PRE 2010 DOCSBUIIJDING PERMIT
Village of Fridley, Minn. N' 2243
Date
.+
Builder �
............................. .
.���
Address . .
��.-`:� . �� �G!' ..... Address .. ..... ............................ .
G
LOCATION OF BUILDING
N
No. . "q.... ....... Part of Lot
...�-tY� , ,e�,d�`a�*► "' �,'t Eaz.�.�',�t"ii�a'~c�+� a��° e+� _ ¢ �r...�................ .
Lot ........ Block ........4S ....... Addition or- Sub -Division ' .. �: � ................
Corner Lot ...... .I ... Inside Lot .. ...... Setback. Sideyard/10 ......................
DESCRIPTION OF BUILDING
To be Used as:
Wt .... ........ ........
Front :. Depth `ice ..Height �. Sq.' Ft. Cu. Ft.
. Front ...... Depth ........ Height Sq. Ft......... Cu. Ft.
Type of Construction: ... Est. Cost . .................. To be Completed.. . .
i
In consideration 0 the issuance to me of a permit to construct the building described above, I agree to do
the proposed work i' -,pi accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
ii
coni Of the payment of a fee of $. .•, per uir is `hereby granted to .4101H. -Int,
:.
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 r ,garding location, construction, alteration, maintenance, repair''and moving of buildings with-
in the village limits d this permit may be revoked at any time on violation of any of the provisions of said
ordinances.
sell e
I
Building Inspector
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. 15 sure to see the Building Inspector for separate permits for these items.
6 �/'7
City of Fridley, Minn. N- 9 9372
BUILDING PERMIT
Date: 7/26/67
Owner: Duane D. Briedgm Builder ,Duane Erickson
Address 6336 VanBuren Street Address 6336 VanBuren Street
LOCATION OF BUILDING
No.6336 �8gt Van Buren part of Lot
Lot3t K,11ik 5Addition or Sub-Division_Florence �arE
Corner Lot _ ____ Inside Lot Setback __ _ Sideyard
Sewer Elevation ____ _ _ . _. Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front 24' Depth 26'XK Height 10' Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft Cu. Ft.
Type of Construction _ __ Est. Cost $1200.000 To be Completed
In consideration of the issuance to me of a permit to c et the building described above I agree to do
the proposed work in accordance with the description above set forth :ipd in com an provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 9.00 permit is hereby granted to Fane B .
Erickson 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.
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heatine, sewer or water. Be sura to we
the Building Inspector for separate pen ft for these items.
AP?'�s�1CC3'l .rite OR MILDING Ar M UT
ADDRESS
A4_
ADDRESS
_ LOCATION OF BUILbuG
NO. STREET U � a-( � .� i� PART OF LOT
0
LOT ��' ` jay BLOCK ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT SETBACK SIDE -YARD
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used Ad:
l iG2 Front
I
_(o Height 4
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. cu. Ft.
Type of Construction Estimated Costo
To Be Completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all *cork 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 ar true and correct.
DATE SIGNA �
(Scheduee of Fee Costs can be found on the Reverse Side).
• � s
Cia f OF
iRx;1 �E irig NNESOTA
OWNER'S NAME
DER
ADDRESS
A4_
ADDRESS
_ LOCATION OF BUILbuG
NO. STREET U � a-( � .� i� PART OF LOT
0
LOT ��' ` jay BLOCK ADDITION OR SUBDIVISION
CORNER LOT INSIDE LOT SETBACK SIDE -YARD
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used Ad:
l iG2 Front
I
_(o Height 4
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. cu. Ft.
Type of Construction Estimated Costo
To Be Completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all *cork 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 ar true and correct.
DATE SIGNA �
(Scheduee of Fee Costs can be found on the Reverse Side).
• � s
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erection of any building of 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:
Uniform Building Code: Type 1,2, & 4- $1.75 for each one thousand cubic feet, or
fraction thereof, in such cubical contents. Type 3 & 5 - $1.50 for each
one thousand cubic feet.
For the purpose of computing fees ,for building permits, the cubical contents of
any building or addition to a uniform height throughout by multipluing the ground
area covered from a point six (6) inches below the floor line of the basement or
cellar to the average height of the upper surface or to the average hei.g' t 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 $5.00.
