •• •-------
c
x .3.225
wa1s4 HT4.
, City of Fridley;
SUO
I
«
N0. RAT`:. TOTAL
Z
u
=Mj
usc,
eby
TZtie uaa-cairn o k Ininikes Strict 'rict acco:dacation for rceewlth the it for tC trhe �o0:dis
o If S 3 a f.
a lw
3 t
u
x .75
v
S
Addiltlanal Fixtures ..:....... . 4 0 0 0 ----
to ded
all
specified, E at aid hereby declares t.�sat a:I t•`►t
2ste I
2.^.r UT CR
3:d ,
s .h _
s Naw F1s:lun. Old 07ol ulr.9%
W
PARTIAL RATE SCHEDULE
and ruling of the D,:partrrOn; of I3u11 �h&,Qo are true sr.d eo:re,-t'
• and ropresentatfons stated in :.`:is app
' 71_76
Fridley, Man
Owner Lavern Fr end
Kind of Building e
Scirar
0"apool
Li:M3I11C FIXTU.'.E RATS:
NO. RATE TOTAL
x 32.0.0.
S
Nw.ber Fixtures 0 0 0 0 .. • • •'• • • • • . • .�.--.-----
Future Fixture Opening
x 51.50
S , .•
New Fixture Old Opening• ••• • • •'• • • •
-- x 51.50
x$3.25
$
CatchDisin.......•••••••••••••
Water ,liester 'L•p to 4:9,000 BTU) • • • •
x S3.00
$_--®----=
Nei+ Ground Run Old Bldg.: 4 4 0,0 4 •• •-------
c
x .3.225
S. -------
V octf.0 Water 1:aatar. 0 0 4 4 4; 0 0 4 4 0.0.0 a
SUO
N0. RAT`:. TOTAL
IIS 71T:SNG FEES:
5,
• 1st3Fixtures ••••�••••••••••"'-------_xS2.00
x .75
v
S
Addiltlanal Fixtures ..:....... . 4 0 0 0 ----
C:a R ::Ye to 193,060 BTU ......... 0. ---z----
x $5.00
5.------
•
Usad as res•.
To be completed about 7-99-76
Estirnat.ed Cost; S 10 00 .
Pas
Old ---Now. building Permit ha•
Stgrcd M{NNEGASCO
• By
Businvu Ph -ire No
ROUGH
FINAL
.50 State Surcharge
p,,e'-�t:gS l+c AL±ERA?IONS—P.afer to Code
JUTY 1th,1976
1520 $ice creek goad,
Fridley,55432,Minnesota
Mr."IKE" Miller,
State Electrical Inspector, �� �: ),K'. ��_, g
c/o City gall,
Fridley '55432 Minnesota
Dear Mr. Miller;
When B&H Electric first came hereto rewire this house,they pro-
ceeded to tear things out.Alon.g with the old wire they removed the in-
sulation from 3/4 of the ceiling in the garage below the house(It was
there for winter warmth for the upstairs porch)Nhen in reality they only
needed to remove 2ftX4ft. for the amount of work that they did.ghen Mr.
Wood was questioned by me about this he saidQUOTE"We will Tl=i the holes
that we make so that you will never know that they were thane."UNQUOTE.
I only wish that this was the case -BUT the situation is this;All that
insulation is still down -and there is a ZX4 ft, hole up there with the
wires exposed to boot.There is no switch box cover,the ceiling conduit
to the yard light sags and interferes with the garage door.I have a hole
In my kitchen. wall ,which was his first attempt for the receptacle that
he did put in about a foot above it. As usual they are unavailable by
phone -and .my letters go unanswered.
My Husband is disabled from an industrial accident -which caused him
to have water on the brain He cannot look up -it hurts him;Gives him a
bad headache -and causes loss of balance.And although I do many things a-
round here since the accident -this is beyond me.So,neither of us can fix
this.
We have a limited income -and were pleased when we could finally save
enough to have this rewiring done -it was sorely needed.But,to have to
call in a carpenter for all this -would work a hardship on us.Beeause of
them my house has been torn up since April,as you know.They came to us
with high praise from a friend -Never again will I take anyone's word for
things like this.
When they left they promised to return to complete the work in a
week -that was a month ago.I told him at that time -should he not comply,
I would call you again. -His answer"Old Ike?I don't worry about him -we've
done business before"The meaning of this escapes me-but,I feel sure that
a man in your position would not condone an injustice no matter who is at
fault.I don't know how much of this is within your jurisdiction-but,I hope
that you can take care of your share -and thed refer me to the proper person
for the balance of it.,
We thank you for your past help in this matter -and for your present
considerationPlease let .me know what can be done about this at your
earliest convenience.
HURRIEDLY, BUT,
SINCERELY,
cc 9IRIAM F.FH
Mr! Bon Holden,
Building Inspector,
#6431 University Ave.N.E.,
Fridley,55432,Minnesota
Dear M. Holden;
April 11,1978
1520 Rice Creek Rd.,
Fridley,55432,Minnesota
Thank you,at least,for returning the pictures --I will need
them to carry on my lone war against the damage being done usl
Since no one in City Hall has condescended to lift a finger In
our behalf.I consider infringement on other peoplets property a
gross indignity to those being taken advantage of -Namely US!
Had the City Engineer listened to me when that land was being
cleared for contraction -We wouldn't be in this fix.
You ask me to exercise further patience -After the four
summers of loss and frustration that we have suffered -and the
negativism from officials that we have encountered -I think that
I have been a paragon of self-control.
I am also positive that if you lived here -and the shoe was
on the other foot -it would be a different story.THEN,I am sure
that you would be able to find the proper people to help you
with little or no trouble.
As for the sod,it should have been in three (3) years ago -
and I wouldn't have to extend further patience -as you so aptly
put it.
Will contact Mr. Hreeick-as you suggest,to try to recoup
our losses.However,I sued last year -WON -and still have the sand,
due to unkept promises.
I shouldn't have to go to court yearly to protect whatts
ours.
WHERE ARE OUR CIVIL BIGHTS?
HURRIEDLY,
BUT,
S INC&RELY,
cc �RIAJMKF.END
I
CITY OF Frie-tiW r-aw
y
6431 UNIVERSITY AVENUE N.E., FRIDLEt, MINNESOTA 65432
TELEPHONE ( 642)579o3t'55
July 18, 1978
Mr. Larry Schmidt
® Action News
WCCO ,TV
50 South 9th St.
Minneapolis, MN 55402
Dear Mr. Schmidt:
We have received your correspondence dated 7/10/78 pertaining
to a matter at 1520 Rice Creek Road. In a review of the infor-
mation attached to your correspondence it appears that the matter
has been through litigation and a judgment determined.
After discussions with the City Attorney, it is our suggestion
that the resident at 1520 Rice Creek Road retain an attorney to
enforce the judgment. If the resident cannot afford an attorney,
contact should be made with Judicare at the Anoka County
Courthouse for legal aid.
If you have any further questions regarding this matter, please
contact our City Attorney at 571-3850•
Yours very truly,
Richard N. Sobiech, P.E.
Public Works Director
cc: Virgil Herrick, City Attorney
RNS/jm
r
PY, 4/1 AV�
Fit;
Dear Friend:
Here's a letter we received from a
viewer.
IWO -7�-
Could you help us solve this viewer's
problem ? We'd appreciate any suggestion,
comment or idea you might have.
One more thing. Please return the enclosed
letter -- or a copy -- to us along with your
reply:
7
Larry ,9chmidt
Action News'
WCCO TV50 South Ninth St. Minneapolis Minnesota 55402 (612) 338-0552
7/1/78
1520 Rice Creek Rd.,
FridleY,55432,Minnesota
ACTION
�NEWS,
WCCO-T.y. ,
50 S. 9kh Street
Minneapolis.Minnesota
Dear Sirs;
We have lived at this address 13 years®Until about 4 years ago the
property behind us was vacant lots.At that time they began to clear and grade
the land for c&nstruotion.Upon seeing how much higher and the angle that
they were grading,I went to the city Engineer to complain.I knew that rain
would cause all that sand to wash onto our land.I was told that the contract-
ors could build but could cause no problems for the present residents;and to
return if I had any problem.By the time that I had problems -I was told that
It was now a neighbor problem and they couldn't interfere.I went from off-
icial to official -even went to the county in Anoka -each time the answer
was negative -and the buck was passed.
There are two properties behind us -One has sodded and left the grade
as it was ----and there is no problem.The other -Mr Larry Blomberg -is behind
our garden -and he has turned a deaf ear to all suggestions as to how he can
keep his sand home.
In desperation I went to the city Attorney -was told that he couldn't
help either- u a sue fox the lost vegetable -back rt,eto.
That sometimes it made people .move when hit in the pocketbook.I oot my
pleas to Conciliation court -Pictures and all4Mr Blomberg insists on a -
taining wall made of railroad ties -the sand comes through the cracks -and over
the top)In fact when the judge awarded me most of ghat I asked he told Mr.
Blomber4that he had changed the grade ----and that was against the law.But,it
seems I can find no one to help to enforce that law.
s all ire put in more black dirt -and planted in the spring -but it is
again a disaster.(PIX enclosed)The sand not only coters the entire garden(
30ft longX12 ft wide )but is so bad it is spilling beyond to our yard.
I can take him to court again.for our losses -but that does not solve
our sand problem.
My Husband had a near fatal accident in 1972 -and it changed our life
stVVe(he is disabled -we are on a fixed income.)Our garden is supposed to
supplement our income4which we need4but also good therapy for himsasit is -
this truly upsets him -all that work down the tube -and it frustrates meas I
am helpless to correct the situation.
Enclosed all the data and piotures-if you need any further information,
please feel free to call -571-4287.
PLEASE HELP US!!I have exhausted all other possibilitles.There must be
some protection for people like us.I have no where else to turn.PLEASE help9
We even tried putting up boards -to stem the flow -but the sand spills
right over the top-can®t even see the black dirt -we are just heart -sick.
Thank you in advance for your kind consideration in the above matter,
and lease let us hear from you soon.
Sincerely,
cc ,a
IRIAM F. FRIEND
1520 Bice Creek Road
Fridley-55432,hinnesota
PHONE -571-4287
I have been advised by my Attorney to notify you -by mail -of M,:
Intantions concerning your retaining walle
RMULLYs If that wall Is not complete and the holes pluggod-to
prevent s '.i. send s. o°iti:. Invading our property -by Oobe•
will take further steps to force you to do so*
M i. W �, A, 4. k,
e r' ,.�:< s� disabled and ra . = .,y X:. ,� � '�'s .e. �.shovelling �^ K Y , •' zs,.
heav;
9: are on a flxod Income and that garden emeans ;lE: great deal t`i\5 s
In balancing e i<„i,,yo' .. the fw', 2 yew,:'.s your :.a.;+.. ,tti.s killed the
,.#Ianys.and this years there ww hardly any yield at alle
MI ''E having ”. garden) covered
with it
winter -
and I don't want your sand mixed with It.We em - affordto waste : _ m . likethat*
o
Fly patience N4
no more OXOUGGSG
_11 w1_v, FRS:, *0 i11 w. Yfi "J' ' ',".,' Mf.f 1
s , Y , w< y .f, •'
..R
cc
MW
MEMO TO: Virgil Herrick, City Attorney
MEMO FROM:- Richard Sobiech, Public Works Director
DATE: July 14, 1978
SUBJECT: ACTION NEWS Letter Regarding 1520 Rice Creek Road
Please be advised the Building Inspection Division received
the attached letter. From the resident's letter, it appears
that litigation has taken place and certain results were
attained pertaining to a resolution of the problem.
At this point in time, I don't know what more the City can do.
You should be advised, we did make contact on July 13th with Mr.
Blomberg who indicated he has been trying to comply with the
court order.
I would appreciate your review of the attached, and your response
to ACTION NEWS, if you feel it is necessary.
RNS/ jm
Attach: 1
��
i
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
TELEPHONE ( 612)571-3450
August 9., 1978
Miriam Fa Fri=end
1520 Rice Creek Road
Fridley, Mn. 55432
Dear Mrs:. Friend:
I. am returning your pictures as Ipromised. I spoke to the Bloomberg's
and they, i=ndicated their intenti=on to sod their back yard soon. Mrs.
Bloomberg said she hoped it would be within two weeks.
.As I` mentioned when I talked to you all I zan do is encourage a
mutual agreement between yourselves and the Bloomberg's to alleviate
the problem of water washing sand over their retaining wall and into
Your garden. T feel that sad would solve 95% of the problem.
Please contact Mr. Virgel Herrick, the city attorney, with your questions
Of legal pursuit. In the meantime I would encourage additional patience
while the Bloomberg's-schedule their sodding work.
Sinc ely
Ron Holden
Building Inspector
RH/jm--o
is
l
City of Fridley
SUBJECT
E
_
AT THE TOP OF THE TWINS
BUILDING
PERMIT
P
RECEIPT N
• COMMUNITY DEVELOPMENT DIV.
r I � PROTECTIVE INSPECTION SEC.
i
I
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L J \ 612-571-3450
9
9/9/80
JOB ADDRESS 1520 Rice Creek Road N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt. 10
I
Aud. Sub. #22
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
La.Vern Friend 1520 Rice Creek. Road N.E.
571-4287
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Midwest Metal
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
ElNEW ❑ ADDITION ElALTERATION ElREPAIR ElMOVE ElREMOVE
x
8 DESCRIBE WORK
Construct a 28' x 12' Addition to Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide fire alarms in addition.
BSE digging ta$ 1=1 athioes
TELEPHONE • ELECTRIC -BIAS Etc.
REQUIRED BY LA V
sEPERATE PERMITS REV11tRED FOR WfRI
HEATING, PLUMBING AND SIGNS.
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
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
$10,400
$5.20
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
NONE
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$63.00
PLAN CHECK FEE
TOTALFEE
$15.75
$83.95
SIGN'FUREOFCONTRACTOR ORAUTHORIZED AGENT (DATE)
9WSI
WHEN PROPERLY
BLDG INSP
VALIDATED THIS IS YO -R PE MIT
WATE
NATUREOFONERtlF WNk'B ILDtRI IDATEI
R
.15924 �
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PER4ITS
(Nese, Alterations, Additions, or Repairs)
' D D R E S S..F+,
TEL NO: 67ZI-,&,
STREET NO: /;1� ';� d STREET:
BUILDER:
ADDRESS:
TEL NO:
Construction Location z
LOT:`2! BLOCK: ADDITION.
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale„
DESCRIPTION OF CONSTRUCTION
Front: Depth: Height: "-
Square.Feet: Cubic Feet:
Front: Depth: Height: J.
Square - Feet: Cubic Feet: t(3 404
d�4Z2
Type of Construction: �- Estimated Cost: $
To Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET
Slie 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: SIGNATURE
Stipulations:
�J U
CITY OF FRIDLEY
APPLICATION FOR PLUMB'IN.G AND GAS FIT i ING PERMIT
Job Address 15-�4�
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
s,)acified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
tlxq:gacts and representations stated in this application are true and correct
Fridley, Mn. L. s , 19 -CT -(—O
OWNER � �®
KIND OF BUILDING
USED AS
M
TO BE COMPLETED ABOUT
N
pC
ro
ESTIMATED COST
PLUMBI\G FIXTURE.RATES:
"
d
TOTAL
Water
PERMIT NO.
Fixts:res
x
$3.00
$ /""690
k
r5
^%_..re Fixt..re Cpenirg
$4 Q
N
.0
It S{
'-
GL
w
�
x
Heater
$
Signed By
f.
Catch Basin
x
$5.00
-4
W
��
Nater :eat__ - to 99,000 BTU
x
$5.00
$
Tel. No.
=�O,CCO B:J to 199,000 BTU
x
$10.00
$
.:i
u
Cl
G
v,
•.� �
O
.0 A
.N
$5.00
$
ROUGH INSP.
.
to
o
x
r+
M *�
a e
ro
G_,S FITTING FEES:
q
yy
as
lec
Date
1st 3 firtares
x
$3.00
$
Additional Fixtures
x
$1.00
$
APPROVAL FOR PERMIT t
Gas Range to 199,000 BTU
x
$10.00
$
IREP AI RS $ ALTERATIONS
First $100.00
$S.OQ
$
eac: add. $100.00 or fraction
$2.00
$
MINIMUx FEE FOR ANY PLUMBING PERMTT IS $7.50 p=-- $.50 STATE sURMRGE
State Surcharge
t
znd 1
4
TOTAL FIX
$ ®
3:3 {
r
1
(i) = rstare Connection, Opening
Connected with Sewer
(!) = New F^ xture, Old Opening
Water
Job Address 15-�4�
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
s,)acified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that all
tlxq:gacts and representations stated in this application are true and correct
Fridley, Mn. L. s , 19 -CT -(—O
OWNER � �®
KIND OF BUILDING
USED AS
REI�SPECTIO`1 FEE
TO BE COMPLETED ABOUT
PARTIAL RATE SCHEDULE
ESTIMATED COST
PLUMBI\G FIXTURE.RATES:
NO.
RATE
TOTAL
(o - NEW BUILDING PERMIT NO.
PERMIT NO.
Fixts:res
x
$3.00
$ /""690
^%_..re Fixt..re Cpenirg
x
$2.00
$
Company
New Fixture, Old Opening
x
$2.00
$
Signed By
f.
Catch Basin
x
$5.00
��
Nater :eat__ - to 99,000 BTU
x
$5.00
$
Tel. No.
=�O,CCO B:J to 199,000 BTU
x
$10.00
$
Stater Softener
x
$7.00
$
New Ground Tt--% Old Building
x
$5.00
$
ROUGH INSP.
.
Date
Electric nater Heater
x
$5.00
$
G_,S FITTING FEES:
FINAL INSP. &
Date
1st 3 firtares
x
$3.00
$
Additional Fixtures
x
$1.00
$
APPROVAL FOR PERMIT t
Gas Range to 199,000 BTU
x
$10.00
$
IREP AI RS $ ALTERATIONS
First $100.00
$S.OQ
$
eac: add. $100.00 or fraction
$2.00
$
MINIMUx FEE FOR ANY PLUMBING PERMTT IS $7.50 p=-- $.50 STATE sURMRGE
State Surcharge
S .50
TOTAL FIX
$ ®
REI�SPECTIO`1 FEE
01
SUBJECT
City of Fridley
WRECKING
® 18845
AT THE TOP OF THE TWINSBU
PERMIT
r
RECEIPT NO.
i L'__�___ COMMUNITY DEVELOPMENT DIV.
r -- PROTECTIVE INSPECTION SEC.
1 i
`
"S CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
3/31/87
JOB ADDRESS 1520 Rice Creek Road N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
10
Aud. Sub. #f:22
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
James Dahl 1520 Rice Creek Road N.E.
574-9358
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 ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE 12 REMOVE
6 DESCRIBE WORK
Remove 20� x 221 Detached Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
'Clean, site of all construction debris.
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
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
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
TOTALFEE
$15.00
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY
(ALI DATED THIS IS YOUR PERMIT
-N=E OF OWNER IIF OWNER BUILDER] IDATEII
BLDG INSP
OaTE
01
Effective Aug. 1, 1981
(City of Fridley
wrscT
Permit No.
AT TIE TOO' 00 TII[ TWO$
r
. .
WRECKING PERMIT APPLICATION
Receipt No.
r�,-------, COMIW«ITTpEV[LO►MEMTDIV.
I i P*aT[CTr" pd[CT10n art.
r...i el" MALL NUOLET 0001
1 �....� J 02-600-3uo
rv
OTE►YEa►K,I�so1•MRCvED
9/15/71
B�
Qnn
Job Address
egal'
Lot No.
Block No.
Tract or Add'tion
Des c .
`
",)- S :-,---
Property Owner -;rn �S f L Address f�-�o ��,c ��phone
�1
`! Jit
JPPhone
Contractor Address
Description
Front
Depth
Height
Sq. Ft.
Cu. Ft.
of Bldg.
A 0
—�- D.- 1
/U
No. of Dwelling Units
Taxes Paid
Tax Receipt No.
Estimated Cost of Wrecking
To Be Completed
Utilities to be Notified and date Services Disconnected
Mpls. Gas Co. N.S.P. Northwestern Bell Tel. Co.
Engr. Dept. Cust. Bus. Of c. Bus. Of c.
372-4850 330-5540 332-4112
Date Date Date
Wrecking Fees: $1.25 for each 1000 cubic feet or fraction
For structures which would be impractical to cube, the fee
shall be based on the total cost of wrecking such structure
at the rate of $6.00 for each $500.00 or fraction.
MINIMUM FEE: $15.00 No State surcharge on Wrecking Permits.
Approved By Water & Sewer Department:
All Bills Are Paid Services Are Disconnected
The undersigned hereby makes application for a permit to wreck the building
described above, agreeing to do all work in strict accordance with the City
Ordinances and rulings of the Department of Buildings, and hereby declares that
,all facts and representations stated in this application are true and correct.
Z)
�,t � N ContOlctor
Date
c
NEW [ ] City of Fridley Effective 4/1/86
ADDN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: L_k.1 c e-
Legal Description:
Owner Name & Address: �'y ��� �� Tel. #
Contractor: Tel. #
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 ly Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length
Width
Hgt/Ground
Sq. Ft.
OTHER:
`
=
R
a
Corner Lot [ ] Inside
Lot aolof
Fk. Yd. Setback
Side Yard Setback
Type of Construction:
w0,*ce
rre,"'
Estimated
Cost: $ J0 y.5®' 00
Approx. Completion Date:
3 Moao -14`57
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: �{$ $
See Back Page for Explanation
DATE: a APPLICANT: Tel.
tin USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS•
m Me . 1� c. -r • , fir'
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$525 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
/01 4 Aw"
a d ��y�
Ty
d
V
A
James Dahl
1520 Rice Creek Road N.E.
Fridley, M 55432
-VaA¢ 10 -2r--T''7
June 15, 1987
On June 8, 1987 the Fridley City Council officially approved your request for
a variance, VAR 487-13, to increase the maximum allowable height of an
accessory building from 14 feet to 16 feet (above grade) to allow the
construction of a detached garage, on part of Lot 10, Auditor's Subdivision
No. 22, the same being 1520 Rice Creek Road N.E. with the following
stipulations:
None.
If you have any questions regarding the above action, please call the
Planning Department at 571-3450.
Sincerely,
James L. Robinson
Planning Coordinator
JLR/dm
Please review the noted stipulations, sign the statement below and return one
copy to the City of Fridley Planning Department by June 29, 1987.
Concur with action taken
SUBJECT
PER. M4T�I11aQm`
of Fridley
r _
2 5 4 4
AT THE TOP OF THE TWINS
BUILDING PERMIT
rpCity
AE-C&PT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
�� ��
r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
I CITY HALL FRIDLEY 55432
612-571-3450
910-F15
8/29/97
JOB ADDRESS 1520 Rice Creek Road NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt 10
Auditor's Subdivision #22 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
James Dahl 1520 Rice Creek Rd NE
571-8482
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Sams
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE °' LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
Ck NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct an 18' x 12' Deck and a 5' x
8' Deck
9 CHANGE OF USE FROM
TO
STIPULATIONS See notations on plan.
W M0
0. 1c
Before dinging call for
all utill'y locations
454.0402
REQUIRED BY LAVA
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR_ CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 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
$2, 296
$1.15
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 F ANY OTHER STATE R LOCAL LAW REGULATING CON-
74.75
Fire SC $2.30
STRUCTION THE PERFORMANCE F CO ST TION.
'/ _�5—
PLAN CHECK FEE
.1
1TO FEE
V8.20
I ATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
N O VALIDA D HIS IS R PERMI
BLD^' INSP DATE
SIGNATURE OF OWNER oF OWNER BUILDERI IDATEI
=W&A
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Effective 1/1/97
Owner Name & Address: S Tel. # Z
Contractor: [i (n -e +/ MN LICENSE # — O - 3 l07-
Address: 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 'j;' Width Hgt/Ground Sat Sq. Ft. S
OTHER: S ",, C1111
Construction Type: b'pr Estimated Cost: $ ._. � ` 1-Z)96;
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $_
DATE: APPLICANT: Tel. #
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
/ �/ S
Fee Schedule on Reverse Side
Fire Surcharge
$..3%
.001 of Permit Valuation (1/10th%)
State Surcharge
$
%. /
$.50/$1,000 Valuation
SAC Charge
$
$950 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
-$450.00 Conservation Pian Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
$
STIPULATIONS:
CITY OF FRIDLEY PERMIT O.: 2004-olsso
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 09/13/2004
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 1520 RICE CREEK RD NE
PIN : 133024440007
LEGAL DESC : UNAVAILABLE
: LOT BLOCK
PERMIT TYPE : BUILDING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 41,910.00
NOTE: SEE NOTATIONS ON PLAN.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS.
PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE
2000 INTERNATIONAL RESIDENTIAL CODE. CONSTRUCT A 28' X 20' ADDITION.
APPLICANT BUILDING PERMIT FEE 562.95
DAHL JAMES STERLING PLAN CHECK FEE 365.92
1520 RICE CREEK RD NE FIRE SURCHARGE 41.91
FRIDLEY, MN 55432 STATE SURCHARGE, VALUE 20.96
TOTAL 991.74
OWNER
DAHL JAMES STERLING
1520 RICE CREEK RD NE
FRIDLEY, MN 55432
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 the provisions of any o er state or local law
regulating construction he perfo ce of ons truction.
Applicant ate
Bldg Ins
p -Dat���
SEPARATE PERMITS Q D FOR WORK OTHER THAN DESCRIBED ABOVE.
NEW [ ] CITY OF FRIDLEY
ADDN [ ] 6431 University Ave NE,. Fridley, MN 55432
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address:
Effective 4/1/2004
(763) 572-3604 Bldg Insp
(763) 571-1287 Fax
Tel. # '.I�L-3 -57/ S26 j -
MN LICENSE #
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
r.1
LIVINGAREA: Length Width G Height Sq. Ft. 560
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER:
Construction Type: Estimated Cost: $ —,
Driveway Curb Cut Width Needed: Ft + 6 Ft= Ft x $ _ $
DATE: –C) Tel. # � APPLICANT: d
Call (763) 572-3604 for Permit Fees if mailingin application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ Fee Schedule on Reverse Side
65% of Permit Fee
$ . .001 of Permit Valuation (1/10th%) z« '
$ $.50/$1,000 Valuation
$ $1350 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 [ ]
$ STIPULATIONS:
� e
o�
Building
BUILDING
Permit No.:A r t t c '
Inspections
RESIDENTIAL APPLICATION
Received By: „t
763-572-3604
CITY OF FRIDLEY
DaiffqdOff 1 2010
763-502-4977 FAX
EFFECTIVE 1-1-2010
- 6 S' - f U YOUR E-MAIL ADDRESS
DATE ICI x
SITE ADDRESS ( � 0
A-� [ Q C�� (C �® � f �
THIS APPLICANT IS:
WNER ❑CONTRACTOR
PROPERTY OWNER/
NAME:MA 4
_
ADDRESS: t 'e- ,� CITY
STATEZIP
TENANT
PHONE:_2 Ce 571�C) 72
CONTRACTOR
NAME:_ fl w� -'e
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
AND CERTIFICATE OF
ADDRESS: CITY STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
,DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCEIREPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: kc -
SIZE OF IMPROVEMENT
LENGTH tee `r" WIDTH b
HEIGHT SQ FT
ROOFING
p HOUSE ONLY
BASEMENT REMODELING SUBMIT
NUMBER OF SQUARES
❑ HOUSE & GARAGE
1. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARA E/
3. List of structural members to be used
PROPOSED HEIGHT:
J�°J
/ /�
FOR NEW CONSTRUCTION INCLUDING DECKS,
IDING
❑ Vinyl
❑Soffit'
ADDITIONS. & PORCHES SUBMIT:
I. Site Plan/Survey showing the existing structures
13 Aluminum
11 Trim
❑ Other
❑ Fascia
cs/
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
FOR WINDOWS - PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
_,(UySWG THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
iNkTk—Ar
$ Le (. do See Back Page for Fee Schedule
$ `Y, e_� —5 65% of Building Permit Fee
$ ') .001 times the total job valuation
$ .0005 x Permit Valuation Minimum $.50
$ $5.00 (State Licensed Residential Contractors)
$ $2100 per SAC Unit (Plans to MWCC for determination)
$ —ft +6ft= ftx$24=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ fl , 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 all rk which 7q= and approval of plans. ,p� � fV
SIGNATURE OF APPLICANT PRINT NAME nArg-�DATE�� - r �-1 (•i