PRE 2010 DOCSa
s,t
6431. UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Mr. Robert Sparks
6220 Sunrise Drive N.E.
Fridley, MN 55432
TELEPHONE ( 612)571-3450
Re: Electrical Service at 6220 Sunrise Drive N.E.- Permit #12,662
Dear Mr. Sparks:
We are writing this letter, per your request, to verify the ampage
of the electrical service for 6220 Sunrise Drive N.E.
Per our records, an electrical permit was issued on June 21, 1978
to install a 100_amp service at your address. On July 6, 1978, the
service was inspected and approved, and the Electrical Inspector
called Northern States Power to connect the service.
If you feel you need any .further information on this work, ple
contact our electrical inspector, Mr. Leonard Eichmi.11er, at this
office between.9.:00 A.M. and 10.:00. A.M. on any weekday.
Sincerely,
i
RON HOLDEN
Building Inspector
RH/mh
r.
SUBJECT P MIT NO.
City of Fridley
A96
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
10/13/78
/
JOB ADDRESS 6220 Sunrise Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
28
2
Sylvan Fulls SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Clarence Graves 6220 Sunrise Drive N.E. 574-0017
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 ❑ REMOVE
X
S DESCRIBE WORK
Construct a 1314" x 1314" Shed
9 CHANGE QF USE FROM TO
STIPULATIONS
Maintain. 6 feet setback from property lines or submit verifying survey..
SEPERATE PERMITS REQUIRED FOR WIRING,
HEATING, PLUMBING AND SIGNS,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR' CONDITIONING.
Wood Frame
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
Z
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.
$1000
$.50WITH
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-
7� so
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$8.00
SIGN U NTRACTOR OR AUTHORIZED AGENT (DATE)HEN
®!��r7?
PROP LY VALIDATED.THIS IS YO/jUR PERMIT
BLDG INSP DATE
SIG*TE OF OWNER IIF OWNER BUILDERI IDATEI •''
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
O 11r, mac° CJaid t% 6 ' BUILDER:
Address: 2 !/i'tr /0<- Address:
. Tel. No.:
No,; Street:
LOT BLOCK.: ADDITION: �� /41 �!o'/�r�' �' C C S
CORNER LOT: IIISIDE IAT: SETBACK.: SIDEYARDS:
Applicant attach 'to this form 1Vo Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Front: %3 r �r Depth: 1 F Height:
Square Feet: 1 7&_ Cubic Feet: 176 o
Fxont: ° Depth: Height:
Square Feet: Cubic Feet:
Type of Construction:®��+ % �✓/✓Y�C— Estimated Cost: $ lG1�C�.Cl�
To Be Completed: /VG'� � S 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 representatio tated in this application
are true and correct. See reverse side far itional information.
DATE: 10-13-7,r SIGNATURE:
Stipulations:
's
S& eD-
BUILDING PERMIT FEE' SCHEDULE
SECTION 2. The Inspector of Buildings 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 repairs 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:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only;'Driveway width plus 6 feet x $14.50
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x $17.20
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from 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 average height of the roof surface
of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 per each five hundred dollars -($500.00) or fraction thereof in the cost
of all proposed work.
In -no case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge. °
VERIFICATION OF FOUNDATION
NOTE: 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.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
City of Fridley12-15947.
SUBJECT
AT THE TOP OF THE TWINS
.
BUILDING PERMIT
f
RECEIPT NO.
-------- COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
t . �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF APPROVED BY
612-571-3450
910-F15
9/30/80
JOB ADDRESS 6220 Sunrise Drive N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
28
2
Sylvan Hills Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Clarence Graves 6220 Sunrise Drive N.E. 574-0017
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 ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 16' x 4' Addition onto Back of Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
�
SEPERAiE PERMITS RE
HEATING, PLUM13I SIGN ECi� WING,
VG AND
Beton
rFtFp d�g�i�
FiEClR1Cc� t'r;ff
/���s
� S fly
8, )f
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
Wood Frame
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. D_WLG. 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
$.55655
$.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$7.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$8.00
SIGNAT CONTRACTOR OR AUTHORIZED AGENT (DATE)
a
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
9
h t I 30 e
BLDG WSP TE
SIGNA E OF OWNER IIF OWNER BUILDER) IDATEI
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PER14ITS
(New, Alterations, Additions, or Repairs)
OWNER:
ADDRESS:
TEL NO: '7c/ a®e
BUILDER: .�/C.
