PRE 2010 DOCSSTATE OF MINNESOTA
w7o•5o DEPARTMENT OF NATURAL RESOURCES
Rev. t Ino DIVISION OF WATERS, SOILS AND MINERALS P.A. No. 78-6103
Centennial Office Building, St. Paul, Minnesota, 55101
IN THE MATTER OF THE APPLICATION OF DAVMNE CORPORATION/ DAVID FICEK
for a PERMIT TO CHANGE THE COURSE, CURRENT, OR CROSS SECTION of Unnamed Wetland
Anoka County,
PERMIT
Pursuant to Minnesota Statutes, Chapter 105, end on the basis of statements and information contained in the permit application,
letters, maps, and plans submitted by the applicant, and other supporting data, all of which are made a part hereof by reference, PERMISSION
IS HEREBY GRANTED to _ Daverrn Cgrp. / David . Fi;c ak whose address for the purpose of notices and other
communications pertaining to this permit is 2200 .Si3ver. Lakg Road which address is subject to change by written
notice- from the permittee. New Brighton, MN. 55112
To excavat-e 3,000 cubic yards of peat. and muck on the east side of a line connecting
a point 100 feet west of the eastern lot line on the boundary between lots 4 and
5, with a point at the southwest corner of lot 7, and to backfill the above de-
scribed excavation, and to excavate an area on the western side along the above
described line 15 feet waterward and 3 feet deep which shall remain open water, all
in accordance with plans submitted with application on
PROPERTY DESCRIBED as: Block 39 lots 4, 5, 6, 7, Innsbruck North 2nd. Addition,
SEk Sec. 24, T. 30N, R.24W
for the purpose of residential development. Anoka COUNTY
This permit is granted subject to the following GENERAL and SPECIAL PROVISIONS:
GENERAL PROVISIONS
1. This permit is permissive only and shall not release the permittee from any liability or obligation imposed by Minnesota Statutes, Federal
Law or local ordinances relating thereto and shall remain in force subject to all conditions and limitations now or hereafter imposed by
law.
2. This permit is not assignable except with the written consent of the Commissioner of Natural Resources.
3. The Director of the Division of Waters, Soils and Minerals shall be notified at least five days in advance of the commencement of the
work authorized hereunder and shall be notified of its completion within five days thereafter. The notice of permit issued by the
Commissioner shall be kept securely posted in a conspicuous place at the site of operations.
4. No change shall be made, without written permission previously obtained from the Commissioner of Natural Resources, in the hydraulic
dimensions, capacity or location of any items of work authorized hereunder.
5. The permittee shall grant access to the site at all reasonable times during and after construction to authorized representatives of the
Commissioner of Natural Resources for inspection of the work authorized hereunder.
S. This Permit may be terminated by the Commissioner of Natural Resources, without notice, at any time he deems it necessary for the
conservation of the water resources of the state, or in the interest of public health and welfare, or for violation of any of the provisions
of this permit, unless otherwise provided in the Special Provisions.
SPECIAL PROVISIONS
I. Construction work authorized under this permit shall be completed on or before July 31. 197$ . Upon
written request to the Commissioner by the Permittee, stating the reason therefore, an extention of time may be obtained.
II. The excavation of soil authorized herein shall not be construed to include the removal of organic matter DOES
NOT APPLY unless the area from which such organic matter is
removed is impervious or is sealed by the application of bentonite after excavation.
Ill. In all cases where the doing by the permittee of anything authorized by this permit shal I involvethe taking, using, ordamaging ofany property
rights or interests of any other person or persons, or of any publicly owned lands or improvements thereon or interests therein, the
permittee, before proceeding therewith, shall obtain the written consent of all persons, agencies, or authorities concerned, and shall
acquire all property, rights and interests necessary therefor.
IV. This permit is permissiveonly.Noliabilityshallbeimposed upon orincurredbytheStateofMinnesotaoranyofitsofficers,agentsoremployees,-
officially or personally, on account. of the granting hereof or on account of any damage to any person or property resulting from
any act or omission of the permittee or any of its agents, employees, or contractors relating to any matter hereunder. This permit shall
not be construed as estopping or limiting any legal claims or right of action of any person other than the state against the permittee, its
agents, employees, or contractors, for any damage or injury resulting from any such act or omission, or as estopping or limiting any legal
claim or right of action of the state against the permittee, its agents, employees, or contractors for violation of or failure to comply with
the provisions of the permit or applicable provisions of law.
V. No material excavated by authority of this permit nor material from any other source, except as specified herein, shall be placed on any
portion of the bed of said waters which lies below.. DOES RIOT APPLY
It shall be the duty of the permittee to determine correctly all pertinent' elevations
at the site of the work for the purpose of complying with trig conditions of this permit.
VI. Any extension of the surface of said waters resulting from work authorized by this permit shall become public waters and left open and
unobstructed for use by the public.
VII. Receipt ivhereby acknowledge of S DOES as payment for NOT cubic yards of sane, gravel
or rock and APPLY cubic yards of muck and silt, the estimated amount of material to be rpmoved hereur.&.
computed at the rate of ten cents per cubic yard for sand and gravel and two cents per cubic yard for muck and silt.
Permittee agrees by acceptance of this permit as shown by commencement of work authorized hereunder to pay, by certified check, bank or
postal money order, made payable to the State Treasurer .and delivered to the Director, Division of Waters, Soils and Minerals, Department of
Natural Resources, Centennial Office Building. St. Paul, Minnesota 55101, for any material removed from the bed of public waters in excess of
that so estimated, at the above rate within thrity days after completion of the work authorized hereunder.
VIII. Place fill extending a maximum distance into the wetland not to exceed area defined
on plans and to excavate an area 15 feet wide, 3 feet deep beyond the fill along its
entire length.
SEE ADDITIONAL, PROVISIONS ATTACHED:
..dc: George Jurgenson, Conservation Officer
Rice Creek Watershed District.
Anoka Co. SWCD
, r
City of Fridley to nATr-nnTcr PnIn nntntni>=cnre ruee � nevne
0.
PEi*. T NUMBErt id-bluj
'dated Nov. 15, 1977
SFECIAL rRMISICNS
(Only the numbered Special Provisions apply to this per ;it.)
Xly The pe ,.'ttee shall comply with all rt.Ies, regations, requIrem nts,
or standards of the R nnesotaa Pollution Control Agency and other
applicable federalt state, or local agencies.
The use of explosives in ar* of the eaters of the state is prohibited.
runless the local State Conservation Officer is notified thereof at
least 45 hours in adva.=e of the tutee the work is to be done. (T4.S.,
Sec. 101.42* Subd. 11). -
Before construction and after completion of the project authorizer/,
permUtee shall supp3,y the Mvisioa of Waters, Soils aad Hinerals, with
photograplU of the -project area.
X Spoil rnaterial shall not
wherever.possible, such
areas subject to flooding.
plain areas because areas
spoil should be placed paral
spread over a lard area so
passage of flood waters.
be placed on the beds of public watersf- ands
material should not be placed ar4:4here wa tYii n
In the event spoil Lnuz be placed within flood
free from flooding are not readily available,. the
,elto the direction of flood flow and/or
as to minimize aVy possible obstruction to the
Ulwn completion of construction, the bed of the public water shall be
restored as nearly as practicable to the original cross-section.
