PRE 2010 DOCSCity of Fridley, .Minn..
6431 TUniivverrsit r Ave. N. E�., M%nneapolis, Minn. 55432
BURDING �TG rE T
Date: _ October 24, 1972
^.117.58
Owner: - Jon Khrawski Builder Leif Henriksen
,Address Address 495 Mississippi Street N.E.
4y'i.7-,
No. Street
Lott of Lot 13B1
LOCATION OF BUILDING
Riverview Terrace N.E. Part of Lot
Addition or Sub -Division. Revised Aud. Sub. #23
Corner Lot Inside Lot X Setback _ Sideyard —
AW4 Elevation - 822. 5.0 Y(juQ4jZdlnl�IWo4 831.50 ,nim{_
,Tpjye_ Top of Footing
I :.
To be Used as:
Dwelling Front 501 Depth 24&3 1 Height 20' Sq. Ft, 1392' CtL Ft �12
—Garage Front 24' Depth 22' Height 10' Sq. Ft _528' Cu, Ft 5280'
Type of Construction Wood Frame Est. Cost MMEW To be completed Feb. -1, 1973
$26,125
Stipulations: Provide a verifying xxxxImm survey before capping. Provide a hard
surface driveway.
WATER LOCATION: 24.5' S.W. of Manhole/ 48' N.W. of PP.
SEWER LOCATION: 16' S.of Manhole (INV. 828.56)
SEPERATE PERMITS REQUIRED FOR WIRINGS
HEATING9 PLUMBING AND �I!GN
In consideration of the issuance to me of a permit to construct buildin ri above, I agree to do
the proposed work in accordance with the desc-iption above set f�� ce provisions of
ordinances of the city of Fridley.
13.07
e
In consideration of the payment of a fee of $ 62, 00 , permit is hereby granted to Leif Henriksen
to construct the building or addition as described above. This permit .is granted upon,
the express condition; that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects -to the ordinances of
Tridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildlzW
an
� city limits and this permit may be revoked at any time upon violation of jqy of the provisions of said
ordih
CLARENCE BELISU - ` - i
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, Bas heating, sewer or water. Be sure to see
Building Inspector for separate permits for these items. 1
N
APPLICATION FOR RESIDENTIAL, ALTPMTIONI
OR ADDITION BUILDINC PERMIT
rTTV nV PuTnLRY MTWVRRnTA
BUILM:
ADDRESS: ,AD SS
U" ze-l-e, 13 nocu —AWIT1014 I ZL& - ,4e .,tea-
COMW LOT: U61M LOT;SETBACK; SIDEYARD:
AWIJ,attach to djU fv=_Vo Certificates of Survey of Lot and proposed
'bull4fto j*e_atj*n dr MM on these Certificates.
To se U004 Am-.
DESCRIPTION OF BUILDING
'50
FVM"
P
,
Square Feet; A`a, Cubin Feet
Front;— 2-'1- —Depth, 22 Height-,
Square .Feet; Cubic Feet; D_
Ty" of Constructioul Estimated Cost: $
a
To Be ,
The uv4ervigned hereby =*es applica"on for.a pe=it for the work herein
Sp if agreetug, -to do all work in atttct accordance with the City of
1VU1,ey Ov0pances and -Xutftp Pf Ote Department cif Bui�dtngs, and Thereby
4pol,are4 dWX all the facts and representations stated ta this appItication
axe true =4 correct,
'.2
D&TS; Z�2 72 6 ZGXATURE:
(O's RWW#0 Side For �Jdjtjonnxorwtidn,
av 11g �1• • wArE�.
It 11111 21
1
3i1 -III is I, ;I 'I I O� .► 8 i is !ellZ N GAS EIEC.
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
/A
?A0
Number Fixtures ............. • ..
1 x $2.00 $
Future Fixture Opening .... a . • ....
x $1.50 $_,C_..00
New Fixture Old Opening ..........
x $1.50 $
Catch Basin ....................
x $3.28 $
$3.00 $ 00
Water heater (Up to 99.000 STV'
x
New Ground Rune Old. Bldg.........
x $3.25 $
Electric Water Heater.... .... ®...
s $2.00 $
GAS FITTING FEEM
NO. RATE TOTAL
lot 3 Fixtures .... • • • • • • • • • • . . • •
`
x $2.00 $�.
Additional Ybdures .. . . . . .... e e a e ..—x$.76
$
Gas Range to 199.000 BTU .. 4.........
x $5.00 $
State Surcharge $ .50
REPAIRS t AI. TIO ger to Cc&_
Description o ®moo . e . 0 0 0. ®. a e m. e a ... a..
e
e . • .a.. • .. aa...• s •.o nes
'
FM
AY /
TOTAL
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 nsling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct
Fridley. Bonn- - — A3
Kind of
Used as
To be completed about . � A �' " _
Estimated Cost. $ ®` �
eo—New. Building Permit No. Permit No.
