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PRE 2010 DOCSDate: March 8, 1973 owner: ..._Mika Kubacki Builder ..-..Amber Cons.tractioti.-.. — --- — Address Address 6070 Stinson Bou._1eVgr.d_ No. ___. 6040.__._ Street Part of Lot _ _.-.__� Lot __ 3 _.__ Block 1 ._____ Addition or Sub -Division ._-_.Amber-Oaka.-Addition -- --_ Corner Lot _ —_ _ Inside Lot -- X Setback — 35'-- Sideyard ___ t 34' sk4i f mevation ...—...._......231..,.30 Approx . _ tiRdU i /iU*jAA _.—_. 934. 80 Minimm— KY Top of Footing To be Used as: Dwa 11 i ng Front 26 t Depth _. ..391 Height 20' Sq. Ft. . � Cu. Ft. S.aYag Front ___._22_' Depth _._22 i. , Height ...._1.0'— Sq. Ft. _ Cu. Ft. Type of Construction Wood Frame Est. cost —X241104 To be Completed Julys 1973 Stipulations: Provide a verifying survey before capping. Provide a hard surface driveway. Set walkout elevation 32 inches above 6050 Stinson(Lot 4, Bl. 1). All floor joists j 2 x 10. $275.00 SAC charge paid,, WATER LOCATION: 10' S. of Sewer Service SEWER LOCATION: 1841 S. of Manhole (Inv. 925.07) 6'� st �i q% � Q1 fRED FOR WIRING, In consideration of the issuance to me of a ding cribed above, I agree to do the proposed work in accordance with the desc ' s p ftMD t & all provisions of ordinances of the city of Fridley. r NQ== Dalberg (See plication) 12.05 State Surcharge In consideration of the payment of a fee of $_6_00. _ _-, permit is hereby granted to Amber Construction to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Inspector CLARENCE BELISLE NOTICE: This permit does not cover the construction, installation for wiring, plumbing, Bas heating, sewer or water. Be sure to ase the Building Inspector for separate permits for these items. 4 ND 0 ERR`- 5WICK VNEES LOT SURVEYS COMPANY 691 7 DAHO ARASCN GOLDEN VALLEY, MINN LAND SURVEYORS BROOKLYN PARK, MiNN REGISTERED UNDER LAWS OF STATE OF MINNESOTA LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIS 6917 Idaho Ave. N. 533-9922 Minneapolis, Minnesota 55128 IN'OLSTRIAL - JUDICIAL.I-c)Mt3IN1^+G �:+'7RE T'1AN 10 TEARS OF t. ^'6urbepar� �lCertif icate IAND .;UR�i'ING fXPEPIFNCi IN THF •.MERrIA1 T�,Pl�GRAPHICAI. _ CITY LOTS FLATTING %IETROPCI i'AN A.RFA SURVEY FOR AMBER CONSTRUCTION COe INVOICE NO. 2837 F.B• 121- G15 0 DEE TES IRON SCALE I"= 30t I M i 135.0 �' 0 <I > I 141 �] e- a 3 ? • d' ti I d' Z 171 �k IV —v Z z IC -f NC4�— t1 e- 3 oc u� 135.0 � I Ir IAT 3, BLOCK 1, AMBER OAKS We hereby certify that this is a true and correct representa. tion of a survey of the boundaries of the above described land and the location of all buildings and visible encroach- ments. .i any, from or on said 1,ind Surveyed by us this r- 7th day of NOl• , 196-9. t LAT SURVEYS COMPANY r' i° , �,bkvc 4W44-4-, ifs 5�0 f F Sf- 6,61 S g�2s.o;�) APPLICATION FOR RESIDENTIAL, ALTERATION.9 OR ADDITION BUILDING PERMIT CITY Of FRIDLEYs MINNESOTA OWM 1 S E L14 4,eL_ BUILM:1 A=dC-9 04 Af -5 2. ADDRESS: .AD SS: 60zo - EY 'COMMLOT 90 IMUE LOT; ETBACK; 3,:57 SIDARD: AWMant- ;Attath to tb-U fw=_Vo Certificates of Surva of Lot and proposed UdjAJoeatt*n dry 4m ttwft Certificates, DESCRIPTION OF BUILDING 'To Be Used As-. &'5 4x9&—'n':f- jz ft4w�m 2 C, Dmth-.— 39 ight: Stpare veet2 Cubic Eget; Front Depth; 2- Height Square Feet, Cubic Feet; Tyfa Of Constructions amg Estimated cost: 00 C) To Be f -7-3 0 TM,andarpigned hereby mak*v applica"on for.a permit for the work herein epealfW1. agreeing to do all work in stttct accordance with the CAty of ftldtey or4Uumces and imtftp of tba Department of BuOdin&S, OAA 'hereby declare$ dWX all the facts and representations stated is this application ace true =4 correct, STOXATURE: (Ose Ravwva Side For Addft4onal Infortgation.; S 14 F7 C' f2c j BUILDING PERMIT FSE SCHEDULE SECTION 2, The Inspector of 4t4ildings shall, before issuing permits for the erccti.on of any building or structure, or for any addition to any existing building or structure, or for any alteration or