XX1 The permittee shall. cover or protect all exposed soil resulting frorr.
the constructiaa authorized by placing riprag, sod, and/car seed on
banks and slopes of said construction for the prevention of soil erosion,
sedimentation and lake/stream discoloration.
XII After the completion of the project authorized, permittee shall supp],y
- � the Division of .Maters, Soils and Rinerals with photographs of the
project area.
Future maintenance excavation of this project shall not exceed the
dimensions herein authorized. Prior to cor-mesc:ing any maintenance
excavation, perrdttee shall advise the Department of Natural Resources of
the volume of rraterialr to be retrrived, the rnarzrier of removal, and the spoil
disposal site(s) proposed. If the Cor= i.ssioner of Itiatural, Resources
deternsnes that a field inspection is necessary prior to approving such
maintenance worix, the perrrd ttee shall sub—,_'t a check payable to the
State Treasurer to -cover the actual cost of the inspection, or $25,00,
uhichever is greater, pursuant to p�innesota Reg ations La 5COO, Paragraph (9).
2�aintenznce excavation shall not be .co=imenced until pe="ttee*s''receip
of the Department * s approval.
(See reverse side for additional orotri.sions, if any.)
XIII This per dt does not obviate any 'requirement for federal., assent from
- the U.S. Corps of Engineers, 1210 U.S. Past Office and Duston House,
St. Paul, Minnesota 55101.
Permittee shaJ2 seed a strip of land abuttin, both sides of the ditch
to permanent grasses and legumes; these strips to reet one of the
following standards:
A. Each strip shall„ be at least 40 feet wide for th- fun length of.
the excavated ditch and shall not be mowed p-,-Jar- to July 15 in
any year; or _
B. Each strip shall, be at least 25 feet wide for the full. length of
the excavated ditch, provided mozing of theses nar—mmr strips -
shall not be dc=e.
-A
9
City of FridleyrT"�2
SUBJECT
P ERMTf NO.
AT THE TOP OF THE TWINS
PERMIT
r
®vIL®IVG
RIPT N0.
L ______ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1
= �
"1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
8/2/78
JOB ADDRESS 5528 West Danube Road N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
3
Innsbruck North Second
SHEET
2 PROPERTYOWNER MAIL ADDRESS
ZIP PHONE
DaVerne Corporation 2200 Silver Lake Road, New Brighton 631-1213
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESSZIP
PHONE LICENSE NO.
HE �.p.
6 USE OF BUILDING
ALU���Q�IR
Residential
7 CLASS OF WORK
NEW ❑ ADDITION ❑ ALTERATION ❑ KPAIA Sf rM0 OVE
E❑
8 DESCRIBE WORK
Construct a 62' x 50' Dwelling d a 25' x 24' Garage
gi
9 CHANGE OF USE FROM TO
f �G �� t r_ alit ocal utilities
Mc 411,ETI-GASRC
STIPULATIONS
Provide a hard surface driveway. Provide sod in ° e�' mint ank� i4e+ ds.
Written soils excavation, preparation and compaction tests by Soils Engineer required
Provide combustion air for furnace. Provide pilaster courses as shown on plans.
Provide truss design and verifying survey by August 15, 1978. NOTE: Department of
NaturalResources has jourisdiction over development on this lot.
SEWER LOCATION: (Approx. 10' Deep In Street) 53' North of Manhole (Inv. 955.35)
WYE ELEV: 955.17 TOP OF FOOTING: 958.37 Minimum
WATER LOCATION: 3' South of Sewer Service.
DRIVEWAY DEPRESSION COST: N/A
TM CRY Of FRIDtE1f
DOES NOT GUARA1410 to
ACCVjtACY Ot UTM
LOCATIONS AND ELWATIV-M,
T.;,,S DATA IS FOR INFORMATICiN PUPPOSES ONLY
d : U'' IN(i �I I!?Lijo \)EDIFY THF.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood Frame
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
R-1
1692 + 576
39,408 To
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.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$55,890
$27.95
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.
$157.63
400.00
0) \
'�
PLAN CHECK FEE
TOTAL FEE
1 GNU -Q /Yt�L ""r'�-C-zk
39.41
624.99
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PRO ERLY VALIDATED THIS IS YOUR PERMIT
7�
BLC WSP
DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)�`�
01
MEMO TO FILE
MEMO FROM: Ron Holden, Building Inspector i-I
DATE: August 11, 1978
REGARDING: Excavation for Building Site at 5528 West Danube Road
in Fridley by DaVerne Corporation
This is to update the file regarding questions and complaints in reference
to the above work. The DaVerne Corporation was issued a development permit
by the Department of Natural Resources on November 15, 1977, to perform
work in the wet lands on this lot. The City of Fridley issued a building
permit for this lot on August 2, 1978. The contractor hired Mr. John S6hnil--z
as his excavator and John began to immediately develope the lot. Muck and
peat had to be removed down to solid material and properly over -sized before
stable (Class V) material was brought in and compacted. Geotechnical Engineering
Corporation is responsible for verifying that the excavation, site preparation,
and compaction are done properly. They must report to us in writing to verify
the soil conditions.
On Wednesday, August 9th., 1978, the contractor's retaining dam to hold out
water, which was made of mostly muck and peat, failed. The result was an
infiltration of muck onto the original sand bottomed pond of the adjo%nl'ng
property belonging to Mr. Richard Erickson. Mr. Erickson contacted us to
express his concern that the material be removed from his pond bottom before
placement of footings made it impossible to bring in a dragline. I contacted
Mr. Mike Mueller of the Department of Natural Resources to ask if they were.
concerned and if they would want to make an inspection.
Mr. Mueller said he felt the DaVerne Corporation had been cooperating more
than "others" in the area and that they would check it when they had someone
in the area.
On Thursday, August 10th, 1978, John Schultz did move a back -hoe into position
to remove a portion of the muck from Mr. Erickson's pond in an effort to
correct the situation. Darrel Clark and myself checked to see how complete
the job was and found that Mr. Schultz's back -hoe couldn't reach all of the
material.
We spoke to Mr. Erickson on the site that same morning and recommended that
he contact Mr. Ficek of the DaVerne Corporation to express his concerns that
the muck be removed before a foundation is installed on 5528 West Danube.
Apparantly Mr. Erickson had done so because Mr.-Ficek had talked to Mr.
Erickson before Friday morning, August 11th, when Dave Ficek phoned me.
Dave indicated that both he and the excavator were aware of the problem and
that they planned to move in a larger back -hoe that could re.ach.the remaining
material. As soon as the site is prepared or when the open water ditch is
cut in from the lot to the north, Mr. Ficek intends to remove the excess
material. I indicated that for all parties involved, it would be best to
do it soon. These facts were relayed to Mr. Erickson this morning by phone.
I promised to phone Mr. Erickson when a removal date was set.