ADDRESS:
TEL NO:
Construction Location
���S STREET:
• STREGT NO: � ��'f � �S' /�%i'�l C✓ �
LOT: BLOCK: ADDITION: /L UA AAJyAJ
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
E \A6 6 IV , Front: `� / Depth: 1" f Height:.
�U P
Square. Feet: UZB Cubic Feet:
Front: Depth: Height:
Square -Feet: Cubic Feet: _
a -J
Type of Construction: Estimated Co $�-
To $e Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET .
Ilie 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 gree and correct.
D,',TESIGNATURE:
Stipulations:
dt
, � �• cc)o
. M
BUILDING IIER141T FEE SCHEDULE
SECTION 2. UW' Iiv.;pector. of BuildinU s :..tall, before permits for the erection
of: any buildincl or :;trucst:ure, or for any addition t:o auy.eristi.tic� building or structure,
Or .for any alteration or repairs to -any existing Wilding or structure, upon application
therefore, require U1e payment by the applicant for such permit of fees to the amount
h.or_ein'-below Set forth and in the manner herein provided to -wit:
1 E31 CONSTRUCTION: Single family homes and Garages: $4.OQ/J_,000 cubic feet:.
Mrii@ CHECK: 25 percent of bui.ldi.ng permit fee.
DRIVBWAY DEPRESSION: (Concrct"c. Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x 'c,:15075
Alternate D: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x $17.85
- ADDI T I OPAL INFORMATION
For the purpose of computing fees for building permits,.the cubical contents of any
building or addition, is determined by multiplying the ground area covered from 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 average height of the roof surface
of themain gable of a pitched roof.
ror.- repairs or alterations to an existing structure, the fee shall be at the gate
of $3.00 rer each five hundred dollars" -($500.00) or fraction thereof in the cost
of all proposed work.
In -no case shall the fee charged for any permit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
VERIFICATION! OF EQU.NDAT IOtJ
fi
NOTE: Permits Oconstruction 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
CERTIFICATE OF OCCUP1c,
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
said structure shall not be used or occupied until a Certificate of occupancy has
been issued.
I
SUBJECT
PERMIT O.
City of Fridley167
4 5
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
• __ COMMUNITY DEVELOPMENT DIV.
SEC.
r PROTECTIVE INSPECTION
1
CITY HALL FRIDLEY 55432
1•j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
8/27/82
JOB ADDRESS 6220 Sunrise Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
28
2
Sylvan Hills SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
574-0017
Clarence Graves 6220 Sunrise Drive N.E.
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 C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Renewal of Building Permit #15947 for an addition
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPERATE PERMITS REQUIRED FOR
OWNG,
HEATING, PLUMBING AND
SlCtitt
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
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT, ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
.
$.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
pERMITFEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$15.00
STRUCTION OR THE FORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$15.50
SIGN NTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
BLDG INSP I F)AIE
SiGNATUBCOF OWNER OF OWNER BUILDER) IDATEI
CITY OF FRIDLEY Effective Aug. 1, 1961
APPLICATIM FOR RESIDENTIAL BUILDING PERMITS
(New. Alterations, Additions, or Repairs)
OWNER:����l� G �'�'� (�Xw c s BUILDER:
ADDRESS: 2 d szti✓a/ f L A lei L" C5 ADDRESS:
TEL NO: 7//—/ ® e 7 TEL 140:
Construction location
• STREET NO: o2 STREET:
LOT: BLOCK: Q_ ADDITION: a LC,T
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.
I- DESCRIPTION OF CONSTRUCTION
Front: / Depth: / --4 Height:
Square. Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: �.��� �,� a Estimated Cost: $ goo
2b Be Obripleted:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET
Me undersigned hereby makes application for a permit for the �)ork' herein specified,
agreeing to do ,all work in strict accordance with a City of Fridley Ordinances and
rulings of the Deiklrtment of IIuildings, and her declares that all the facts and
representations stated in this application are,4rue and correct.