NSSSD Connection Charges based on Location- Area 1 or 2.
D
X r-6' a.
fi 2-
�-
A
01,
SUBJECT
PE
City of Fridley
18.403
AT THE TOP OF THE TWINS
BUILDING PERMIT
_
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
// 5-Y7
r 1 PROTECTIVE INSPECTION SEC.
p2®
1 i i CITY HALL FRIDLEY 55432
j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
4/30/86
JOB ADDRESS 6336 Van Buren Street N. E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
Pt. 8,9,10
5
Florence Park Addn. to Fridley SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Phillip Salewski 6336 Van Buren Street N.E. 571-6692
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
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
❑ NEW 7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 12' x 13.5' Addition and a ll' x 14.5' Garage Addition
9 CHANGE OF USE FROM TO
STIPULATIONS Variance approved for side yard setback from 10' to 7.8' by Appeals
Commission on April 29, 1986. Bedroom must have an egress window. Provide
products of comubstion fire alarm. Provide frost footing with foundation
insulation.
SEPARATE PERMITS REQUIRED FOR
un WIRING, HEATING, PLUMBING AND SIGN&
ti G
Belor'L"k ,cg''call local _Utilit
TELEPH E'AkTRIC - GAS Etc,
REQUIRED By LAW
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
]
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
$5.10
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$10,20.0 ``.%°>`_
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.
$86.50
LAN CHECK FEE
TOTAL FEE
$21.63
$113.23
NTRACTORORAU HORIZEDAGE T (DATE
WHEN PROPERLY YQI TED THIS IS YOUR PERMIT
YS
i NATURE O NER iIF OWNER BUIL ERI (DATE)
d BLDG iNSP T
A
01,
NEW [ ] City of Fridley Effective 4/1/86
ADDN. f R-1 AND R-2 1
ALTER. [ ] Building Permit Application
Construction Address: W -�UL.Ilk V- -) W --
Legal Description: ® 'at
Owner Name & Address: � � LU a L r L1 S fZ 1 Tel. #
Contractor: Tel. #
Address: U
P DorrI )i
LIVING AREA:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT /
Length l2- Width l3. J Height Sq. Ft.
GARAGE AREA: Length 11 Width Height Sq. Ft. 1 ��
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
ICQ)e (4q. -37)V 0, Pay •9q 4- I$.9 r ='1,01(0, IS f: 10dOLP
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: ouj 61,"--- Estimated Cost: $
Approx. Completion Date:
Proposed Driveway Width If New Opening Is Desired:
DATE:
APPLICANT:
CITY USE ONLY
Alt. A Alt B
$ $
See Back Page for Explanation
Tel. #
Permit Fee $ %S() Fee Schedule on Reverse Side
Plan Check $ a 1.6-3 25% of Building Permit Fee
State Surcharge $ 5 -to $•50/$1,000 Valuation
SAC Charge $ $475 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
TOTAL $
Agreement Necessary [ ] Not Necessary [ ]
� I � � •�
STIPULATIONS:
C/1
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 Valuation Fees
$1.00 to $500.00 $10.00 (Minimum Fee is $15.00)
$501.00 to $2,000.00
$10.00 for the first $500 plus $1.50 for
each
additional $100 or fraction thereof, to and including
$2,000.
$2,001.00 to $25,000.00
$32.50 for the first $2,000 plus $6.00 for
each
additional $1,000 or fraction thereof, to
and
including $25,000.
$25,001.00 to $50,000.00
$170.50 for the first $25,000 plus $4.50 for
each
additional $1,000 or fraction thereof, to
and
including $50,000.
$50,001.00 to $100,000.00
$283.00 for the first $50,000 plus $3.00 for
each
additional $1,000 or fraction thereof, to
and
including $100,000.
$100,001.60 and up
$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.