CC: Dick Sobiech
Darrel Clark
Dick Erickson
• CITY OF FRIDLEY
APPLIC/1'CIOii FOR RESI ENTIAL BUILDING PERMITS
MEW, ALTERATIONS, {ADDITIONS, OR REPAIRS)
OWNER: �A U� C® ° BUILDER: 2)14-�(fo&P
Address. - A " ®L� Address: ZZa 6 !2L!Sk LA/—'
Tel. No.: t 3/ /1?/3
No. :��Z-g Street: %'%- 04"f)U/3&
LOT : z BLOCK.: � ADDITION: IWALAXI A-v6/ef /L)- Z V d
CORNER LOT: INSIDE TAT: SETBACK.: 35 SIDEYARDS: fD %D
Applicant attach 'to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Used As:
Front: 4 Depth: Height:
Square Feet: Cubic Feet: 320 16 01' 8
Front: Depth:
IV-
Sauare Feet: Ve Cubic Feet:
Z„ "-/ Height:
M
Type of Construction: W000 Estimated Cost: $
To Be Completed: /d
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 representations stated in this application
are true and correct. See reverse side for additional i formation.
DATE: SIGNATURE:
Stipulations: ��/•
go d%9�
C-aaaA-m- 450
� crw j1 n Oris 1%► °
�!'�1'�,.� � � _ -'� A ted• ���;'' ��' � ,J�. '�"`� �;
'�.l S1� t GTGsa► /W1. !� ��
9
4
. .�,; , CITY OF BUILDING AEA
-e
EXTERIOR ff, ZGE "U" COMPUTATION
( 'o ba submitred mith building e itapplication)
One or f wo .family dwelling .... .�.. �..�Owner
r Site a¢d s
Contractor IM Vc Zek)"
LINEAL FT. OF
FOS A f' s P .ad ,.t �� ft. a ve geAde
a �. TOTAL EXPOSED' WA
4PAQ WAILIL CQ TRUCTION: "U" value.. x area Cq
A- Z6 "U�c �,q. ft. d 5 f
�Uff KP x sC.
De 1fernc C �, r�' �U� PI~ sq. ft. 0 x U A
att sheets, sq. ft. U (A)
"U x sq. ft. U (A)
IOU" x sq. ftp
U� x sq. (U) (A )
WINDOWS: "U" Tae x area
take`",& type V- "Un
sq.ft® f Cl 4 .. U)(A
x sq. ft. m U) (A )
a:. "Un x sq. ft. 1U) (A
"U" x sq. ft. (U) (A
"U" x sq. ft.(U(A)
"Un x sq. ft. � {U ( ,}
Make
"U" value x area
a�6e t '...� F..'¢j"8- `�+'} iP gg6d®®n aP t�` Sqa ft. ga. •`^�a'1 C,1 1, ffl{vqunx `3q. ft. 7 A )
"Un U x sq. ft. A)
R "U" x sq. ft. . (U) (A )
TOTALS Sft.;t 7,1 (U) (A
TOTAL (U) (A) VALUES
q
DIVIDED BY TOTAL WALL AREA
AVERAGE PUS'olq . or lesa for 1 & 2 family dwellings
®23 or less for all other buildings
.ROOF/CEILING:
TOTAL AREA: Pi Ei
sq. ft.
Detail r°efeie ce UV4 x sq. ft. (U)(A)
from N� r muff � � x sq. ft. l: ��m' (U)(A)
S
attached sheets. "° x sq. ft. (U)(A
Describe openings,= 'p. _ m `�U� x sq. ft. t..� ., (U) A
in ir®of. IUB x sq. ft. w {U) A)'
TOT
DOTAL {U) (A) VALUES r AA�, "1"' Sq. ft. .O (U) (A
DIVIDED BY TOTAL ROOF/
CEILING AREA -
�VE GE `*U",04- fcor ventilated roofs ►° -1 r ,.. � �
for all sthor con3truction
1
2
3
4
5
6
7
6
la
11
12
1a
14
15
ae
n
19
la
21
21
23
24
25
2E
21
26
25
30
31
32
33
34
35
H
31
31
30
40
CO WLLS, . JUNUS COMPANY 67000 GREH N 1509 RUFF
G7505C COVLRLE$S MADE IN U.B.A.
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FIG. #3 "SECTION
1. Interior air. ft3m
4 .moi° om/��^'� J�"' ,
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6. Exterior air film 0.17
TOTAL (R)"
rRUn41%R= . 0,69
FTG. , 1 i
1. Interior -atir"fil
3 ♦ y /�u J /7 / Ay//j�yg �08 -1
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TOM (R)
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6. Exterior air film 0.17
TOTAL (R)
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I. Interior air ft1l.n- 0.68
3. Exterior air film 0.17
TOTAL (R)
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FIG. #i APLAN VIE'W
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TOTAL (R)
FIG. #1
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0.68
3.
4 .
5
6. Exterior air film
0.17
TOTAL, (R)
"U"= I /R=
1. Interior air film
0.68,
3..
AMY
4.
fl. ExLerior air f 11m.
0.17
TOT
1. interi''r ffIT-
Exroric,. film 0.17
TOTAL (R)
(8) 'Ib.LL l
XW I= 10111
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6
Lwterior- air W 2m
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Imm: USE :,Lo% OF AI.XA FOR
InUrlor air film 0.61
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1. InterJor air film
FIG R 7 TTWY --. - " v 1,, , '2
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TEE, utT—
f A 1A
773-
STATE OF MINNESOTA
DEPARTMENT OF NATURAL RESOURCES
P.A.No 78_6103
W 7o an
OF WATERS, SOILS AND MINERALS
Rev, 1 1170 DIVISION
Centennial Office Building, St. Paul, Minnesota, 55701
DAVERNE CORPORATION/DAVID FICEK
IN THE MATTER O� THE APPLICATION OF
TO CHANGE THE COURSE, CURRENT, OR CROSS SECTION of Unnamed Wetland;
for a PERMIT
Anoka County.
PERMIT
the rmit application
Chapter 105,
Pursuant to Minnesota Statutes, which ar ,sis of statements anti f made a parthereofbyn eferenece, PERMISSiON
and other suptwating data, all of
letters, maps, and plans submitted by the app whose address for the purpose of notices and other
Corp /David Fi,�P�
IS HEREBY GRANTED to Daverne
2200 Silver. Lake Road —which address is subject to change by written
communications pertaining to this permit is New Brighton, MN. 55112
notice from the permittee.
on
obetweenline
lotsconnecting
To excavate 3,000 cubic yards of peat and muck
nhtheeast
boundar
lot line o y
a point 100 feet west of the eastern
lot 7, and to backfill the above de -
' S, with a point at the southwest corner of
eabove
1 alongthe
westich
on
scribed excavation, and to excavate an area deep sha11remainwater, all
and 3 fee p
described line 15 feet waterward
in accordance with plans submitted with application on -
Block 3, lots 4, 5, 6, 7; Innsbruck North 2nd. Addition,
PROPERTY DESCRIPED as:
SE'k Sec. 249 T. 30N, R.24W
Anoka COUNTY
residential development.
for the purpose of
This permit is granted subject to the following GENERAL and SPECIAL PROVISIONS:
i GENERAL PROVISIONS
4hP tmitttM from enV liability etr Olaliryabon irntrrrco+l I)v 0.1,nnesoto $tNlutQK, Federal
OnIV and shall not release I� „ .>atte, '"would by
�.
I This rprmit is perrrtisaive
- „I;.U,.,: TF,,v et{3 and Shai: i,. r:.nn ,r• ti+rr •. •:ai�: t r„ , .-„n.f ••, ,., .,•,
Law or 10041 nrtGndnrr', r l
law.