DATE: �- a 7 - a SIGNATURE: fi
Stipulations:
�o
pc ��
BUILDING PERMIT FEE SCHEDULE
The Inspector of buildings 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"repairs
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 FEES
$1.00 to $500.00 $10.00 Minimum Fee $15.00 plus surcharge
$501 to $2,000 $10.00 for the first $500 plus $1.50 for each
additional $100 or fraction thereof, to and
including $2,000
$2,001 to $25000 $32.50 for the first $2,000 plus $6.00 for each
additional $1,000 or fraction thereof, to and
including $25,000
$25,001 to $50,000 $170.50 for the first $25,000 plus $4.50 for
each additional $1,000 or fraction thereof, to
and including $50,000
$50,001 to $100,000 $283.00 for the first $50,000 plus $3.00 for
each additional $1,000 or fraction thereof, to
and including $100,000
$100,001 and up $443.00 for the first $100,000 plus $2.50 for
each additional $1,000 or fraction thereof
PLAN CHECK: 25 percent of building permit fee
DRIVEWAY DEPRESSION ESCROW: Concrete Curb Streets Only
Alternate "A": Removeal and replacement of curb and gutter only
Driveway width plus 6 feet x $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 x $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.
43-®8i6a.r®
Effective Aug. 1, 1981
CITY OF FRIDLEY
AppljCATION FOR PnwFa Pi eNrs_A.H€A�UJ1lG, ..COQLING,__VENTILATION REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RATE TOTAL
Furnace Shell and Duct Work,
Burner
$
20.00
$
Gas Piping
$
10.00
$
(piping needed with new furnace)
Gas Range
$
10.00
$
Gas Dryer
$
10.00
$
Air Conditioning (all sizes)
$
10.00
$
All Others/Repairs.and Alterations
1% of Value of Appliance or Work
$
COMMERCIAL/INDUSTRIAL
18 of Value of Appliance or Work $
State Surcharge $ .50
TOTAL FEE $ 10.50
Reinspection Fee ($15.00) $
Rough Insp.
Date
Final Insp.
Date
Approval for Permit --
MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00
PLUS $.50 STATE SURCHARGE
Attach. stack verification form with.replacement furnace permits
Job Address 6220 SUNRISE DR
Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432
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.
Fridley, Minn. 9-8 , 1932
OWNER CLARENCE GRAVES
KIND OF BUILDING FRAME
USED AS RESIDENCE
TO BE COMPLETED ABOUT SAP
ESTIMATED COST $400.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO. 06
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.
Trade Name DYNAVENT size No. DNV —2 5
Capacity Sq. Ft. EMR BTU HP
Total Connected Load Kind of Fuel
BURNER - Trade Name
Capacity _ Sq. Ft. EDR
Size No.
BTU HP
Company
Signed By i
Tel. No. 343-71-39
HOUSE HEATING TEST RECORD
ADDRESS - 6220 Sunri�Bn 17)Y' APT. FLOOR CITY SUBURB g'' rid ley
OCCUPANT_ C arnece Graves OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY Minn®gasc0 INSTALLED BY
Electrical Work .By Gas Line By
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE navent MAKE OF BURNER
Madel DNV-25 Model
Serial'' Max. BTU Rating
INPUT �MAKE OF FURNACE
Model
CONTROLS
THERMOSTAT Heat Plug
Vent Size/41CL11-0
'77 �1--,
Volvo ��� '`` ' ��✓ ��
KIND OF LINER
SIZE NONE
Limit
Draft Hood
Regulasor
Limit Setting
Filters Size
'dumber
Fan Setting
Chimney Location
Inside Outside
Pilot Type
Chimney Construction
Pilot Make
Pilot Model
Smoke Bomb
Wiring
Pilot Timing
Draft
Test Tag
L.W. Cut Off
Door Pressure
Lighting Inst.
Pressure
Date
'
^ Percent CO
2
Tested
Input CF1 Percent 02
Company Testing
Stack Temp. Percent CO
Name of Tester
Form 235
WELL DRILLING FOR FOUR GENERATIONS
■I Renner & sons 15688 JARVIS STREET N.W./ELK RIVER, MN 55330/(612)427-6100
INCORPORATED
MINNESOTA DEPARTMENT OF HEALTH
717 SE DELAWARE STREET
DIVISON OF ENVIRONMENTAL HEALTH
MINNEAPOLIS, MINNESOTA 55440
ATTN: Mr James Nye
(612) 623-5339
SUBJECT: WELL ABANDONMENT
RE: NOTIFICATION
Dear Mr Nye,
DATE: September 18th, 1987
=X
This letter is to notify you of a water well in your district that should
be sealed according to the Water Well Construction Code MCAR §4725.2500-2900.
E.H. RENNER & SONS, INC. has been notified by the owner of this property or
an interested party and have subsequently submitted to them an estimate for
the sealing of this well under our LICENSE #71015. We have also included
a copy of the current code requirements with our estimate.
In submitting our estimate, the owner may also receive additional estimates
and hire any number of Minnesota licensed water well contractors in this area
to seal their well. However, there is a possibility that this well may not
be properly sealed and thus jeopardize the ground water and Publice Health.
E. H. RENNER & SONS, INC. wishes to provide you this information for future
reference to assure the abandonment report is submitted.
PROPERTY OWNER: Mr. Clarence Graves PHONE # 574-0017
- ---- -- -- -
ADDRESS: y �unrise rive " .)
ri ey,
WELL LOCATION: In the South Stoop area WELL DIA. 2
Weli room ottset WELL DEPTH UK '
Sin rely ubmitt
oL ,
Raymond T. Renner, CWD/PI
Vice President
E.H. RENNER & SONS, INC.
State License #71015
CC: Citv of Fridle
6431 University Ave.
Fridley, MN. 55432 ATTN: Mr. Darrel Clark--571-
RER/rr 21/13
A.
STATE OF MINNESOTA DEPARTMENT OF HEALTH
County Name r w
WATER WELL RECORD b!lNNkSOTA UN/AUX H'8LL NO
Anoka
Minna,* statular is"o?•." Wdw saxpk
IAMO
ownsh p Name t ownshIp Number Rangeumber Section No. Fraction
4. WELL DEPTH (own ed)Daw of Carlo
Fri d 1 e 30 rr 2 4 w 3, 4 S W 'AS W 'aS W 11
`7
Distance and Owtum from Road Intersection or Street Address and City of Well Locatpan
& DRILLING muTtiou
6220 Sunrise D r . Fridley
13Cable tool 413 9everse 7o Driven IM Dug
M Hollow rad M Air 00 Bored 110
Now exactonN01 wen in section grid:
with " ' Sketch map oaf well locat
I , t Addition Name
_ 1 _
A.
a0 Rotary 80 Jetted g0 Power (Auger
t
DRILLING FLUID
1
•-+- - f - �- �- lock Number
W
7. USE
1 E mi. Lot Number W C'Al
Xpomestic 413 Monitoring BO Heat Pump
20 Irrigation M Public 90ladustry
to Vrt l" -V Gc.,,"blti°
,- -r- 1 t:v1C��✓ �c/tittt $��
30 Teat Well 613 Municipal 100 Commercial
70 Air Conditioning 1117
1 mile -- y . 1
8 CASING
HEIGHT: Alrrv`.�!
V -Black 411;n eaded
Surface It
HOLE DIA
2. PROPERTY OWNER'S NAME
e,�j
Ir CxV
20 Galy. M Welded
ddr��•t'1�
Address i
Drive Shoe? You_No_
30 Plastic 80
S V
�i
b, to rl Weight IxiJl,in
in, to It.Weight W11-
hu to It. Weight IbsJlt.
to.
_ _tn, to.:
tea. go--
o.L
3. FORMATION LOG
COLOR
HARDNESS OFFORMATION
FROMI
TO
LSCREEN Or open bsia
Make rroul 0. to a
Type Dis
SIWGause Length
F1T'PWCS:
Set between rL and ft,
10. STATIC WATER LEVZL
ft. 0 below 0 above Date Mourned
land surface
11. PUMPING LEVEL (below land sur(ace)
rL atter bn. pumping gp n
fL after bra. ptuaping
IL HEAD WELL COMPLETION
10 PUless adapter, manufacturer mallet
�$esement offset 3O At least Ir above grouts
60 Iheatpe casing protection
13. WELL GROUTED?
fYea O No
eat Cement 20 Bentonite 30
Grout material < c_; from
14. NEAREST SOURCES OF POSSIBLE CONTAMINATIQN
fees direction tyya
Well disinfected upon completion? O Yea O No
I& 'UMP
Date installed O Not lastaited
Manufacturer's came
Model number
j HP Vohs
�^y
Length of drop pipe t it. capacity g p o
Material of drop pipe
Type 10 Submersible 30 LS, Turbine 0 Reciprocating
loat 40 Centrifugal M
1& EKI$TING WELLS
Unused well an property? 4)[es O'No
Urr a aro
chert, ' arrdrd
Abed erma=I O Temporary O Not mw
1 REMARKS, ELEVATION. SOURCE OF DATA, etc.
I& WATER WELL CONTRACTORS CERTIFICATION
This well was drilled wrier my lurisdicllan and t4111 b
�j + '
C J�'i� ` � �' 1 �` G Q �' �� r -
Mwl Irua to the beat of my
��'� v t l.)4'��',.y/�
kaowledgearxibelf� '.
Mork Well Company, Inca 02133
a7
1'� m tri but1 R `�
Adana 7 ( "f �r our A v e . N . W . ` • "d"k a
11
CLVIneV�
ot,L f' `�' i�t� ��vv�t�,
T
t,
6 PL-
AuViwiioril Represen
Name of Drmw^"-
SUBJECT
City of Fridley
2902 5
AT THE TOP OF THE TWINS
BUILDING PERMIT
rr� -------COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
0
1
-3
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF APPROVED BY
'�
L J` 612-571-3450
910415
3/17/99
JOB ADDRESS 6220 Sunrise Drive NE
1 LEGAL
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DEscR.
ILOTNO.
28
2
Sylvan Hills Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Dwayne Payne 6220 Sunrise Drive NE
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Kodiak Construction 2607 Brighton Ave NE, M ls., MN 55418
781-0286 8608
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
❑ NEW O ADDITION ❑ ALTERATION ! REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (18 Sq) Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building
Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
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
$1,542
$.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
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$51.25
Fire SC $1.54
TR CTIO R THE PERFORMANCE CONSTRUCTION
PLAN CHECK FEE
TOTAL E
e
Lice s SC $5.00
$58.56
S-GNATUpE OF CON'a pa Op AUTMOAi2E0 AGENt iDATE�
ENP OP
I-P��
NSv
AT IS IS YOUR PERMIT
)ATE
SIGNATURE OF OW NER iiF OWNER BUILDER. iDATEi
NEW [ ] Effective 1/1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
1,qo a3
ConstructionAddress: Z- Z O
Legal Description:
Owner Name & Address:
0
Tel. #
Contractor: /<'a 0I'/1 --/c- s f-. MN LICENSE # &6 o 8-
t/AG/,P. f
Address: 4-cw- Tel. # —>,,f/ o z C
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:
l e10JL Ord.=
Construction Type:
Estimated Cost: $ �5
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: 3 `/7-'11 APPLICANT:
r Tel. # �i e
CITY USE ONLY
Permit Fee
$ /_ ���
Fee Schedule on Reverse Side
Fire Surcharge
$ �. `�
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 17 2
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$ S . Ca (`u
$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
$ ' S
STIPULATIONS:
BUILDING PERMIT FEE SCHEDULE
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 VALUE FEES
$1 to $500 $21 (Minimum Fee is $21 plus surcharge)
$501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, .to and including $100,000
$100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 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 it has been constructed
will be required before proceeding with the framing.