C�
VA L) u I? C 0
fru
ied pi, co &A
k e U\ wr
---
`b
-2
Be-
?ouRck
<.-- tv
SUBJECT
PERMI
City of Fridley
(I
200 2
AT THE TOP OF THE TWINS
BUILDING PERMIT
i
-.z
L'______ COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
` p
r PROTECTIVE
1 ; �
NUMBERREV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
L 612-571-3450
910-F15
7/17/89
/ /
JOB ADDRESS 6336 Van Buren Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
8 , 9 , 10
5
Florence Park Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Phillip Salewski 6336 Van Buren Street N.E. 571-•6691
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 Ck REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside Dwelling
9 CHANGEOFUSEFROM TO
STIPULATIONS
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
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
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
$2,000
$1.00
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.AL4Y OTHER STATE OR LOCAL LAW REGULATING CON-
$45.00
STRUCT ON R PERFORMANCE OF CONST UCTION.
L r
-Y
P N CHECK FEE
TOTAL FEE
$46..00
,
-1?
SIGNATURE OFC TRACTOR OR AUTHORIZED AGENT ID EI
�.. HEN PROPERLY VAL TED THIS IS YOUR PERMIT
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
BLDG )NSP )ATE
NEW [ ] Effective 5/1/88
ADDN [ ] R-1 AND R-2
ALTER [ ] Building Permit Application
Construction dress:
Legal Description:
Owner Name & Ams: P, i X x r j -.b 5-fV / e Tel.
Contractor: �� ���r' tA� �' . i Tel. # 71-,66%1
Address: 4z2
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
ILIV M AREA: length Width Height Sq. Ft.
GRPUNM AREA: length Width Height Sq. Ft.
DECK AREA: ldtAhWidth Hqt/Ground Sq. Ft.
07HER: S�L�� �� l j
Corner lot [ ] Inside lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $ oZ , 006'
Approx. C mpletion Date: G
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
W'dth + See Back Page
DATE: / APPISCANT: Sr Tel. #
CITY USE CNLY
Permit Fee $ -c-- o C) --
State
State Surcharge $ /, D
SAC Charge $
Driveway Escrow $
Park Fee $
Sewer Main Charge $
$ .4)
STIPUTATIONS :
Fee Schedule an Reverse Side
$.50/$l,000 valuation
$575 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
- • :�I•-1
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:
$1 to $500 $15 (Minimum Fee is $15 plus surcharge)
$501 to $2,000 $15 for first $500 plus $2 for each additional $100 or
fraction thereof, to anxi including $2, 000
$2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional.
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction thereof
EPZVEN iY PRESSIC1 ESCROW
(Concrete Curb Streets Only)
Y
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.
Permits for construction will be issued a minium 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.
t/
111
SUBJECT
P `
City of Fridley
T35�
2 2
AT THE TOP OF THE TWINS
BUILDING PERMIT
i ,
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
_
PROTECTIVE INSPECTION SEC.
/---1 CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
3/22/94
JOB ADDRESS 6336 Van Buren Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
Pt 8, 9,P
10 5
Florence Park d SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Phillip Salewski 6336 Van Buren St NE 571-5040
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.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
xO
8 DESCRIBE WORK
Install footing for storage area in basement
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS I 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
$500
$.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SACCHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
SIGNATUR.OF O RACTOROAUTHQRIZEDAGENT (DATE!
WHEN PROPE L VALIDATED THIS IS YOUR PERMIT
LER
BLDG I SP SATE
SiGNATURE OF ER IIF BUILD R IDATEI
t/
111
NEW [ J
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: 65�; -3 -3
Legal Description:
Owner Name & Address:
Contractor:
Address
Effective 1/ 1/94
93q
Tel. #� / . j C,
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft. -
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:i
Corner Lot [ ] Inside Lot [ ]
Type of Construction:
Approx. Completion Date: _
Ft. Yd Setback Side Yard Setbacks
Estimated Cost: $ �(✓�i� �-
1.
(Cost on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft Ft x $ _ $
DATE:% Z 1 APPLICANT:
Tel. #-7
CITY USE ONLY
Permit Fee
$ 15- 00-
Fee Schedule on Reverse Side
Fire Surcharge
$ , 07<D
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 4 S -D
$.50/$1,000 Valuation
SAC Charge
$
$800 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 [ ]
o�
TOTAL $
STIPULATIONS: . u
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 $15 (Minimum Fee is $15 plus surcharge)
$501 to $2,000 $15 for fust $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1;000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1;000
or fraction thereof, to. and including $50,000
$50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional
.$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional -
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2039,50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 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.
SUBJECT
P ..