2. This permit is not assignable el"'Pt kith the written consent of the CornnrssionFr of Natural it tirn,i
Waters, Soils and Minerals shdll be notified at least five days in ddvan, c dire `onvnencement of the
The notice of permit issued by the
3, The Director of the [)rvision of
hereunder and shall be notified of its completion within five days thereafter.
work ares ttri�ed
Commissioner shall be kelt securely posted in a conspicuous place at the site of operations.
previously obtained from the Commissioner of Natural Resources, in the hydraulic
t '-tec
Q. No change shall be made, tit written permission
authorized representatives of the
dimensions, capacity or location of any items of work authorized hereunder.
f terdonstruction to
uring d after
5. The permittee shall grant arcess to the site at all re of the ti aumesthorized r the
he deems it necessary
forResources,
Commissioner of Natural Resources without y time
f Natural
on
by thf
interests of pub health and welfa et or for violation of any of the provisions
6. This Permit may be terminated
6.
corf¢Qrvation of the water resources o the state, oe nothe
in the Special Provisions.
of this permit, unless otherwise provided
SPECIAL PROVISIONS
Construction work authorwed under this permit shall be completed on or before July 31 1978 Upon
I the reason therefore, an ex ten tion of time rnaY be obtained�E•
.
written rerpiest to the (..ornmissioner by the Permittee, stating
lter
nic ni
11. The excavation of soil authorized herein shall not he rPtrLY to include the removal of ns the aaea from which such organic matter is
NOT
iI
or is sealed by the application of bentonite after excavation.
removed is impervious
ag gofany
rda n or mere is therein, the
of anything authorized by this permitshalIinvolvethetaents
III. In all cases wrty
here. the doing by the permittee t ereo
rights or interests of any other person or persons, or of any publicly owned lans or improven
or authorities concerned, and shall
obtain the written consent of all persons, agencies, rr
permittee, before proceeding therewith, shall
interests necessary therefor.
i'
acquire all property, rights and
Noliabilityshallbeimposed upon orincurred bythe5tateofMinnesotaoranyofitsofficers,agentsoremployeas,,
to anY liaison or property rewlting from
i
IV. Thisperrnitisftermissiveonly
or perx,nally, on accou .t of the granting hereof or on account of any damage
or contractors relating to arty matter hereunder. This permit shat
its
officially the permittee,
any act or omission of the permittee or any of its agents, employees,
limiting any legal claims or right of action of any person other than the state against
or limiting any legal
`1
or in injury resultin from any such act or omission, or as estopping
not be construed as estoliP nq or
or contractors for violation of or failure to comply with
u+ c.ontrai;turs, for any damage 1 Y g
agents, employees,
claim or right of act,on of the state against the permittee, its agents, employees.
applicable provisions of taw.
a,
the provisions of the l,errnit or
nor material from any other source. except as sp eufied harem' shall be placed on any
o-1.
V. No material excavated by authority of this permit
portion of the bed of sai<1 waters whirh lies below. ES NOT APPLY
determine correctly all pertinent elevations
It shall be the duty of the vermtttee to
at the site of the work for the purpose of complying with the conditions of this permit
waters and left open and
VI. Any extension of the surface of said waters resulting from work auth�rired to •this permit shall become public
unobstructed for use by the public. +
(over)
I
SPECIAL PROVISIONS
VII. Receipt is hereby acknowledw of S DOES as payment for NOT cubic yards of sand, gravel
or rock and APPLY c,,t,,c times ul tr,UL. a9110 v,t, ,i,v estimated amount of material to be removed nereund-
computed at the rate of ten cents txr cubic yard for sand and gravel and two cents per cubic yard for muck and silt.
Permittee agrees by acceptance of this permit as shown by commencement of work authorized hereunder to pay, by certified check, bank or
postal money order, made payable to the State Treasurer and delivered to the Director, Division of Waters, Soils and Minerals, Department of
Natural Resources, Centennial Office Building. St Paul. Minnesota 55101, for any material removed from the bed of public waters in excess of
that so estimated, at the above rate within thrity clays after completion of the work authorized hereunder
Place fill extending a maximum distance into the wetland not to exceed area defined
on plans and to excavate an area 15 feet wide, 3 feet deep beyond the fill along its
entire length.
SEE ADDITIONAL PROVISIONS ATTACHED.
cc: George Jurgenson, Conservation Officer
Rice Creek Watershed District
Anoka Co. SWCD
City of Fridley
DATED AT ST. PAUL, MINNESOTA,OF
�.. . ►�._
a
-imp
OS/ W� � ✓l w
9-200 Silver Lake Roa �
Serendipidy Court
New Brighton, Mn. 5511?
' Registered Builder
r 612/631-1213
Mr. Ron Holden
City of Fridley
6431 University Ave. N.E.
Fridley, Pli nn . 55432
Re: 5528 W. Danube Road
Lear Ron:
August 23, 1978
Per our conversation of August 22, 1978, DaVerne Corporation
plans to resolve the problem of excess fill placed in Mr. Richard
Erickson's pond.
Upon completion of the footings and backfill, John Schultze,
my excavator will arrange for a drag line or equivalent to remove
the foreign material, as can be determined visually and under your
direction.
The excavation is to approximate the pond bottom beginning at
the western shoreline of the pond at 0' to approximately 5' in
depth on the common property line of 'Mr. Ericksons and 5528 West
Danube Road.
14eather permitting, the work shall be done before September 15,
1973.
Unless I receive a phone call from either the City of Fridley,
Mr. Erickson, or the attorney for ,3r. Erickson, I will assume per-
mission has been granted to us to trespass on 1401r. Erickson's property
in order to do the work.
;S*ncerelZyours,
David E. Ficek
DaVerne Corporation
DEF:ms
cc: Mr. David Erickson
4320 Highway 101
Ninnetonka, ;Minn. 55343
Y
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
Number Fixtures
Future Fixture Opening
New Fixture, Old Opening
Catch Basin
Water Heater - to 99,000 BTU
100,000 BTU to 199,000 BTU
Water Softener
New Ground Run Old Building
Electric Water Heater
GAS FITTING FEES:
1st 3 fixtures
Additional Fixtures
Gas Range to 199,000 BTU
REPAIRS & ALTERATIONS
First $100.00
each add. $100.00 or fraction
NO.
RATE
TOTAL
Cl x
$3.00
$ a27i 0 0
>,
01
$ ,® 0
1
$2.00
vR•
X
$5'.00
w
-x
Water
y�
x
q
$
x
$7.00
$
4 HO
$5.00
q
00
-Wrop
pro
W
'$3.00
$ 3, a o
Heater
•.�1
}�
b
$10.00
$
N
$4
.0
Nym
H
m
o
M
fl
M
W
OO
B
.0
m
W
c
m
�
w
(d (dto
U m
99
0
0 3a
kec
F
iF
,Y
1st
2nd
'
3rd
4th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
Number Fixtures
Future Fixture Opening
New Fixture, Old Opening
Catch Basin
Water Heater - to 99,000 BTU
100,000 BTU to 199,000 BTU
Water Softener
New Ground Run Old Building
Electric Water Heater
GAS FITTING FEES:
1st 3 fixtures
Additional Fixtures
Gas Range to 199,000 BTU
REPAIRS & ALTERATIONS
First $100.00
each add. $100.00 or fraction
NO.