By
Business Phone No 9 Q 2-3 !7 .
ROUGH
FINAL y oG - %5_
1
Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and r
Air Conditioning Systems and Devices J
GRAVITY WARM AIR:
Furnace Shell & Duct Work
Replacement of Furnace ...................................
Repairs & Alterations—up to $500.00 ...
Repairs & Alterations each add. $500.00
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU
each add. 60,000 BTU
Replacement of Furnace
Repairs & Alterations—up to $500.00
Repairs & Alterations each add. $500.00
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ......
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water
Each add. 200 sq. ft. EDR Steam _........
Each add. 320 sq. ft. EDR Hot Water
OIL BURNER—to 3 gal. per hour ..........
over 3 gal. per hour—See Fee Schedule
GASBURNER ................ ....................... _...........................
GAS FITTING FEES:
1st 3 Fixtures
Additional Fixtures
Gas Range to 200,000 BTU
VENTILATING SYSTEMS
Duct work etc. not to exceed 2,000 cfm
Each additional 1,000 cfm ..................
AIR CONDITIONING
ALTERATIONS & REPAIRS
Locat'
$.................................
City of
The undersigned hereby makes application for a permit for the work herein
$"'"'.-_.""-""""""""' specified, agreeing to do all work in strict accordance with the City Ordinances
$................ and ruling of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
$.......... ....... ._.....,Minn.,........._...._ ......._(_..d.....e_ ...., 19._....
Owner................................. .. .:...... _ ._...._...._---._....------- .
$ .. ..............................
Kindof Building ....................... _........ ..... /'f�G�� Q—......_.....................................................
$.......... ..__............. Used as�
...............................................................,................. _....
.BTU $......._...._.._..............
NO
$........... ....-------- _._--
$ ............ _ _ .................
Tobe compeletd about ............................................... _................... _.................... ......... :.... _..............
.._.ems
EstimatedCost, $..................�......................_.................................._..................._... jf
DESCRIPTION OF WORK
HEATING or POWER PLANTS. (underline) Steam, Hot Water, Warm Air —
Trade Name Size No.
Capacity Sq. Ft. E D R BTU
Total Connected Loa(i Kind of Fuel
AIR CONDITIONING
Trade Name
$ ..... _.............. _.......... Electric
$ ...... _........................
$............_......._..........
$..... ._............. W
TOTAL FEE $..... .........................
(remarks --over)
Size No.
Gas
S!Af' RRAN AIR CIINDIiIWIENr., tide
b� CE�iIER CRIME _
Signed ....................... ....TV?1] PIE.) F�LiS tii iJ�lES iTA 554.3si
By ............................... .............. _......................... .............. _.........
. .
Business Phone No.........
BusinessAddress ................. _... ..................................... .............. ..............
DEPENDABLE i AIR CONDITIONING INC.
COMM ERC I A L
• •COON BLVD. COON RAPIDS, MINN. 55433
City of Fridley
6431 University Ave. N.E.
Fridley, Mn. 55432
ATTENTION: MECHANICAL PERMITS
Dear Sir:
We would like a refund on two cancelled jobs for air conditioning. The names are :
James Glidden at 7398 Concerto Curve
Mechanical cost $10.50
Electrical cost $15.50
L,Aod Carlson at 6472 N.E. Riverview Terrace Permit # 9626
Mechanical cost $10.50
Electrical cost $15.50
Sincerely,
Joyce Chouinard
JC:bjs
Enc.
IV
SUBJECT
PERMIT
City of Fridley
®_ 19 5110
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
R IPT
Ly__ COMMUNITY DEVELOPMENT DIV.
INSPECTION
r PROTECTIVE SEC.
1 CITY HALL FRIDLEY 55432
,•�
NUMBERREV.
DATE
PAGE OF
APPROVED BY
'"' 612-571-3450
910-F15
6/3/88
JOB ADDRESS 6472 Riverview Terrace N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
pt. 13
1 Revised Auditor's Subdivision #23 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
R. Carlson 6472 Riverview Terrace N.E. 572-1283
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
I
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 ❑ REMOVE
8 DESCRIBE WORK
ReroOf Dwelling (31 Squares)
9 CHANGE OF USE FROM TO
STIPULATIONS
Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys.
On all new roofs or tear-offs and replacement roofs,
State Code requires that 2 layers of 15 Ib. felt,
mopped together, ;be installed to a point 24 inches
up from exterior wotrm
oioat the use of other
approved u+lderla=�rtritibrane..