City of Fridley
6601
AT THE TOP OF THE TWINS
BUILDING
E R M I T
P
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
e ,
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7/14/98
JOB ADDRESS
6336 Van Buren St.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt.8 9 Pt.
0 5
Florence Pak
SHEET
n Fridle
2 PROPERTYOWNER MAIL ADDRESS
IP PHONE
PhilliR Salewski 6336 Van Buren St.
571-5040
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Owner
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
YS
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside three sides of house; reside garage
9 CHANGE OF USE FROM
TO
STIPULATIONS
Call for building wrap inspection
before covering.
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
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
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
1300
.65
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.
$43.00
Fire SC. $1.30
PLAN CHECK FEE
TOTAL E
4
S�GITLIRF FC 1 TRACTO A ORIZEDAGEF iDATEI
N P P ALIDAT
IS IS YOUR PERMIT
BLD NSP
MATE
OF OWNER OF OWNER BUILDER) )DATE)
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address:
Contractor:
Tel. #lap 7/' 50��
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 ENIPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width HVGrouud Sq. Ft.
OTHER:
Construction Type: Estimated Cost:
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
A.
DATE: 7—/ 'APPLICANT: P,N �' Tel. #
6() CITY USE ONLY�, c ��
t
Permit Fee $ Fee Schedule on Reverse Side
Fire Surcharge $ 30 .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1000 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 [ ]
t
TOTAL $
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
$1 to $500
$501 to $2,000
FEES
$21 (Minimum Fee is $21 plus surcharge)
$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.
SUBJECT
PERMIT NO.
City of Fridley
26637
AT THE TOP OF THE TWINS
p
BUIL ®I
PERMIT
� '
LvJ
1 �
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
_ _
er PROTECTIVE INSPECTION SEC.
d
e
e
NUMBERAEV
DATE
PAGE OF
APPROVED BV
1 CITY HALL FRIDLEY 55432
�j 612-571-3450
910-F15
7/16/98
JOB ADDRESS 6336 Van Buren
I LEGAL
LOT NO. pt
113.00K
TRACTOR ADDITION
SEE ATTACHED.
DESCR.
XXX Pt. 8 9
5
a0eaOM
Florence
Park Addn. to FaNe
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Phillip Salewski
571-5040
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
American Roofing & Construction
-
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
O NEW ❑ ADDITION ❑ ALTERATION] REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof 19 S Tear-off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with State Building
Code.
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
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
ISTALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVER G THIS EOF WORK WILL BE COMPLIED
$1584
$.79
WITH WHETHER SPECIE D H EIN R NOT RANTING OF A PERMIT
DOES NOT PRESUM TOG E THO TO IOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF A Y OT R TA LO L LAW REGULATING CON-
$51.25
Fir SC $1.58
STRUCTION OR T E PE 0 A F C STRUCTION.
I
PLAN CHECK FEE
TOT TF EE
'_�l h
License $5.0
$198.62
SIGNA REO TRACTORORAUTFIORIZEDAGENT (DATE
EN R P
+BLD INSF'
VAI-1 A THIS IS V 1JR PERMIT
MATE
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description: II
Owner Name & Address: tt. I ha (P _ems lct Tel. #
Contractor: �a -�,�' MN LICENSE #
Address: �i� C_c f ( Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: � �'a I CD7 -;� < 7-/<--I/A,/ � 44
Construction Type: Estimated Cost: $ ! ��
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft =- _ $
DAT>: -(/ l APPLICANT�,��-� Tel. # zj J%
TOTAL
STIPULATIONS:
r
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$
0,
.001 of Permit Valuation (1/10th%)
State Surcharge
$ , ?%
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
. 06
$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:
r
BUILDING PERNIIT 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.
..ITY OF FRIDLEY INSPECT iUN DIV.
3431 University Ave NE
Fridley, MN 55432
763-572-3604
Urinal
Basement
Floor
Floor 2
Floor 3
Floor 4
PLUMBING FIXTURE RATES:
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Wash �'�"•:.:::�' r.
. Auto.
..: .....:�.:
�.. •:M;
Shower
:...>
Ti a ; ; Drain
Washer
:.....,..
NO. RATE TOTAL
New Fbctures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas"
Gas Range"
Gas Dryer"
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
Effective On Jan 1, 2001
Gas " v Water Heater
,.A>.::.:
.. r..
I
j . ::::: Gas
E ec
Rance t�:=•-:<_ -
JOB ADDRESS
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.
�-, 7-G ',206
O
Owner
v -
Building Used As -
Estimated Cost PERMIT NO. / l
PLUMBING COMPANY,
SIGNED BY
Approved By
is _
TEL NO.—
Rough-in Date Final Date �f
State Surcharge $ .50
""""`"""" FEE FOR ANY PLUMBING/GAS PERMIT IS !
TOTAL FEE $ILI fl� PLUS THE S-511 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacina an existing 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.
Yes ( ) No
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination.
Yes ( ) No
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances.
Yes () No
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications.
Yes () No
When required to Install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications.
Yes ( ) No
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances.
Yes ( ) No
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes.
Yes( )No( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input Fan Assisted or
Appliance #2 Type �r rz �TU Input Fan Assisted or
Nat
Nat
_sy
Appliance #3 Type BTU Input Fan Assisted or
Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter
inches
Appliance #1 Vent Connector Height ft Length ft Diameter in
Type
Appliance #2 Vent Connector Height ft Length ft Diameter in
Type
Appliance #3 Vent Connector Height ft Length ft Diameter in
Type
ALTERATIONS: (Describe
HEATING CO:
Signed By: Date:
Building
BUILDING
Permit Fee
Permit No.w p" d
Inspections
Plan Review
RESIDENTIAL APPLICATION
Received By: Mk
763-572-3604
$
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
CITY OF FRIDLEY
Date
763-502-4977 FAX
$
$2100 per SAC Unit (Plans to MWCC for determination)
$
ft + 6 ft = ft x $24 = $
EFFECTIVE I -I-2010
$
$450 Conservation Plan Review
DATE o
t� j
(� (O YOUR E-MAIL ADDWS
/V!�
SITE ADDRESS
$
Agreement necessary ( ) Non Necessary ( )
THIS APPLICA"IS:
OWNER ❑CONTRACTOR
Make checks payable to: City of Fridley Attach Stipulations
PROPERTY OWNER/
NAME: e W -
TENANT
ADDRESS: U CITY
C STATE7IPN5`��
PHONE:_
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE #
EXP DATE
AND CERTIFICATE OF
ADDRESS:
CITY STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
4iSINGLE 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
❑ MAINTENANCE/REP R ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT SQ FT
ROOFING
Q HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
1. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
[]Soffit
ADDITIONS, & PORCHES SUBMIT:
❑ Aluminum ❑ Trim
I. Site Plan/Survey showing the existing structures
9 Other �(G�
11 Fascia
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:
(USING THE 1997 U.B.0 FEE SCHEDULE)
I
'I"U'l'ALJUB VALUA11U1N
UC:C:UY"Uy l-YYh
Permit Fee
$
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $24 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
Make checks payable to: City of Fridley Attach Stipulations
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 wort which requires revie and approval of plans./ %
SIGNATURE OF APPLICANT S - A PRINT NAMFj�/1 Jd�l/1 i n � /IQW IDATE�_ ����
Page 2 - Building Residential Application
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
$23.50 (Minimum Fee is $23.50 plus surcharge)
$501 to $2,000
$23,50 for 1' $500 plus $3.05 for each additional $100 or fraction, to and
including $2,000
$2,001 to $25,000
$69.25 for 1" $2,000 plus $14 for each additional $1,000 or fraction, to and
including $$25,000
$25,001 to $50,000
$391.25 for 1' $25,000 plus $10.10 for each additional $1,000 or fraction,
to and including $50,000
$50,001 to $100,000
$643.75 for 1" $50,000 plus $7 for each additional $1,000 or fraction to and
including $100,000
$100,001 to $500,000
$993.75 for 1' $100,000 plus $5.60 for each additional $1,000 or fraction to
and including $500,000
$500,001 to $1,000,000
$3,233.75 for the 1' $500,000 plus $4.75 for each additional $1,000 or
fraction to and including $1,000,000
$1,000,001 and up
$5,608.75 for the 1' $1,000,000 plus $3.15 for each additional $1,000 or
fraction
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 proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Only
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977