RATE
TOTAL
Cl x
$3.00
$ a27i 0 0
3 x
$2.00
$ ,® 0
x
$2.00
$
X
$5'.00
$
-x
$5.00
$ C, 4)
x
$10.00
$
x
$7.00
$
x
$5.00
$
x'
$5.00
$
x
'$3.00
$ 3, a o
x
$1.00
$
x
$10.00
$
$5.QQ $
$2.00 $
State Surcharge $ .50
TOTAL FEE $ n E 5,®
REINSPECTION FEE
($10-00)
Job Address !S'j 2-2� We - S bA-N U CrP,
Department of Buildings
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, Mn. `) — L � , 19 -78
OWNER e -4 -VV -r— C-0
KIND OF BUILDING (-gypy -P-=—
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company
I /
Signed By (� J
Tel. No. T�
ROUGH INSP.
p Date �y
FINAL INSP. �6 l
I Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
r v z
0
f _
r
November 28,
.I
6431 UNIVERSITY
1978--
Mr.
978
Mr. David Ficek
DaVerne Corporation
2200 Silver Lake Road
New Brighton, MN 55112
AVENUE N.E., FRIDLEY, MINNESOTA 66432
Re: Final Inspection at 5528 West Danube Road N.E.
Dear Mr. Ficek:
TELEPHONE ( 612)571-3460
A final inspection was made on November 27, 1978 of the above address and
the following items were noted which must be completed before the structure
can be finaled out;
1. Provide a hard surface driveway by June 1, 1979.
2. Provide sod in the front and side yards by June 1, 1979.
3. Provide combustion air to furnace area by December 11, 1978.
4. Post address on structure by December 11, 1978.
5. Uncover hydrant near north end of 5548 West Danube Road by December 11, 1978.
6. Clean out drainage ditch on north. side of property by December 11, 1978.
o47. Submit verifying survey to City by December 11, 1978.
We will expect all of the above items to be completed by the scheduled dates
when reinspections will be made to determine compliance. If you have any
questions on these items, please contact me at 571-3450.
Sincerely,
DARREL G. CLARK
Community Development Adm.
DGC/mh
CC: Occupant
5528 West Danube Road N.E.
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
e
RATE
TOTAL
>
eu
$
Future Fixture Opening
x $2.00
$
New Fixture, Old Opening
4ja
S
water
Catch Basin
x $5.00
$
Water Heater - to 99,000 BTU
x $5.00
$
a n
0a
a
q
x $7.00
w
w
g
$
Heater
x $5.00
$
fa
1st 3 fixtures
x '$3.00
4.1
Additional Fixtures
x $1.00
$
Gas Range to 199,000 BTO
a
$
REPAIRS & ALTERATIONS
p
J O
^•�
+�
m
$2.00
N�
o
a9
O
S
49 N
N
�
N
�
q
y
u
c
0
LO
w
6A�3
c�
o
as
leo
1st
2nd
3r3
zz
4th
(R) - Future Connection Opening
Connected with Sewer
M - New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x $3.00
$
Future Fixture Opening
x $2.00
$
New Fixture, Old Opening
x $2.�0
S
Catch Basin
x $5.00
$
Water Heater - to 99,000 BTU
x $5.00
$
100,000 BTU to 199,000 BTU
x $10.00
$
Water Softener
x $7.00
$
New Ground Run Old Building
u $5.00
$
Electric Water Heater
x $5.00
$
GAS FITTING FEES:
1st 3 fixtures
x '$3.00
$
Additional Fixtures
x $1.00
$
Gas Range to 199,000 BTO
x $10.00
$
REPAIRS & ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
S
State Surcharge
$ .50
TOTAL FEE
$
REINSPECTION FEE
($10.00)
_ r
Job Address
Y
. Department of Buildings \
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, Mn.
OWNER �' 3 v v� �C✓ �\
xIND OF B ILDI G
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST n
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company r� g
Signed By
Tel. No.
ROUGE INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.SO PLS $.So STATE Su2n Am
CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
Furnace Shell & Duct Work
Replacement of Furnace
Repairs & Alterations -up to $500.00
Repairs & Alterations each add. $500.00
MECHANICAL WARM AIR:
Furnace Shell & Duct Work to 100,000 BTU
each add. 50,000 BTU
*Replacement of Furnace
Repairs & Alterations -up to $500.00
Repairs & Alterations each add. $500.00
STEAM OR HOT WATER SYSTEM:
Boiler & Lines up to 100,000 BTU
each addn. 50,000 BTU
Boiler only up to 100,000 BTU
each addn. 50,000 BTU
OIL BURNER- to 3 gal. per hour
each add. 3 gal. per hour
RATE TOTAL Job Address5-�
$12.00 $
7.00 $
7.00 $ Department of Buildings
4.00 $ City of Fridley
Tel. #571-3450
$12.00
4.00
7.00
7.00
4.00
$12.00
4.00
7.00
6.00
$10.00
10.00
GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00
(over 199,999 BTU see Fee Schedule)
GAS FITTING FEES:
1st 3 Fixtures x $ 3.00
Additional Fixtures x $ 1.00
Gas Range to 199,000 BTU x $10.00
AIR CONDITIONING
FAN HEATING SYSTEMS See Fee Schedule
VENTILATING SYSTEMS
ALTERATIONS $ REPAIRS
State Surcharge
TOTAL FEE
ROUGH INSP.
vale
011
FINAL INSP. ® /s
Date Q
APPROVAL FOR PERMIT ]
REINSPECTION FEE
(.$10.00)
$
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
*Attached stack verification form
•
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Wate Warm Air- No. tjC / 6.5'
Trade Name �/�111L Size No. /05-, 0 /J Q
Capacity / , Sq. Ft. EDR BTU 145, 00 L) HPC/
Total Connected Load �, �� Kind of Fuel N" 'e ye----
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company 12gl
Signed By
Tel. No.
The undersigned hereby makes application for a permit for the work herein
$ i7.
specified agreeing to do all work in strict accordance with the City Codes
$ (,v
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. ad` — % 19`
OWNER '01,
$
KIND OF BUILDING Gas/
$
$
USED AS P
TO BE COMPLETED ABOUT
$
$
ESTIMATED COST
$ id%•v'�
OLD - NEW BUILDING PERMIT NO. PERMIT NO,
$
$
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
*Attached stack verification form
•
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Wate Warm Air- No. tjC / 6.5'
Trade Name �/�111L Size No. /05-, 0 /J Q
Capacity / , Sq. Ft. EDR BTU 145, 00 L) HPC/
Total Connected Load �, �� Kind of Fuel N" 'e ye----
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company 12gl
Signed By
Tel. No.
to -i: ki
HEAT :LOSS -CALCULATIONS
Coef.1
DEPARTMENT
Weatherstrips
AS H V4 ��
Reference
19—
;;2' GI
Construction N
Windows
Doors
! Yes—>Vo
Out. Wall lint.WaU Ceiling
Yes --No
Fl.1 ,4 M B 6 X Room I Length
Width 2
Height '-
Windows and Doors—Crackage and Area
Net exp. wall
Width Haight No. of Lineal t .
No. of pane of pane lights of crack
Area
sq. ft.
3 7
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
z *,� /9
f`i
Ceiling
3 )
u
//.;k U
Coef.
Btu
Infiltration
*0
a 7 —"0
Glass
60
Exp. wall
S
Net exp. wall
lot. wall
Ceiling
0
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
%G,- C)
F1.1 Room I Length / 0
Width /U
Height
Windows and Doors—Crackage and Area '
wld h Haight No. of Lineal ft.
No. of pane of pane lighte of crack
Area
so. ft.
Coef.
Btu
Infiltration
Glass
/0
o
s"o G
Exp. wall
k s?'
Net exp. wall
7 11,
1 .91 1
61z V_
Int. wall
Ceiling /v .5'0 C
Floor
Total -Btu.
squired sq. ft. E.D.R. or sq. ins. WA. Leader area
Fl. /,v /',v� Room (Length / Width /G Height
Windows and Door—Crackage and Area
Width Height No. of Llneal ft. Area
No. of pane of Dane Ilghtr of crack sq. ft.
a a v �G 1 1 3� 1 1.11
OF BUILDINGS VILLAGE OF CHAMPLIN
D. Insulation
Roof Floor Kind How Applied
F1.1 L j&' N4 Room length / Width / Height
Windows and Doors—Crackage and Area
*loth Hsigbt No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
y G S �-
Coef.1
Btu
Infiltration
1 /91 �4
;;2' GI
CJass
/ 3 0
�U
Exp. wall
1,76
Net exp. wall
Int. wall
Ceiling�p
16
$'
13 D
, C
floor
Net exp. wall
Tt►tal Btu.
3 7
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
OF BUILDINGS VILLAGE OF CHAMPLIN
D. Insulation
Roof Floor Kind How Applied
F1.1 L j&' N4 Room length / Width / Height
Windows and Doors—Crackage and Area
*loth Hsigbt No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
y G S �-
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 MZ L. Room I Length 2 3 Width Height Sr-""
Windows and Doors--Crackage and Area
Width Heigbt No. of Lineal ft. Afoa
No. of pane of pane Ilabto of crack sq. ft.
�a
Coef. Btu
Infiltration
�" 740
Glass
Coef.
Btu
Infiltration
Net exp. wall
2
Inc. wall
Cala"
Exp. wall
Net exp. wall
7 c?, Cu
Int. wall
Ceiling
a
//.;k U
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 MZ L. Room I Length 2 3 Width Height Sr-""
Windows and Doors--Crackage and Area
Width Heigbt No. of Lineal ft. Afoa
No. of pane of pane Ilabto of crack sq. ft.
�a
Coef. Btu
Infiltration
�" 740
Glass
e� S"v p o 0
Exp. wall
.s
Net exp. wall
2
Inc. wall
Ceiling
Floor
Total Btu.
6 O V
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
F1.1 /`� 4� L Room I Length / Width 3 Height S'"
Windows, and Doors.trackage and Area
*loth Height No. of Llneat ft. Area
No. of Dan• of pass lights of crack eq. ft.
Coef. Btu
Infiltration - —
Glass —
Exp. wall
Net exp. wall
Int. wall
Ceiling �3 S .S- /6 S_
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
r—
BROOKLYN PRINTING i AD�
SUBJECT
PERMIT NO.
City of Fridley
3
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
C IPT
�
• _____ COMMUNITY DEVELOPMENT DIV.
I PROTECTIVE INSPECTION SEC.
r
NUMBER
REV
DATE
PAGE OF
APPROVED BV
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
JOB ADDRESS 5528 W DANUBE RD NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR,
7
3
INNSBRUCK NORTH SECOND ADDITION SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
BRIAN STEPPE 5528 W DANUBE RD NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
CUSTOM REM ODELERS INC 8329 CENTRAL AV
784-2646
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 0 REPAIR ❑ MOVE O REMOVE
xx
8 DESCRIBE WORK
RESIDE
9 CHANGE OF USE FROM
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
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
11 890
6.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
ICENSE SC 5.00
198.00
WHEN PROPE
Y VALIDATED THIS IS YOUR PERMIT
IgOATEi
SIGNA uREOF 9�'RA'�.E
SIGNATURE OF OWID TE I
8 1 INSP
MATE
. a....:.' .a:. v:. ... ... . . a.a ..v a a. a... :.:v: �.... �.. r...., vv v... a.a ..wv r v v+v v. v. r. r... v. r. a. ..a a.. ... v.. . a. v.a v.v r v. v.v v. a. vavan.. v. v+.. vavay.v. vava ati vv r v (avvv. va.�.. • a v a v.v-v)v r. ............f. ♦. r. �. r.l..ra..
-NEW [ ] Effective 8/l/95
ADDN [ ] CITY OF FRIDLEY
ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2`�`T
Building Permit Application
Construction Addre.,
Legal Description:
Owner Name &Address:►°}ate a „� �(` S Z-00 Tel. # ? V
Contractor: Lrel5 7 r; An LICENSE #
Address: — 2 C " Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq.,,Pt.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: "
� Estimated Cost: $
Approx. Completion Date: 9
(Cost on Back)
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $
2A
DATE: � PPLICANT: Tel. #
CITY USE ONLY
Permit Fee $ Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ ,,.50/$1,000 Valuation
SAC Charge $ $850 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ - $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $
STIPULATIONS:
a
1�
SUBJECT
City ®f Fridley
25321
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
R
�
1 • COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 53432
612-571-3460
910-F15
7/28/97
JOB ADDRESS 5528 West Danube Road NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
3
Innsbruck North Second
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Bryan Steppe 5528 West Danube Road NE
574-2569
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
O NEW ❑ ADDITION ❑ ALTERATION? REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (30 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the 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 BO DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWtG. 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
$2,502
$1'25
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL F
$7 .50
RE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
EN OPE (DATED H IS YOUR PERMIT
�'OGN
100T EI
BLDit INSP
BATE
1�
NEW [ ) Effective 1/1/97
ADDN [ ) CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�jP3�-r
ConstructionAddress:
Legal Description:�����y���
Owner Name & Address: y ze `�% �-� � ���y� Tel.
Contractor: ®Lz?�'e 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 R"ROVEMENT
LIVING AREA: Length Width Height
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
OTHER:
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Sq. Ft.
Sq. Ft.
Sq. Ft.
m-----44 31") S 2_ /f
Estimated Cost: CZ)
(Fee Schedule on Back)
_Ftx $ _ $
DATE: APPLICANT: d,612y� WJ ��y�— Tel.
CITY USE ONLY
Permit Fee
$ r, ���
Fee Schedule on Reverse Side
Fire Surcharge
$ �• S-0
.001 of Permit. Valuation (1/10th%)
State Surcharge
$ j ,
$.501$1,000 Valuation
SAC Charge
$
$950 per SAC. Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
$ , S
STIPULATIONS:
'd6c
CIIYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
December 11, 2000 PW00-127
Ms. Janet Steppe
5528 West Danube Rd NE
Fridley MN 55432
Subject: Property Line Information
Dear Ms. Steppe:
I have reviewed the Certificates of Survey on file with the City of Fridley for the properties at 5528 and 5502
West Danube Rd_ The earlier dated surveys for each property are proposed surveys prior to construction
they are therefore no longer valid and have been superceded by later surveys. The later dated survey for
each property is a foundation layout survey only and would not identify any later construction. These
surveys are valid and accurate only to the date, 1978 and 1976 respectively, on the surveys.
These surveys are acceptable for locating the property line between the two properties only if agreed to by
both of the involved parties, namely you and Mr. Mackenthun. Disputes over property line location are a
civil matter and not the charge of the City Public Works or Engineering departments.
Exact identification of the property line and corners would need to be done by a Professional Land Surveyor
registered in the State of Minnesota to perform such duties. The corners should be marked with an iron
pipe or bar and a plastic cap identifying the responsible surveyor and his/her registration number. The City
of Fridley does not have such a person on staff and therefore cannot conduct these activities. It is the
responsibility of the homeowner to obtain these services. A Certificate of Survey by the Registered Land
Surveyor is a legally binding document independent of the wishes of an individual property owner.
If you have any other questions, you may contact me at 763-572-3550.
Sincerely,
Jon H. Haukaas
Public Works Director
JHH:cz
cc: G. Lenzmeier, Fridley PD
1,
Officer MicheIIe Gease
Fridley Police Department
6431 University Ave NE
Fridley, MN 55432
Officer Michelle Gease:
December 2, 2000
We are still trying to resolve the property line issue we have with our neighbor, Steve Mackenthun (5502 W.
Danube Rd). We have been working with the police since October 13, 2000 with no apparent progress.
On October 28, 2000, Mr. Mackenthun and myself had another dispute over the Iocation of the property line.
One of Mr. Mackenthun's arguments during this interchange was that because the police had not contacted him
in regards to the property line yet (as he feels he was promised), that his position on where the property line was
located was correct and we were wrong. Our determination of where the properly line is based on two
independent certified surveys completed by two different surveyors after our two houses were built. His
determination is based on a hollow pipe that was pounded into the pond area behind our garage for unknown
reasons. This pipe is about 12 feet off from where the certified surveys indicate the back, southwest corner of
our property is located.
I tried to call you on Friday, November 17, 2000 but found that you were out until Monday, December 4, 2000.
As I indicated to you the previous week, we wanted to get this resolved and that I was getting the feeling that we
were being put og in hope that winter would come and things would cool off between us and our neighbor. You
assured me that was not the case. I explained that because of the ongoing and escalating issues, we needed
resolution now. You agreed and indicated that you would contact the city again to see how things were going as
far as having the property lines identified.
Because you were not going to be in for over two weeks and we wanted this resolved, I called the number you
referred to in voice mail for immediate help. I talked with Gary Lenzmeier, Deputy Director of the Fridley
Police. He contacted Ray Statler of the City of Fridley to help me locate property line. Ray indicated that the
City did not get involved with locating the property lines and there was nothing more he could do for me. Gary
Lenzmeier also called Mr. Mackenthun. When Gary Lenzmeier called me back, he informed me that Mr.
Mackentun had stated that there was no dispute over the property line, he just wanted to be left alone.
As pleased as I am to hear that Mr. Mackenthun has now indicated to the police that there is no dispute over the
property line, we need this confirmed because Mr. Mackenthun has demonstrated in the past that he will come to
agreement and then break that agreement. Neither my husband nor I have had any type of interchange with Mr.
Mackenthun since October 28, 2000. We have given no indication that we changed our position as to where the
property line is located. Mr. Mackenthun's statement that there is no dispute in regards to the property line
evidently is based on a change in his position, not ours.
In regards to his desire to be left alone, Mr. Mackenthun needs to understand that he is creating conflict by
• disposing of his leaves on our property and against city ordinance
• being verbally abusive towards us
• laughing at our teenage daughter when she tells him to stop staring at her
• staring at us, our children and our visitors when we are in our yard or are arriving/departing
• intimidating us by coming out and standing in his yard close to where we are for the purpose listening to our
private conversations of making us feel uncomfortable
• stealing items from our property
• continuing to claim ownership of our property
If he continues to harass, abuse, intimidate, or invade our rights, he needs to understand that we are going to
seek resolution. By ignoring his intrusive behavior for the past several years, it seems that he has gotten the
message that he can become increasing intrusive without any consequences. He needs to know that we are no
longer willing to tolerate this behavior. He cannot antagonize the situation and then sit back and claim that he
just wants to be left alone. He needs to stop the game playing and take personal responsibility for his actions.
What we want done to settle these issues:
• Follow up in regards to Mr. Mackenthun's statement on October 28,2000 that the police have not gotten
back to him in regards to the property issue. The police or the City of Fridley need to contact him as he is
evidently expecting it.
• Provide Mr. Mackenthun with a copy of the certified survey of his property which was completed after his
house was built, with a statement from the City that his property extends 22 feet from his garage (he has in
the past claimed that his property extends to our garage which is about 30 feet from his garage and at other
times 34 feet which goes into our garage. He bases his opinion on a hollow pipe, which was placed in the
pond behind our garage. It is unknown who put the pipe in the pond or for what reason).
• Inform Mr. Mackenthun that the surveyor's property markers in this area were many times marked by rebar.
The surveyor's marker with their identification numbers should be at this same point but most likely
underground (this is what I understood from my conversation with Ray Statler me on November 17, 2000).
• Agreement with the City of Fridley that if we should decide to put a fence up in the future, that the certified
1, surveys on record at the City are sufficient and no additional surveys would be required. In addition to the
surveys for Mr. Mackentun's and our property, the surveys for the properties behind both of our houses will
also confirm where the back, southwest corner of our property is located. According to city records, two
different companies surveyed Mr. Mackenthun's and our property. With the other two properties behind us,
potentially there are a total of four independent surveys. The fence would run from the back, southwest
comer of our property to the property line at the southwest comer our garage. Both of these points will be
easily identified based on the surveys on record at the city. A post marking each of these points and a string
tied between them would be used to determine a straight line for the fence. We would put the fence up a few
inches inside our property line rather than right on the line to make sure we do not cross onto Mr.
Mackenthun's property. We understand that as long as we do not put the fence right on the property line,
there is no need for additional surveys.
• Agreement with the City of f ridley that the burden of proof will be placed on Mr. Mackenthun if decides to
dispute the four certified surveys on record at the city. It is unreasonable that he can contest the legitimacy
,may of these surveys and place the burden of proof on us. We accept the surveys and are not disputing their
legitimacy. These surveys were done before either of us owned our properties so there is no chance that
either of us had an affect on their outcome. Due to the dispute, any surveys conducted at this time may be
subject to suspicion. You cannot give power to people who want to make claims without any basis and
victimize others who have substantial proof which is the case here. We are not disputing a few inches; we
are disputing 8 to 12 feet. We are requesting that the City notify us if this is sufficient. N this is not
sufficient, let us know what, in addition to the 4 certified surveys on record at the City, is sufficient to
identify the lack, southwest corner of our property.
• I would also like a statement from Gary Lenzmeier in the file in regards to his conversation with Mr.
Mackenthun on November 17, 2000, documenting Mr. Mackenthun's comment that there is no dispute over
the property line.
• To address Mr. Mackenthun's desire to be left alone, the police should talk to Mr. Mackenthun again about
his antagonistic behavior identified above and how it is causing tension.
• I want to be informed as to the outcome of the above issues.
• After these issues are addressed, I want to be notified when I can review the documentation/ police files that
are accessible to me in regards to this issue so I can verify its completeness in case future action is needed
Please call me with an update and with an estimated timeline to address these issues.
Janet Steppe
5528 West Danube Rd NE
Fridley, MN 55432
(651) 296-5917 (Work)
(763) 574-2569 (Home)
cc: Gary Lenzmeier
Statler.