repairs to any existing lutiding or structure, upon application therefore, require the payment by the applicant for such Permit of fees to the amount herein below set forth and in the mer herein prQvided tomwits UNIFORM BUILDING CODE; Type 1, 2 & 4 a $2.15 for each one thousand cubic feet, or fraction thereof, in such cubical contents. hype 3 & 5 a $1.85 for each one thousand cubic feet. ,ADDITIONAL INFORMATION For the purpose of pomputing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area. covered #ream a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the averages t of the roof surface of the main gable of a pitched roof, Sm irs or alterations to an, existing strWture, the fee shall be at the rate of $5,00 per +esa five h�mdred dollars ($300,00) gar f=.ct.ion thereof in the coat of all proposed Work+ In VP cme small the fee cbarW for azg permit as set forth in Section 2 be than $5.00, s VORTFICATION Of FOUNDATION 4 Permits for construction will be issued a ntuimum of 24 hours from the tim of ,application,, to allow for proper review of the proposed structure and of the construction site., R A C4,tj-fiq4 Survey of the lot, g6moing the locates of the foundation, once, it bas been cons ted, will, be rewired before MceedW with the framivg, CERTIFICATE OF OCCUPANCY Application for a Certificate 91.0ccupancy shall be made teas (10) days prior to the use or occupancy of my allucture for which a building permit has been issued; and said structure shalt not be used or occupied until a Certificate of Occup=cy has been issue4, If 645-3601 TUR CITY TESTIRG HOD E06190196LRBOBIRTORY, Inc. CHEMICAL & PHYSICAL TESTS • INSPECTIONS • RESEARCH Amber Construction, Inc. 6070 Northeast Stinson Fridley, MN 55421 Attention: Mr. Norman Dahlberg Gentlemen: March 21, 1973 CHARLES W. BRITZIUS. P.E. President JOHN F. GISLASON. P.E. Executive Vice -President NORMAN E. HENNING. P.E. Vice -President Engineering ALBERT C. HOLLER, F.A.I.C. Vice -President Chemistry CLINTON R. EUE Secretary Treasurer RE: Residence at 6040 Stinson Boulevard Fridley, Minnesota Laboratory #94398 This letter concerns the recent investigation and tests our firm per- formed of the soil conditions at the above referenced project. Our work was performed at the request of Mr. Dahlberg. The proposed building will be a one-story, wood -frame, single family residence, with a full basement and attached garage. The structure will be supported on normal spread footings, which we assume were designed to be placed on soils capable of supporting 1200 to 1500 psf. Bottom of footing elevation for the house portion of the building will be approximately 2' below the garage footings. A portion of the west exterior footing, from the northwest corner to a point approximately 10' south, will step down an additional 2' to provide protection against frost for a basement walkout. No preliminary soil borings were put down at this site and, therefore, we have no information regarding the soil conditions at depth. How- ever, our available geological information indicates the soil profile in this area is generally comprised of glacial till. This material consists of brown, silty and clayey sands containing some gravel. We understand the entire building area had been previously excavated below scheduled footing grade and 2' of fill was subsequently placed in the garage and east half of the house areas. Approximately 6" of fill has been placed below footing elevation at the southwest house corner and 4' in the northwest corner. However, at least 2' of the 4' fill sequence at the northwest corner was later removed to allow placement of the basement walkout footings. AS A MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURSELVES, ALL REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS, AND AUTHOR- IZATION FOR PUBLICATION OF STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS 15 RESERVED PENDING OUR WRITTEN APPROVAL HOME OFFICE: ot,HototHo�� 662 CROMWELL AVENUE ST. PAUL, MINN. 55114 BRANCH OFFICES: BISMARCK, N.D. FARGO.N.D. GRAND FORKS, N.D. MINOT, N.D. LA CROSSE, WIS. ROCHESTER, MINN. SIOUX FALLS, S.D. WATERLOO, IOWA Amber Construction, Inc. 6070 Northeast Stinson Fridley, MN 55421 Attention: Mr. Norman Dahlberg Gentlemen: March 21, 1973 CHARLES W. BRITZIUS. P.E. President JOHN F. GISLASON. P.E. Executive Vice -President NORMAN E. HENNING. P.E. Vice -President Engineering ALBERT C. HOLLER, F.A.I.C. Vice -President Chemistry CLINTON R. EUE Secretary Treasurer RE: Residence at 6040 Stinson Boulevard Fridley, Minnesota Laboratory #94398 This letter concerns the recent investigation and tests our firm per- formed of the soil conditions at the above referenced project. Our work was performed at the request of Mr. Dahlberg. The proposed building will be a one-story, wood -frame, single family residence, with a full basement and attached garage. The structure will be supported on normal spread footings, which we assume were designed to be placed on soils capable of supporting 1200 to 1500 psf. Bottom of footing elevation for the house portion of the building will be approximately 2' below the garage footings. A portion of the west exterior footing, from the northwest corner to a point approximately 10' south, will step down an additional 2' to provide protection against frost for a basement walkout. No preliminary soil borings were put down at this site and, therefore, we have no information regarding the soil conditions at depth. How- ever, our available geological information indicates the soil profile in this area is generally comprised of glacial till. This material consists of brown, silty and clayey sands containing some gravel. We understand the entire building area had been previously excavated below scheduled footing grade and 2' of fill was subsequently placed in the garage and east half of the house areas. Approximately 6" of fill has been placed below footing elevation at the southwest house corner and 4' in the northwest corner. However, at least 2' of the 4' fill sequence at the northwest corner was later removed to allow placement of the basement walkout footings. AS A MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURSELVES, ALL REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS, AND AUTHOR- IZATION FOR PUBLICATION OF STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS 15 RESERVED PENDING OUR WRITTEN APPROVAL s Amber Construction, Inc. March 21, 1973 Page 2 On March 13, 1973, our firm was requested to perform two soil density tests in the fill material placed to attain bottom footing elevation. Tests #1 and #2 were performed in accordance with the moisture -density relation of soil as designated by ASTM:D698-70. As shown on the attached reports, these areas have met the specified 95 percent compaction. Two tests performed the following day near the northwest corner failed to meet the 95 percent compaction specification. In addition, the fill material below footing grade in the lower walkout area had become saturated and unstable. At Mr. Dahlberg'srequest, we inspected the unstable soils on March 14, 1973. At this time, the forms were in place for all footings, except those near the northwest corner, and the placement of concrete had begun. Using a shallow hand auger, the fill in the walkout area was found to be quite wet and soft. The frozen natural soils at the perimeter of the excavation had begun to thaw and were draining into the lower footing area, creating the unstable condition. We recom- mended the saturated fill be removed exposing the underlying glacial till. Then, the footings could be either founded on the natural soils or the trench excavation refilled to grade with a compacted, clean sand fill. It was decided, by Amber Construction, Inc., to refill the trench with concrete rather than adopt one of the two previously mentioned procedures. Consequently, we observed that all fill was removed in the walkout footing area and concrete was placed to bottom footing grade. The resulting footing was approxi- mately 10' long and ranged in thickness from 1' to 3'. It was recommended the low density fill in the floor slab area be recompacted prior to placement of the concrete slab. This could be accomplished by subcutting the area of the low tests approximately 2' and placing the fill along the lower walkout footing, at the completion of wall construction. The subcut portion could then be recompacted and tested prior to placement of the remaining 2' of fill. If you have any questions regarding this letter, please feel free to contact us. Very truly yours, TWIN CITY TESTING AND ENGINEERING LABORATORY, INC. Dale J. Sthafer Soils Engineering Inspector zz� /e- s::: Thomas K. Smith, P.E. DJS:TKS:rs Copy to: Fridley Building Inspection Depa_rtmen t 845-3601 I,�1 ' CITY TESTING AND ENGINEERING LABORATORY, INC.- ENGINEERS NC: ENGINEERS AND CHEMISTS ayPeCp�o y 662 Cromwell Avenue - St. Paul, Minn. 55114 s ®g MOISTURE - DENSITY CURVE SAMPLE NO. 1 PROJECT: RESIDENCE AT 6040 STINSON BOULEVARD DATE: March 20, 1973 FRIDLEY, MINNESOTA REP®RTED To: Amber Construction, Inc. COPIES To: (1) Fridley Building Inspector LABORATORY NO. 94398 METHOD OF TEST: ASTM:D698®70, 'Method "A", (44 Basis) TYPE OF MATERIAL: Sands fine to medium grained, brown (SP -SM) MAXIMUM DENSITY: 1208 1b. /Cu. ft. OPTIMUM MOISTURE= 11.1 % 118 l MOISTURE CONTENT -% ca0i LABORATORY No. 9®4398 TEST NUMBER: 1 DATE TAKEN: March 13, 1973 UNIFIED SOIL_ CLASSI_F_ICATiOIii: Sand, fine to (Moisture -Density Sample -- medium grained, Number) a little gravel, brown (SP -SM) -1 DATION: 10'N & 2'W of SP corner of garage DEPTH BELOW M O; FOOTING ELEVATION-. DEPTH BELOW EXISTING GRAS: 6A1 0 March 138 1973 Sand, fine to medium grained, a little gravel, brown (SP®SM)ml 8°S of NE corner of house N MLD DENSITY DETERMINATION; Method Density in Place By Sand=Cone Method, ASTM: D1556-64 (44 Basis) Dry Density (pcf) 117 118 Moisture Content W 9.3 11.1 Plus #4 Material W 15 15 LABORATORY MOISTURE-UENSITY RELATION OF SAIL: Method ASTM;D698m70, Method "A", (44 Basis) Maximum Dry Density (pcf) 120.8 120.8 Optimum Moisture W 11.1 11.1 COMPACTION TEST RESULTS: Compaction W 96 97 Specified Compaction W 95 95 REMARKS: The above test locations were selected by Twin City Testing and Engineering Laboratory, Inca Compaction meets specifications in the above test areas. AS A MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURSELVES. ALL REPORTS ARE SURTO AS THE C"FIOENTIAL PROPERTY OF CLIENTS, AND AUTHOR- IZATION FOR PUBLICATION OF STATEMENTS, CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS IQ R3$SERVED PENDING OUR WRITTEN APPROVAR Twig City T® and Enginewing Laboratory, Ina. 645-3601 TWIN CITY TESTING AND ENGINEERING LABORATORY. INC. O`,"K.l.Iry.FNr ENGINEERS AND CHEMISTS yp®eri 662 Cromwell Avenue - St. Paul, Minn. 55114 ? REPORT OF: DENSITY TESTS OF COMPACTED FILL pft PROJECT: RESIDENCE AT 6040 STINSON BOULEVARD DATE: March 20, 1973 FRIDLEY. MINNESOTA REPORTED TO: Amber Construction, Inc® COPIES To: (1) Fridley Building Inspector 6070 Northeast Stinson Fridley, MN 55421 Attn: Mr. Norman Dahlberg LABORATORY No. 9-4398 TEST NUMBER: 3 DATE TAKEN: March 14, 1973 UNIFIED SOIL CLASSIFICATION: Sand, fine to (Moisture -Density Sample medium grained, Number) a little gravel, brown (SP-SM)ml LOCATION: VS & 10°E of NW corner of house DEM BELOW BOTTOM OF FOOTING ELEVATION: 2s DEPTH BELOW EXISTING GRADE: 2 e FIELD DENSITY DETERMINATIO 21 March 14, 1973 Sand, fine to medium grained, a little gravel, brown (SP®SM)-1 10°S & 10tE of NW corner of house MW 6®1 Method Density in Place By Sand -Cone Method, ASTM: D1556®64 (-#4 Basis) Dry Density (pcf) 112.5 110.0 Moisture Content NO 7.0 7.0 Plus #4 Material W 8 11 LABORATORY MOISTURE -DENSITY RELATION OF SOIL: Method ASTM:D698=70, Method BeA", (44 Basis) Maximum Dry Density (pcf) 120.8 120.8 Optimum Moisture (T.) 11.1 11.1 COMPACTION TEST RESULTS: Compaction W 92.5 91 Specified Compaction (%) 95 95 REMARKS: The above test locations were selected by Twin City Testing and Engineering Laboratory, Inc. Compaction is below specifications in the above test areas. AS A MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURSELVES. ALL REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS. AND AUTHOR- IZATION FOR PUBLICATION OF STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS IS RESERVED PENDING'OUR WRITTEN APPROVAL Twin City Test' g and Engineering Laboratory, Inc. Ey 1 hg" T ,. wen® Eaeczbq ad my r-t-mmmagh, 37gem (And D@�&w P 1.MAT4'!P4 VA= AM: MS TCTAL pmmwe men a Dud ,5 wh .810.00 RGPlacemeat of Ymmace lemma 0.00 'Repairs & A4eratioas—up to ��5.r&0m 6.00 - — 7140PiYS L'� AIWMU0710 c SEE ;! �NOW.CQ . S.co v-- — – cv Shell & D Work to 129,0w BTU..each add. 69,E gm ............... .....t�9 Replacement of Furnace 0.00 � R apadrs & Alterations—up to SMM 3.00 4L- Asipars 1g Alteratims each add. M3.00 &00 a rumace Shell & Lines—to 400 sq. ft.. EDR Stews $10.00 $, --- l�wnace Shell & lAne--to 040 sq. it. EDR Hot Water 10.00 �. Each add. 300 sq. ft. ZDR Steam 3.00 Mach add. 330 sq. ft. MDR Hot water 3.00 OIL l0 —to 3 gal. per hourover 3 gal. per hourcee Fee Schedule AIR CONWITIONMO FAR it EATIM SYSTUN WEN TI>4 LTENG STSTSM ALTMATIONS k PJCPAI39 ROUGH FMJ6 6 is" F" ndmwkbI TOTAL FM City of Maley: The uimdersi ed hereby mal es app&lcagam fere a pertrzeit f� ��. Asia ljesreiy� specified, agreeing to do all work in with he qty Md vuling" of the Department Of Buildings, iid hereby d=la W t5`Iia� an Qe 20�'E; and representations stated in this application are ttzugz aaa €e acE. Fridley, Pan ,�=+—.—� �� Kind of Building .---.- Used as To be completed abo�ut�--�,- ---_-. Estimated Cost, w BuikUng Perinit No. Permit no. tan"ias-ovuq 6fUBURgHN AIR D®NDITIONp4 Q�OT ]I$ CENTER .nR,ir Co. �®�� mINNES19rA City of Fridley SUBJECT r17981 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 �•j NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5 14/85 JOB ADDRESS 6040 Stinson Boulevard N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 Amber Oaks SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE ke/Linda Kubacki. 6040 Stinson boulevard N.E. 574-1269 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. e 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW CA ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct an 181 x 12' Three Season Porch. Addition 9 CHANGE OF USE FROM TO STIPULATIONS Approved by Appeals. Cox=iss.ion on 4/9/85 for a 7' side yard for living area. WARNING PERMITS REQUIRED�® SIGNS diFOR call local allot � SEPARATE KEATIN ,. PLI�!l�BIN BIefore gging IP@NC. ELECTRIC ® GAS E TELEPHONE . REQUIRED By LA 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 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 $9,550 $4.77 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- Y STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ' AN CHECK FEE TOTAL FEE $20.13 $105,40 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY ]DATED THIS IS YOUR PE MIT , BLDG INSP 4ATE SIGNATURE OF OWNER IIF OWNER BUILDER) IRATE) I. , NEW [ ] ADDN. ALTER. [ J City of Fridley �R-1 AND R-2 Building Permit Application Effective 4/1/84 Construction Address: Legal Description: -3 S s Owner Name a Address: �`�/`� Al' --e V /0 a�1&90- / Tel. #,67q-12-67 Contractor Address Attach to this application, a Certificate of survey or the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length _ L� Width Height Sq. Ft. 0 GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: - Corner Lot [ Inside Lots[ F . d. Setback Side Yard Setback �— Type of Construction: !� D G �. Estimated Cost: $ Approx. Completion Date: `7 Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ See Back Page for Explanation DATE: APPLICANT: �ir��' ff 1 L2Tel. Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ P' $ , rel> $ 1419 Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $425 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] A11%16,S- S a7e-�'Ig7U /0 ` r7� P12 s g I BUILDING PERMIT FEE SCMWULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: Total Valuation $1.00 to $500.00 $501.00 to $2,000.00 $2,001.00 to $25,000.00 $25,001.00 to $50,000.00 $50,001.00 to $100,000.00 $100,001.00 and up Fees $10.00 (Minimum Fee is $15.00) $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000. $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000. $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000. $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000. $433.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof. DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50 Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75 VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. ( ~��K~ | \-)y�` ;;� ,. i ,�. � �_ _; �.K . .E� cn ? ',-" 7l A lf 0. ...� c c 79.44 _ A e lb rtt� EAso-*6miA CL oma' l`' ►! Z w �s � I�"� �, W '• � _ 12.'r 26.0 1-06 tv 'fi �• a i S �':G� cA " b � � � q t��.�� d k� 11.1 . r ' 79.44 - •i VC ;q,: %�!�.,�','�' db ��d l., k: , :. �, ?�.,,, ,• •<`;� t^:.rg �'i;�`7 „ ,";r,° �v°� �4. r`M � `.� '�'� Slr I'>r '�'st,:> >.+. ,.39 a t, �•�.. �'' ',3 � daa_�r t w.r,� `'�h ,w 5 ' �:�'t"... STI ■ - //`�tl' SO._'� �Kf S�■(! i - '} $'. '4^._ 1 ,.''• .G ;�. -5` .sv Spry ::., b"f^a ,}.. �' as , n g� F : �`i � nt�,% '�, •r ,�, rr:rrir�>�. ^,� �` '.i . :F 4 :, -q: -VK .5... 7 -, ,�., , f : �` � r � n:yvC r _ s{.a`• {fi, � - R=te: `i _ t ..;,a � , Yt '� d -•9 ?� . 3 < �'��_. ...0 p�,"terra w. a k F t. - - g. s � _.� q� a. t .�3j,,x. t > �•i-M -at�"a.r, e,t., ..r �,. Y, 'r*':.se_, ft` z. , CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 17631 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Rate TOTAL Furnace Shell and Duct Work, Burner - ,Also,Re Ip acemenl Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work $ 10.00 $ $ 10.00 $ $ 25.00 $ State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective On January 1, 2002 JOB ADDRESS® OWNER -1 ' aLZA t� ch ,gyp BUILDING USED AS_ -A , ESTIMATED COST PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units_ Circle One (Steam) - (Hot Water) ( arm Ai ) Trade Named Size No. _ BTU HP EDR Fuel 'Ui . g5 Total Connected Load Burner Trade Nam BTU HP Size No EDR $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE 4 1L,4 HEATINCO�y i Au cr,��r Signed TEL #� FAX Approved By Rough -In Date Final Date-� i 6 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VENI.- VENT CONNECTOR AND COMM ISTION AIR VERIFICATION When replacing an exit ina furance, 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. Ye) No ( ) The venting system is plasbc/PVC and meets all current codes' n manufacturer specifications including sizing, length, number of elbows and to ination. Yel{ 4 No( ) The undersigned also verifies that the replacement unit is a list d assembly and meets the current codes and manufacturers specification This does i^clude AGA-GAMA CatPgon, I Central Furnace Venting Table for fan assisted and natural draft appliances. Ye(`j No( ) The existina comhustion air is sized and installed to meet theticurrent codes and manufacturers specifications. 9 Yes No( ) When required to install a new mrnhustion air, it will be sizedland installed to meet the current codes and manufacturers specifications. Yes) No ( ) When installing a new yentina system, the undersigned hereby verifies that - \\ it is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Ye) 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 Sime/Common Vent and Ven onn c or Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU input Far) t'kssisled or Ndi 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 HEATING CO:MP�L, Signed By: — Date