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LQAD
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
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
$1,50.0
$.75
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-
$35.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
LAN CHECK FEE
TOTAL FEE
$35.75
I TUR OF CONTRACT ROR uTHORIZ AGENT (DATE)
TS YOUR PERMIT
••WHEN PROPERLY VA(!e
't
�l^^jq/tL
BLDG INSP qA7
SIGNATURE OF OW E OF WNER BUILDERI IDATEI
IV
NEW [ ] City of Fridley Effective 5/1/88
ADDN [ ] R-1 AMID R-2
ALDER [ ]
Construction Address
Building Permit Application
k ft
tO - � , 'P ( U
C -&—
Legal Description: PA (Z -g- 0 4 Lo - 13 2 -0- -jL S e 9 AL cQ yrs sL, � b, v , a z 3
Owner Name & Address: F. C A -1Z L s o /J Tel. # S7 Z / 2 t 3
Contractor: �s «- F- Tel. #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposoed construction drawn on it to scale.
IMM AREAL Length Width Height Sg. Ft.
GREAGE AREA: Length Width Height Sg. Ft. '
DECK AREA: Len h Width Hgt/Ground Sg. Ft.
i #
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
wipe of Construction: Estimated Cost: l
Approx. Completion Date: — iFT
Proposed Driveway Width If New Opening Is Desired:
5_3-&�
71
Width + 6'
APPLICAM:' L'
CITY E COY
Alt. A Alt. B
See Back Page
Tel. # s ? 2 /
Permit Free Fee Schedule on Reverse Side
State Surcharge $ %S $.50/$1000 Valuation
SAC Charge $550 per SAC Unit
Driveway Escrow $ Alt. 'A" or Alt. 'B° Above
Park Fee $ Free Determined by Engineering
Sewer !lain Charge $ Agreement Necessary [ l Not Necessary [ ]
TOMAL $
BIONS:
suaJEcr
PE
City of Fridley
$ 4267
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
Ir?
�
COMMUNITY DEVELOPMENT DIV.
I ______ ti PROTECTIVE INSPECTION SEC
r i
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
6/14/96
JOB ADDRESS 6472 Riverview Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
Pt 13
Revised AS #23
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Rodney Carlson 6472 Riverview Terrace NE
572-1283
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
R
❑ MOVE ❑ REMOVE
6 DESCRIBE WORK
Enclose existing openporch; convert to 4 season porch
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$3,500
$1.75
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$87.25
Fire SC $3.50
PLAN CHECK FEE
TOTAL FEE
92.00
SIG OF CONTRA 7OR AU HORI DAGENT (DATE)
//WHEN PAOPERLV LIDAT D THIS IS YOUR PERMIT
S GNATURE OF 04NERIII OWNER BUILDER)
BLDG INSP
DATE
NEW t ]
Effective 3/1196
ADDN [ ]
ALTER [ ]
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
$
Building Permit Application
ConstructionAddress:
e
� �� V-9- ewe��iewTeee4e�- F7L to
Legal Description:
SAC Charge
Owner Name & Address:
® kl&- S 6A-1 Tel. # 5- 77 - B Z
Contractor:
MN LICENSE #
Address:
Tel. #
$
Attach to this application, a Certificate of Survey of the
Erosion Control
lot, with the proposed construction drawn on it to scale.
$450.00 Conservation Plan Review
DESCRIPTION OF EWROVEMENT
LIVING AREA:
r r, t .
Length a3 Width / Lbt ii Height Sq. Ft. l
--j-
GARAGE AREA:
Length Width Height Sq. Ft.
DECK AREA:
Length Width Hgt/Ground Sq. Ft.
OTHER:
teWc C 6-X IS ®%AI'6- Ole e - Seas o ,-I
Comer Lot [ ] Inside Lot
Ft. Yd Setback Side Yard Setbacks
Type of Construction:
F-40VAC Estimated Cost: $ '3S-00—
3S-00—Approx.
Approx.Completion Date:
pc`F 9 (10
(Cost on Back)
Driveway CurP Cut Width Needed: F . Ft = F x $ _ $
DATE: t; APPLICANT: Tel. # %7 Z, -/ 2 83
CITY USE ONLY
Permit Fee
$ d
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1110th%)
State Surcharge
$ /e' ��
$.501$1,000 Valuation
SAC Charge
$
$900 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
STIPULATIONS:
$ zoo
CE f. CAT -0-F-,SU
tj M S' -U RT- M
-A
LA-ty-D .-S,,URV. E Yblk
4201 N.E. 3TH-STRENET
COLUMBIA HiniGHirs swl
I swomov CEAtTiiY Tm^T,T-MIS SUMWZY. PLAN; -OR .REPORT WAS PREPARED BY ME OR UNDER MY DIRECT SUPERVISION
ANO V"AT 4 A34. A GULV.^CQjST=M* LAND SURVEYOR UNDER THE LAWS Of THE STATE OF MINNESOTA..