CITY OF FRIDLEY INSPECTION DIViSION
,6431 University Ave NE l � � i �
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VEN°f'ILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES.
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
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
Rate
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT aS 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 May 10, 1999
JOB ADDRESS G �) �ZAOI �( � PS b
i,
OWNER A,r�L
TOTAL ,(J� r
BUILDING USED AS S i cg�
$ 0
ESTIMATED COST SPERMIT'NO. /3 9
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units-_ Circle One (Steam) (Hot Water) ( arDAKi
$ Trade Name A L4 Size No. 3 S�
BTU 6 • HP EDR
$ �S, Fuel Total Connected Load
Burner Trade Name Size No.
$ BTU _HP 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.
s—SIS'so
SWAM EMS 90 AR = -f n
410 W1MT LAW 8T,1�-u
HEATING CO ''.� 1r ,, MN 554-2nSS
Signed �' ��° DATE L
Approved Byz Rough -In Date Final Date — �`�
CHIMNEY AND STACK VERIFICATION
The undersigned, hereby verifies that the existing chimney or stack:
1. '.Has been. carefully examined Yes O No ( )
2. Is free from rust or deterioration Yes O No ( )
3. Has no foreign objects lodged within Yes () No ( )
4. Is securely supported Yes O No ( )
5. Meets all current Code requirements for size
and total BTU's connected Yes () No ( )
6 Has total heating BTU's of
All other BTU's
TOTAL BTU's
7.
Has a liner been provided for water heater
Yes (
) No
( )
8.
Has combustion air been provided for water heater
Yes (
) No
( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
suBjECT
NO*
City of Fridley
33559
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
No
COMMUNITY DEVELOPMENT DIV.
V__--__
r -I PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
1 J\ 763-571-3450
910-F15
5/28/03
JOB ADDRESS 5528 West Danube Road NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
3
Innsbruck North
Second SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Bryan & Janet Steppe 5528 West Danube
Road NE 763-574-2569
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Dave Wiger Construction, 901 Rice Creek Terr NE, Fridley, MN 55432 763-572-8403
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
8392
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 40' x 12' Deck
9 CHANGEOFUSEFROM
TO
STIPULATIONS
See notations on plan. Deck approved to cantilever over easement.
1WARNING
Before digging call f®F
all utility locations
45"002
RFOURRED BY LAW
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
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 1 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
$5,961
$2.99
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-
$125.25
Fire SC $5.96
STRU N OR THE PE ORMANCE OF CONSTRUCTION
'u
PLAN CHECK FEE
TOTALFEE
Lic ns e SC $5.00
$139.20
SIGNATURE OF CONTRACTOR OR AUTHOR�DATE�
WHEN PROPERLY VALIDATED THIS IS YO R PERM
SLOG �N$P TIAiE
S-GNATURE OF OWNER SIF OWNER BUILOERi. iDATEI
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: '�01 CISIL C"9A_y'(1
Legal Description: �c yj ° N et'-*" X
Owner Name & Address: S&MA) `�-��"'�'` 5TEPAE Tel. # ';PeP3—,5-7�-
Contractor: -04 Ud l' )AJ t 6fle MN LICENSE # 0,3
Address: Ems' %R Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA:
Length
Width
Height
Sq. Ft.
GARAGE AREA:
Length
P Width
'7
Height
« �~
Sq. Ft.
Sq. Ft.
DECK AREA:
Length
Width
Hgt/Ground
l
OTHER:
® v,P/2
twim'7- V
A04
�
E"'11%414 ,"
Construction Type:
���
�`C T) FF,*
Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Ft x $ —=$
DATE: APPLICANT: c Tel. #
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
CITY USE ONLY -
$
TOTAL $ A3'.0O
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [
The Home Depot ## 2802, 5650 MAIN ST, NE, FRIDLEY, MN 55432, (76
Sun Jul 14 13:24:54 2002
File saved as: f:\dn\decks\7140BC7A.DEK
Deck Dimensions for Deck 1
�'l0v
�W Goin
CK
s oVQ
INS CT104 IliN
--
25' 5" 3' 41—
25' 5" 2' 3'E4'—
34'
IL
Joist Spacing = 16 in. o.c.
Railpost Spacing = 96 in. o.c., Baluster Spacing = 3 in., Toe Spaci = 3 in., ailing Height I
Stair 1: Rise = 7 in., Run = 11 in.
34" ,
A1440 Id/
ax O i
A
e4A,
G 84a !4 �E
CERTIFICATE OF SURVEY
For;
DA V'ERNE CORP
0
W
1w1fD
JD.9 s
T�
�90 4
e4
IRS
lee. 4P19
Ufi/ff-
e6.
Lot 7, Block 32 INNSBRUCK NORTH 2ND ADDITION, Anoka County, Minnesota.
3 od �`�?
t
we hereby certify that this Is a true and correct representation of a survey of the E. G. RUD a SONS, INC.
boundarles of the above described land and of the location of all buildings, If any, LAND SURVEYORS
thereon, and all visible encroachments, if any, from or on said land. 3
E.G. RUD E6 SONS, INC. 847 155th Avenue N. E.
Wed this re day of WE. I
Anoka, Minnesota 55303
*jw Aom*U �1f,/V;w by Tel: 434-6505
Minn. Reg.. Na. o
PLUMBING
RESIDENTIAL APPLICATION
City of Fridley
�_o V,� .,
Permit Number
Received By
Date Received
NOTE: IFPROPERTY IS NOT OWNER/OCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT.
DATE YOUR E-MAIL ADDRESS
SITE ADDRESS C.S
THE APPLICANT IS: (CIRCLE ONE) WNER CONTRACTOR
r
NAMEY�eL%
PROPERTY OWNER/
ADDRESS Ol%L
TENANT
CITY STATES ZIP 6yrl`��i
PHONE #
NAME LICENSE #
ADDRESS
CONTRACTOR
CITY !— STATE ZIP
PHONE # FAX#
PERMIT TYPE
SINGLE FAMILY TWO FAMILY TOWNHOUSE
TYPE OF WORK
❑ NEW REPLACEMENT
DETAILED DESCRIPTION OF WORK E0 Z.0fcF ^;"4g" 1 44"%'% e 44y -1&F_
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED
FIXTURES: (INDICATE TOTAL NUMBER OF EACH)
BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING
BATHTUB GAS PIPING (Need City License) SWIMMING POOL WATER SOFTENER ($35)
CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREY. ($15)
DISHWASHER LAUNDRY TRAY WATER HTR ($35) FOR IRRIGATION
WATER METER OTHER
Permit Fee $ MINIMUM: $15.00 or 5% of cost of the Improvement -whichever is
Plan Review $ greater on work less than $300
Surcharge $ .50
TOTAL DUE $ Make checks payable to: City of Fridley
THIS IS AN APPLICATION FOR A PERMIT – NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing 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; that the work will be in accordance with the approved plan in the case of�Ark which
requires review and approval of plans.
NAME OF APPLICANT �tJG�%�, & 2/ac� DATE
Please type or print
SIGNATURE OF APPLICANT
CITY OF FRIDLEY COMMUNITY DEVELOPMENT DEPARTMENT
6431 UNIVESITY AVENUE NE, FRIDLEY, MN 55432
(763)572-3604