DATE OL
SCALE I"=;
MINNE§O-r REGISTRATION 'NO'. 5332 O= IRON MONUMENT
Loc -
A
.0
4 \c)
�cl
'A
0
-0 %-
2
L V
56 �y
Survey of
That pqrt . of Lat 13, Revis.ed Auditor's Subdivision No. 23, Anoka County,,`mm
rtesota
d6tcribed *as_foIIoWs: oning
at a poi.nt bn4he northerly line of said .LQtj3,''.dista-nt.
84.0.8 --feet- so> th -ly of the.. northeasterly corner- of-soi.d.Lot. 13;
lot*14-6f-�q-i�.
1
--4f,,,6kt6
-the.so6therly 4d
-
"S y -o ost.—
4,106-W—k, the -.,southerly
ofsaki
-o+j; .-�w, �3 wfe6i so6t�-W!�-dtterf f fi44-4�&
corner 6 6-4. -dj t 11r>e ofiai,
A.
140.41-f
sout WO-terty �cj V
C
0 q,poi nt -on -
t the
d el
pointthe of b4 poti rt,-
qtn!�mq; thence _j� J*b --A
pq Y.�, t
_
-Oasemeiptjqi.4fl vewdj pvrpovt the --sout iiiTy"15--- -46reofa
"h
foc N,
"s eUl
e c, "id, i46�
a ov-
wqx.,Pu-rp �P�Ayq-,-
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
Stories
Basement
Floor 1
Floor 2
Floor 3
Floor 4
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
ath.. .
Wash ::pittt:k:::<:>;: Floor
tC)�� Auto.
Urinal X.
uk> Shower Sink Tray at<> Drain 'Ba>s''€ Washer
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
New Fixtures
$ 7.00
Old Opening, New Fixture
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Sump/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Water Heater —Electric
$ 7.00
Water Heater — Gas**
$10.00
Gas Range**
$10.00
Gas Dryer**
$10.00
Back Flow Preventer Required ( )Yes () No
Type $15.00
#5,-5 e-
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
Effective On March 1, 1996
Gas CVtisc'<> Water Heater
Ran e
:iX>>i>
. Gas
.� e
JOB ADDRESS &Y%-2- A)• 9. 1Ue'7CVI('Z<-)
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
Owner �0 N
� a$
Building Used As
Estimated Cost PERMIT NO._/`f
PLUMBING COMPMY
SIGNED BY���, ��--� TEL N0. S 2 Z —12fr3
Approved By Rough—In Date Final Date
50 a
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS 120.00
$ PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.
MEMO FROM
o 0"1a C 4-"Z- t-svAJ
F41D6[mac` A74 AJ, 5-3-V2 Z -(l2-) 5-72- -/zeP3
eq/L)
a
299-313-7, 4-A✓6 /o"m6fj(64s)
le- 710/v 0
-J-6xA-)C--, .1 cl9 10 777e- r144 -J-O217- (
U)044C Is bO-AJC- _ v �� L Lt 4 c� 7� c�S i� r�JtSmoi,
wH—icl
y
v®�N Ctg fLL&v� ..
�5
b
6
MANUFACTURED BY CUSTOM BUSINESS FORMS, INC., MINNEAPOLIS, MINN.
01
SUBJECT
City of Frialey
3=19
AT THE TOP OF THE TWINS
B U I L D I N G
P E R M I T
i
� rr
`v ______ COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
1 �
=
1;'� CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L 612-571-3450
914415
6/1/00
JOB ADDRESS 6472 Riverview Terrace NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
I Pt 13
Revised Auditor's Sub. #23 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
.Rodney Carlson 6472 Riverview Terrace NE
763-572-1283
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
O NEW ❑ ADDITION O ALTERATION K@ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (33 Sq) Tear -off
8 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
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
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
@@
$1.44
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,884
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TO AL FEE
87.57
S�GNA R FCON:RACT ROR uTNOp4E pGENi tDATEi
VALI AT'THIS I$YOUR PERMIT
/��
4E=VO
ly'A
S�GNATUBE OFOWNE WNERBUILDERi IDA Ei
B
01
NEW [ ]
Effective 1/1/2000
ADDN [ ]
CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ]
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
L�2
Legal Description:
Owner Name & Address: bDNey sd� Tel. # 76 3 5'2.2- 12T 3
Contractor:
MN LICENSE #
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 Width Hgt/Ground Sq. Ft
OTHER:
kG141='9 Tv -*off
Construction Type: Estimated Cost: $ " <3' Ox
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
DATE: / o-OWAPPLICANT: Tel. # 7
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
0
Permit Fee $ (-).3. ---�T Fee Schedule on Reverse Side
Fire Surcharge $ - <05 ell' .001 of Permit Valuation (1/10th%)
State Surcharge $ l�� y`! $.50/$1,000 Valuation
SAC Charge $ $1100 per SAC Unit
License Surcharge $____________$5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ C f
STIPULATIONS: