PRE 2010 DOCSe
STATE OF MINNESOTA
W7o•5o DEPARTMENT OF NATURAL RESOURCES s
Rev. ttno DIVISION OF WATERS, SOILS AND MINERALS KA. No. 78-6103
Centennial Office Building; St. Paul, Minnesota, 55101
IN THE MATTER OF THE APPLICATION OF DAVERNE 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, and 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 DaverneCOrR,]David Fi,rek whose address for the purpose of notices and other
communications pertaining to this permit is 2200 Silver. Lake Road, which address is subjectto change by written
notice from the permittee. New Brighton, MN. 55112
To excavate 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 3, lots 4, 59 6, 7, Innsbruck North 2nd. Addition,
SEk Sec. 242 T. 30N, R.24W
for the purpose of residential development. Anoka COUNTY
This permit is granted subject to the following GENE RAL 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.
S. 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.
6. 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
1. Construction work authorized under this permit shall be completed on or before July 31. 1978 , . Upon
written request to the Commissioner by the Permittee, stating the reason therefore, an extention of time may be obtained.
il. 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.
III. In all cases where the doing by the permittee of anything authorized by this permitshal I involvethe taking, using, or damaging of any 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 perm:issiveonly.Noliabilityshallbe imposed upon orincurredbytheStateofMinnesotaoranyofitsofficers,agentsoremployees.,
officially or personally, on account of rfie 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. DOESiOT
It shall be the duty of the permittee to determine correctly ali pertinent elevations
at the site of the tuork for the purpose of complying with the 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.
V11. Receipt is hereby acknowledge of S DOES as payment for NOT cubic yards of sand, gravel
or rock and APPLY cubic. yards of muck and silt, the estimated amount of material to be removed 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.
cc: George Jurgenson, Conservation Officer
Rice Creek Watershed District
Anoka Co. SWCD
• r
Cityof Fridley V� r)ATF❑ AT ST_ PAUL_ MlkJNFSATA T141c ndv na
0.
PEMIT NUMBEit ld-blu.i
Dated Nov.. 15, 1977
SICIAL r�0`dISSC:vS .
(Only the rrambered Special Provisions apply to this per mit. )
XZV The pe =dttee shall comply with all rules, regulations, requIrements,.
or standards of the Minnesota Pollution Control Agency and other
applicable federal, state, or local agencies.
The use of explosives in any of the waters of the state is prohi,bated
unless the. local State Conservation Officer is notified thereof at
least 48 hgur_ s in advance of the time the stork is to be done. CM.S.,
Sec. 101.112, Subd. 11).
Before construction and after completion of the _project authorized,
permittee . shall supply the Di vision. of raters., Soils 2nd Miral.% with;
tbhotoaran% of the . proiecct area.
X Spoil material shall, not
wherever. possible,, such
areas subject to flooding.
plain areas because areas
spoil should be placed p
spread over a large area so
passage of flood waters.
be placed. on the beds of public waters, -and,
material should not be placed ar�4here within .
In the event spoil ras t be placed. within flood
free from flooding are not readily,available, the
para
el to the direction of flood fig i and/or
as to udmim3,ze any possible obstruction to the
Upon completion of construction, the bed of the public water shall be
restored as nearly, as practicable to the origi-nal cross—section.
1 The permittee shall cover or protect all, exposed soil resulting from.
the construction authorized by placing riprap, sod, and/or 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 supply
the Division, of ;-raters, Soils and Minerals with photographs of the
project area.
Future maintenance excavation of this project shall not exceed the
dimensions herein authorized. Prior to co =a cin? any, maintenance
excavation, permiittee shall advise the Dspartnant of Natural Resources of
the volume of material to be removed; the r &-user of removal, a -A the spoil
disposal site(s) proposed. If the Cor�ssio:-er of natural Resources
determines that a field inspection is necessary prior to approvi-ng such
maintenance work, the permittee shall subrdt a check payable to the
State Treasurer to'cover the actual cost of the inspection, or $2'.00,
whichever is greatr, pursuant to 1dnnesota Regulations la 5=, Paragraph (g) •
Ylaintenance excavation shall not be commenced until per..tteels''receipt
of the Department's approval.
(See reverse side for additional provisions, if any.)
XIII This permdt does not obviate, am 'requIrement for federal assent fro.t
the U.S. Corps of Engineers, 1210 U.S. Post Office and, Custom House,
St. Paul, Minnesota 55101.
Perrattee shall seed a strip of land abutting both sides of the ditch
to permenest grasses and legumes,, these strips to n --et one of the
following standards:
A. Each strip shall be at least 40 feet. Hide for the full, length of
the excavated ditch aad shall not be rc p-1--lor to JuIY 15 in
any year; or
B. Each strip shall, be at least 25 feet wide for the fullleng�h of .
the excavated ditch, provided MOIdng of these naz ler strips
shall not be done.
City of Fridley
SUBJECT
PERMIT
I r. 14831
AT THE TOP OF THE TWINS
PERMIT
r
BUILDING
CEIPT NO.
COMMUNITY DEVELOPMENT DIV.
n
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 555548 West Danube Road N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
55
3
Innsbruck North Second SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
DaVerne Corp. 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 L E E NO.
NEH 1
5 ENGINEER MAIL `•OR WIRJ1�P PF�Q jng C.ah"ENg' U[Itlt!
HEAPja LlV�g t Ui 1
otap
6 USE OF BUILDING
Residential RFQ1 11RED BY LA
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 60' x 26' Dwelling and a 22' x 24' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS provide a hard surface driveway. Provide sod in the front and side yards
Provide. combustion air to furnace. Provide truss design & verifying survey before
August 15, 1978. Provide 4th Deck Post or 3 ply 2 x 10 deck girder. Written soil
excavation, site preparation and compaction tests by soils 'engineer required.
SEWER LOCATION: (Approx. 9' Deep In Street) 29' South of Manhole (Inv. 954.49)
WYE ELEV: 954.59 TOP OF FOOTING: 957.89 Minimum
WATER LOCATION: 6' South of Sewer Service
DRIVEWAY DEPRESSION COST: N/A
Ud CITY OP FPJDW DOES NOT GUARAME! v;.-
ACCVRACT OF UTILITY LC"TK M AND ELEVAIiC-r.. .
TM DATA IS FOR IN FOMA PULpasn ()?AV Abt;;;
MOM #JMQ It 5ML0 YOFY TH MIMARON
ON THE Stili,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
Wood Frame
OCCUPANCY GROUP,
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
32,160
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
1376 -I- 528
TotcIC
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$45,575
$22.79
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-
$125.64
$400.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$32.16
$583.59
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT ( ATE) -
WHEN PROP LY VALIDATED THIS IS YOURPERMIT
bWG. INSP DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
F"A
Seale
�,e{
t+t yi Sr+g.
Stir
Ktill
r
24
V
a � �}�ac�S��1 � � � •" fvt9 � t j � � ' �V '
3
.df P;tl 3 i:.Y DCZ ftJLPTF
a� e.
ycl'�ttr �s�El�rt Y 0I' 11T61.9T"( L�a�^R. AND ElEvi
a rD 1�c 9 THI,'b DATA 15 TOR 1P�I�ORMATiON ®SES 0N.L
�, r
N$ USIOG It SHOULD VERI&NE RWORiL,i,i�j
om 110 SITE 14,6,y -ed6y i,:a� c. surasy, pion, Gr r6p6rl vias.
aL� �
---ii bv ni nq eiicc? ^u orvimn and 1113r
r•,:;y Fn,, WO Suivvy+x U!Wer the kavas
PSR PNk- /
/-7i�s6rUc.(r
,Z ^' ,4'do'ii`ioiy , �%r�o.¢r► L'ou�ry, /l�lii�n ` E R N L. S T Q R U ®" •
434 50-48
_.. ,
X,44x2
Al
p ® "
T62fOf F® --®,o6-- 7
9
PAIIII P9f- xe- le
4 9
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: �J�f+yE�NE� BUILDER:
Address: Address: &�C- 4,4
Tel. No.:—!v �/- /Z
No.: S-5-4 Street: GUkA) 04F -
LOT: BLOCK: ADDITION: 1100.5WAUC/L
COR14ER LOT: INSIDE LOT: �>4– SETBACK.: -3-5- SIDEYARDS:
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 As:
Front: 60 Depth: Height:
Square Feet: 1_520 Cubic Feet: ,
Front: Depth: Height: ��
Square Feet: ,:? Cubic Feet:`��
Type of Construction: p4�� Estimated Cost:
To Be Completed: /
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 sid for 7add*tional nform tion.
DATE: '715- SIGNATURE:
Stipulations: / li
11 5-otty-
3
1.
2.
Address
Legal .. 3 r ��� , p• ,
L-,T . -� 8 .
3.
Zoning
i8�
.4.
Lot width •�(5!
5. •
Building Width 66 -•
6..
Front Setback 3�
7.
Total Use
8.
Lot Coverage ate,
9.
Easements
1 ariance
Soil
2-
Contractor' �AJEKw
13.
Phone �--.
. 14.
chitect
Drainage.
�. 16
7.
Energy Ashrae
Utility Locations
18.
Specials
j19.
Driveway opening �l
Truss Design /
Combustion Air
23.
.24.
25.
i
STATE OF MINNESOTA
W 7.0.50 DEPARTMENT OF NATURAL RESOURCES
P.A, No. 7$-6103
+eV 11/70 DIVISION OF WATERS, SOILS AND MINERALS
Centennial Office Building, St. Paul, Minnesota, 55101
IN THE MATTER bF THE APPLICATION OF DAVERNE CORPORATION/ DAVID FICEK
fora PERMIT TO CHANGE THE COURSE, CURRENT, OR CROSS SECTION of Unnamed Wetland
Anoka County.'
4`
PERMIT
}gin
Pursuant to Minnesota Statutes, Chapter 105, and on the basis of statements and information contained in the #wmit atDIt11C4ttipn,
ti
letters, maps, anti pians submitted by the applicant, and other supporting data, all of :vhrch are inane a ;air hlveof hp rnf&OCIV0. PEPIMISSION
IS HEREBY GRANTED to Daverne Corn. /DayidF,r Plc whose addreA for the wits-DS$Of n0110n4ftd0t W
communications pertaining to ovs hermit is 2200 Silver. Lake Road--. oNh, h 8tiffr(*5a '4 skanect to ClWnvcl by written
notice from the permittee. New Brighton, MN- 55112
To excavate 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 boundar.v 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 rouain open water, all
in accordance with plans submitted with application on -
PROPERTY DESCRIBED as: Bloch 3, lots 4, 5, 6, 7, Innsbruck North 2nd. Addition,
SE'k Sec. 24, T. 30N, R.24W _
for the purpose of residential development. Anoka COUNTY
it is rants subject to the following GENERAL and SPECIAL PROVISIONS.
This perm g d t
`41
xry
OVISIONS R
L PROVISIONS
t This permit is permissive only and shall not release the permittee from any liability r obligation Imposed by Minnesota Statutes, Federaf
,onp,oi.sfiend
Law or Iotal ordinance!, reianny thereto and shall n•mam in tor.:c suhie,-t to alp , n1 ..... nit. r t ec .ftrr imposed t)v
law.
2. This permit is not assignable except with the written consent of the Commissioner of Natural Resources.
The Director of the Division of Wafers, Soils and Minerals shall be notified at least five days in advance of the commencement of the
3,
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
1
Commissioner of Natural Resources for inspection of the work authorized hereunder.
This Permit may be terminated by the Commissioner of Natural Resources, without notice, at any time he deems it necessary for the
6.
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
s
of this permit, unless otherwise provided in the Special Provisions.
SPECIAL PROVISIONS
31. 1978 - . Upon
1. Construction work authorized under this permit shall be completed on or before July.,31,
written request to the Commissioner by the Permittee, stating the reason therefore, an extention of nine may be obtained
It. 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.
III. In all cases where the doing by the permittee of anything authorized by this permit shal I involve the taking, using, ordamagingofany property
rights or interests of any other person or persons, or of any publicly owned lands or improvements thereon or interests therein, the
i
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.NoliabilityshallbeimposeduponorincurredbytheStateofMinnesotaoranyofitsofficers,agentsoremployees,
damage to any or property resulting from
officially or personally, on account of the granting hereof or on account of any person
any act or omission of the permittee or any of its agents, employees, or contractors relating to any matter hereunder. This permit shall
its
not be construed as estopping or limiting any legal claims or right of action of any person other than the state against the permittee,
or as estopping or limiting any legal
agents, employees, or contractors, for any damage or injury resulting from any such act or omission,
its employees, or contractors for violation of or failure to comply with
claim or right of action of the state against the permittee, agents,
the provisions of the permit or applicable provisions of law.
V. No material excavated by authority of this permit nor material from any other souES rce except as specifiel�Pin,shall be placed on any
portion of the bed of said waters which lies below.
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 the 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 arta
tk l
p
unobstructed for use by the public.
(over)
EXTZRIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER PLAN NO. t�
SITE ADDRESS DATE
CONTRACTOR , LI >iN'� L.oe'j PHONE
Determine working square footage of each
2--
1. Total exposed wall area.... e e � � �° ° --' sq eft. x-14
2. Total roof/ceiling areae..... sq.ft.
3. Total floor/canto area...,,,o sgofto x ,�1Q
Total exposed wall area above floor
a. Total Wall Window areae.oe.......e.eeeeeeeso.
be Total door area.ee.o.eeeee.e.e.ee.ee.soee..o."•�
c. Total sliding glass door area.....e..eee...om
d. Total fireplace Wall area .......
e. Total wall framing area (average 10%)......e®
f. Total net wall area above flooroee.ee.eoe.e..
g. Total rim joist area....seeseeoeoeeee..00eoe.- s°
Total exposed foundation area °
h. Total foundation Window area..e...e...o.e..oe
i. Total net foundation area above grade. e e e e . e o 1`-f 7/77
Determine "II" value of each wall segment
a `1e -;1�x "D"
b s �sly"-' x "II" 27' 1
do x "Up
e o " x "u9°
x nun
g •R x "II" . r
x nun c I
4. e..see•oseoe.e.eeoeo.oes.esoeeeeee.
If item #4 is the same as, or
the intent of SRC 6006(c)2.
Total = s
item #1, you have met
f, s
Total exposed wall area above floor = M
ae Total wall window areaeeeeo.eeea.eees..esee.o.e
b. Total door area.......... ee....o............e..
o. Total sliding glass door areae oeseeso.sseeesee. /
d. Total fireplace wall ar�ae.•.e.oe..s...oeo..eoe
e. Total wall framing area (average 10�).....s.... '
f. Total net wall area above flooroo.oee.eeooe.seo
g. Total rim joist $reaeooeeo.eo.000.eo.00e..seoo.
Total exposed foundation area =
ho Total foundation window arsaooe.eeeoeee.00e.e.o
i. T®tal-net foundation area above gradesooeseesoo
Determine "Ln value of each wall segment*
a. Y "Un
o. 1 "U" _
d. 7C "D"
e. Z,I "Q"
X gun
6® $ gun s
h. Z "D"' _
i. I nun _
Subtotal = 24/
r . t
Total exposed roof/ceiling area
J. Total skylight arA$emmeee..seeeseeeeeeseeememeseme.e..e•
k. Total roof/ceiling framing area (aver. (.10016"o/c)
(.0625024"o/c) . e e
to Total net insulated roof/ceiling area... a * * 0 0 0 0 0 q 0 * e 0 0 a
Determine "U" value for each roof/ceiling segment
• x
k• x "U" a s
1. x "U"
5. ....em.e*.*.*s.s.ase.*.s*s**.s*..**ssssee.....eo• Total "
If total of #5 is the same as, or less than #2, you have met the
intent of SBC 6006 (c)'i .
Total exposed floor/cant. area
m. Total floor/cant, framini area (average *10,%)*****0**0•
ne Total net ins floor cant* areaeosesesseese.e.*ssso
Determine "U" value for each floor/cant. segment
M.- x "U"
ne x "U" _
6*•*ee.se.*•s*ee*eeseeeeesee.emeeeeeee.eemsee•*emee Total =
If total of #6 is the aame as, or less than #39 you have met the
intent of SBC 6006(0)3.
ALTERNATE BUILDING IIWEL9PE DESIGN
To utilize the total envelope system method, the values established
by the sum of items #4, #5 and #6 shall n&d be greater than the sum
of items #1, #2 and #3.
Prepared by
Date
Cl "! Y OF rR! X'LEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
Job Address s-% ! g �"
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
OWNER
KIND OF BUILDING
USED AS
Fridley, Mn. _1 z3 , 19 7/
of
TO BE COMPLETED ABOUT
PARTIAL RATE
m
ESTIMATED COST
U
PLUMBING FIXTURE RATES:
x
o
TOTAL
Water
of
p}
m
Q
$ %i® 0'
w
a
m
a
$ &,0
.14
4J
'W
o
w
x
$2.00
Heater
N
C
x
$5.00
$
Signed By
,xi ''J
c
W
3
�
' x
N
b
P.
U
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
-.�i
01
yet
.0
b
C
`- x
8
Ji •.�i
m ro
o .mac
a yN
N
M
N
b
ani
$
u
�ro
ai
.+Q
w
S
s�i "O
o w
to
.�
w
U ro
a
tai
Date
U
O
;as
nec
$
R
Gas Range to 199,000 BTU
x
$10.00
I Allr-
APPROVAL FOR PERMIT
1 .i
1
11
1st
2nd
3rd
4 th
(R) Future Connection Opening
Connected with Sewer
(°) New Fixture, Old Opening
Water
Job Address s-% ! g �"
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
OWNER
KIND OF BUILDING
USED AS
Fridley, Mn. _1 z3 , 19 7/
REPAIRS & ALTERATIONS
First $100.00 $5.00 $
each add. $100.00 or fraction $2.00 $
State Surcharge $ .50
TOTAL FEE
REINSPECTION FEE
($10.00) .
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $. So STATE SGRCHARGE
TO BE COMPLETED ABOUT
PARTIAL RATE
SCHEDULE
ESTIMATED COST
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
OLD - NEW BUILDING PERMIT NO.
PERMIT NO.
Nusber Fixtures_
x
$3.00
$ %i® 0'
Future Fixture Opening
_j' x
$2.00
$ &,0
Company
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Signed By
Water Heater - to 99,000 BTU
�
' x
$5.00
$ So
Tel No.
®, (o
100,000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
`- x
$5.00
$
ROUGH INSP.
Electric Water Heater
x
$5.00
$
Date
GAS FITTING FEES:
•
FINAL INSP. 3 C)
1st 3 fixtures
L_ x
•$3.00
$ 3,00
Date
Additional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
APPROVAL FOR PERMIT
REPAIRS & ALTERATIONS
First $100.00 $5.00 $
each add. $100.00 or fraction $2.00 $
State Surcharge $ .50
TOTAL FEE
REINSPECTION FEE
($10.00) .
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $. So STATE SGRCHARGE
V
New Brighton, Minnesota 55112
Registered Builder
(612) 631-1213
O j /✓;
October 269 1979
Mr. Nasim Qureshi
City Manager
City of Fridley
6431 University Avenue N.E.
Fridley, Minnesota 55432
RE: 5548 'West DanuDb Road ® Sewer/Water Connections
Dear Mr..Qureshi:
Enclosed you will find a copy of a bill from Ray Perron, my
sewer/water subcontractor. This bill has been paid by me.
The -charges are above and beyond the normal installation of
sewer/water. Incorrect locations for hook-up were given to him
by the City of Fridley. These are his charges in his attempt
to find the locations.
I hereby request a check for $300.00 be mailed, to me at the
above address. Your time and cooperation are gratefully
appreciated.
Cordially yours,
a�
DAVERNE CORPORATION
David E. Ficek
L.
I .
t
FROM .. °C .11
.ak! -�... _._._ Grv�h
....__.__ .. ......
Co
TO -
ADDRESS
^ I S , / 1/G>�m..�G.e�,
ORDER NO. ---- ---- --
CITY -4
/r STATE
TERMS
: City of Fridley
SUBJECT
PERMIT
AT THE TOP OF
14331
THE TWINS
PERMIT BUILDING
•
'
NO
' LCEIP-T
• COMMUNITY DEVELOPMENT DIV..
r PROTECTIVE INSPECTION SEC.
h,� CITY HALL FRIDLEY 55432
'I+
NUMBER
REV.
DATE
-
P
PAGE . OF
APPROVED BY
j, J~ 612-5603450
910-F15 '
8/2/78
N ;
�r
JOB ADDRESS
X5548 West na»_u� Road N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION _ S AGH
f a r EE ATT ED
DESCR.
rj
3
Innsbruck` North Second
SHEET+
2 PROPERTYOWNER MAILADDRESS .- ... ZIP
PHONE
DaVerne Corp.. 2200 Silver Lake Road, New Brighton
631-1213
;v.r
p ZIP
3 CONTRACTOR MAIL ADDRESS rt ,
PHONE LICENSE NO-,
a
Same
4 ARCHITECT OR DESIG4NER MAIL ADDRESS ! ZIP
PHONE E NO r
WARE
NWE
5 ENGINEER' . j MAIL-% tP PRON I ENS N?
•' �L$ Fol? W`fjj SINE U1gg itg $fit 4c$ UiFflti
) t
SIC him TRIPHONE�?t
6 USEGF BUILOING :. ; :
•
Residential'
RED- Byx
7 CLASS760 WORK
111
�0 NEW 0 -ADDITION 0 ALTERATION 0 REPAIR
0 MOVE 0 REMOVE ,,
S DESCRIBE WORK
Construct a 60' x 26' Dwellingn '
a d a 22' _ x 24 Garage
�T
r
9 CHANGE OF USE FROM TO
STIPULATIONS Provide a hard surface driveway. Pavvide sod in the
front and side yards
;
Provide combustion air to furnace. Provide truss design & verifying survey before
August 15, 1978. Provide 4th Deck Post or 3 ply 2 x 10 deck girder. Written soil
excavation, site preparation and compaction tests by soils engineer required.
k�.
SEWER LOCATION: (Approxi 9',.Deep In Street) 29' South of Manhole
(Inv. 954.49)
WYE ELEV: 954.59 Top OF FOOTING: 957.89 Minimum
=:
WATER LOCATION: 6' South of Sewer Service
`S'ka':
DRIVEWAY DEPRESSION COST: N/A
IHI QTY or . FRIDLEY . DOES • .. NOT - GUARANTE'
AC CT CW UfiILFi'9f LOCAMNS Al�bD Ed EVAKC
3;.
TH13 DATA IS FW INFIaItM' 4IN PUVOUS 171AT
PSWNS ..USING It WOM VITRIFY THE tMFA&MAl OM�
ON THE Wt.,
� 4
� J .
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
1376 +
528
32,1.60 Tot
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$45,575
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$22.79
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR. THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
t.
$32.16
$583.59
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT I ATE)
WHEN PROP LY VALIDATED THIS IS YOUR PERMIT
• G INSP (
OATE
SIGNATURE OF OWNER 0F OWNERBUILDERI IDATEI
v'
6431 UNIVERSITY AVENU
December 26, 1979
Mr. David Ficek
Daverne Corporation
2200 Silver Lake Road
New Brighton, MN 55112
N.E., FRIDLEY, MINNESOTA 66432
Re: Final Inspection at 5548 West Danube Road N.E.
Dear Mr. Ficek:
(612)571.3450
A final inspection was made on December 20, 1979 of the above address
and the following items were noted which must be completed before the
structure can be fina.led out;
1. Post address numbers on structure by January 21, 1980.
2.- Provide sod in the front and side yards by June 15, 1980.
3. Provide a hard surface driveway by June 15, 1980. .
4. Provide deck railing with maximum spacing of 9 inches by June 15, 1980.
5. Provide deck off kitchen by June 15, 1980.
6. Provide City with copy of verifying survey by January 21, 1980.
We will expect the above items to be completed by the scheduled dates
when reinspection will be made to determine compliance. If you have.
any questions on these items, please contact me at 571-3450.
Sincerely,
DARREL G. CLARK
Chief Building Official
DGC/mh
- 17, 1980
F
apt �"kfri' yw iA^
� S��E•'ax� t2Y ti47
Yh r AI.S � y
6431 UNIVERSITY AVENUE N.E_, FRIDLEY, MINNESOTA 55432
TELEPHONE ( 512)571-3450
Mr. David Ficek
DaVerne Corporation
2200 Silver Lake Road
New Brighton, MN 55112
Re: Final Inspection at 5548 West Danube Road N.E.
Dear Mr. Ficek:
A final reinspection was made on June 16, 1980 to determine compliance
with our letter sent to you on December 26, 1979. It was noted that
the sod has not been installed in the front and side yards.
We will expect this to be completed by July 15,.'.1980 when a reinspection
will again be made to determine compliance. If you have any questions
on this item, please contact me at 571-3450.
Sincerely,
G
DARREL G.
Chief Building Official
DGd/mh
CC-. Mr. Dennis Lemke
5548 West Danube Road N.E.
'
SUBJECT
p5mmrwo.
City ®f Fridley
�"25344
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
r
♦L -------- COMMUNITY DEVELOPMENT DIV.
r � -- PROTECTIVE INSPECTION SEC.
1 . �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i s---a CITY HALL FRIDLEY 55432
612-571-3450
910415
8/4/97
JOB ADDRESS 5548 West Danube Road NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
3
Innsbruck North 2nd
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Dennis Lemke 5548 West Danube Road NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
K-Designers 10650 County Rd 81, #201, Maple Grove, MN 55369 424-1000 City
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
❑ NEIN ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside House & Garage (Vinyl)
9 CHANGE OF USE FROM TO
STIPULATIONS Install building wrap and have inspection
of same unless
manufacturer's specifications state it is not required.
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
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVfMNING THIS TYPE OF WORK WILL BE COMPLIED
$IS,H7O
$7.94
WITH WHETHER SPEC I H EIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUM G E AUT RITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS O T R ST E O LOCAL LAW REGULATING CON-
STRUCTION R T E ORM OF CONSTRUCTION.
PLAN CHECK FEE
TOT FEE
G(
Li S
$5.
$266.06
j SG AT CONTRACT OR AU HORIZEDAGENT ID TEI
HEN P
VALIDAT THIS IS UR P MI
BLD )NSP
MATE
SIGNATURE OF OWNER I IF OWNER BUILDER) (DATE)
NEW ( )
ADDN [ ]
ALTER [ ]
Legal Description:
Effective 1/1/97
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
� ��ConstructionAddress: �� O, M LVk ,ev
Owner Name & Address: Tel. #
Contractor:
Z MN LICENSE #
Address: D6 rD
e 6ae-_ Tel. # %2zf
.001 of Permit Valuation (1/10th%)
Attach to this application, a Certificate of Survey of the
$_ ?,
lot, with the proposed construction drawn on it to scale.
SAC Charge
DESCRIPTION OF IMPROVEMENT
LIVING AREA:
Length Width Height Sq. Ft.
GARAGE AREA:
Length Width Height Sq. Ft.
DECK AREA:
Length Width Hgt/Ground Sq. Ft.
OTHER:
C(
$
rNr
Construction Type:
�1,xJU( Estimated Cost: $ 20
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft Ut ix $ _ $
DATE: 8/c( 07 APPLICANT: Tel. #
TOTAL $(�(..��
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ %. Fee Schedule on Reverse Side
Fire Surcharge
$ 1 `j
.001 of Permit Valuation (1/10th%)
State Surcharge
$_ ?,
$.50/$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 $(�(..��
STIPULATIONS:
E
suaJEtr
P
City of Fridley
3 01 13
AT THE TOP OF THE TWINS
BUILDING
PERMIT ("'
NO.
IRZ&Frr
COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1 �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
=
I "'1 CITY HALL FRIDLEY 55432
' 612-571-3450
910415
8/24/99
10B ADDRESS 5548 Rxxxka West Danube Road NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
3
Innsbruck North 2nd SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Barbara 4 Dennis Lemke
571-2370
3 CONTRACTOR 'MAIL ADDRESS
ZIP PHONE LICENSE NO
Diamond Exteriors 2700 NE Winter S
1-800-224-3661
ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW 0 ADDITION 0 ALTERATION - REPAIR 0 MOVE O REMOVE
B DESCRIBE WORK
Reroof house and arae 31 sq). Tear-off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code.
Permit Inspection Cards
Will Be Mailed ,
To Homeowner To Post
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
2709
$1.35
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
53.25
FJA SC $2.71
PLAN CHECK FEE TO FEE
Lice S 5 2.31
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATE,
HEN A,O ALID THIS IS UR PER
(�
S,GNATURE OF OWNERpF OWNER BUILDER,jOATEI
BlD NSP ' gAtE
E
24 1.
NEW [ ] Effective l/ 1/99
ADDN [ ] CITY OF FRIDLEY
ALTER[ SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:.5 7 1J �
Legal Description: i ��- t C) I
Owner Name & Address: aa��� Tel. # (f _ 5-71 -LD-5-70
Contractor: q)®- r, ':;'�c MN LICENSE # ;� 0 93 L4
Address: X00 d(5 , G) , (nmpcs�Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRUT110N OF 1WROVEIvIIiJN'T
LIVING AREA:
Length
Width Height Sq. Ft.
GARAGE AREA:
Length
Width Height Sq. Ft.
DECK AREA:
Lepgtk
Width Hgt/Ground Sq. Ft.
OTHER:
it
Construction Type:
Estimated Cost: $ 67?�96 /
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
®
r
# ^
DATE: 6�
APPLICANT:
Tel.
CITY USE NLY
Permit Fee 5�$ee
Schedule on Reverse Side
Fire Surcharge $
• `� r
.001 of Permit Valuation (11110th %)
State Surcharge/3.) $
$.50/$1,000 Valuation
SAC Charge $
$1050 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:
o
Building
$
BUILDING
See Back Page for Fee Schedule
- -
Permit No.:
Inspections
RESIDENTIAL APPLICATION
65% of Building Permit Fee
Received By:
763-572-/3604
e '
CITY OF FRIDLA&.-EY
Fire Surcharge
Date Rec'd:
DATE / tel, ®s
YOUR E-MAIL ADDRESS / e� kC
License Surcharge
SITE ADDRESS J y 42 D % e /t" V -di dl e N
THIS APPLICANT IS: (OWNER
❑CONTRACTOR
$
PROPERTY OWNER/
NAME: --D e -A A #`J 4-,6Aa A .4 !144-
Curb Cut Escrow
ADDRESS:
&A &A i1 s9P✓ce/y'��c+ CITY ��f d d � K STATE_&WIP ftL
TENANT
Erosion Control
PHONE: -7(P3—S2/—),3-76
$450 Conservation Plan Review
CONTRACTOR
NAME:
(,J ✓1 eA
Fee Determined by Engineering
STATE LICENSE #
EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS:
CITY
STATE ZIP
WITH APPLICATION
PHONE FAX
❑ SINGLE FAMMY/NEW CONSTRUCTION SIZE
PROPERTY TYPE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION
❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH
❑ ROOF ❑ DRAIN TILE
DECK
❑ SIDING ❑ OTHER
❑ SWIMMIING POOL
TYPE OF WORK:
❑ NEW
❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:/??,e
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
NUMBER OF SQUARES
❑ HOUSE ONLY
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1.
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE: pq
HEIGHT:
❑ DETJ f I JE _G ?E
/p� .i'
3.
List of structural members to be used
PROPOSED
SIDING
!
/
FOR NEW CONSTRUCTION INCLUDING DECKS,
& PORCHES SUBMIT:
El Vinyl
❑So
ADDITIONS
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑er�
WINDOR'S
❑ cla
2.
3.
and proposed project
Two sets of construction plans
Energy Calculations
IN EXISTING OPENINGS 03Y LOCATION
OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBP, SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED
NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MA1'LKIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION S OCCUPANCY TYPE
Permit Fee
$
c`�� , o�J '
See Back Page for Fee Schedule
Plan Review
$
0 0,
65% of Building Permit Fee
Surcharge
$
e '
(.0005) times the total job valuation — Minimum $.50
Fire Surcharge
$
1 , ®
.001 x Permit Valuation (1/10%)
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1450 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $20 = $
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 Sti ulations
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 fa ermit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work w 'ch r quires �edrov ofplans. jp"SIGNATURE OF APPLIC ��o ' PRINT NAMIB.L0AJN/E l'• Zl7il�C/� DATE l'p7���
torA �-M- E �
Building
BUILDING
Permit. No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
DATEADD! /-
S YO E-MAIL ADDRESS
SITE
THIS APPLICANT IS:
OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: 0 'uss
TENANT
ADDRESS: � C& Diu AE: et CITY , C2 i 14
-STATE/WIP S
PHONE: % a5- ®- 7 0
CONTRACTOR
NAME: -
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: CITY
STATE ZIP
WITH APPLICATION
PHONE FAX
FAMILY/NEW CONSTRUCTION SIZE
PROPERTY TYPESINGLE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPEADDTTION
❑ GARAGE/SHED ❑ WINDOWS
❑ ASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
El ADDITION '
❑ ANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: Mob bao o 10K ni Sr w ,f ' 4.S 4(S6A eel a.11P,,-eFAt1W
SIZE OF IMPROVEMENT LENGTH /aZ � WIDTH 1424 ' HEIGHT (� / Sq. Ft.
ROOFING
❑ HOUSE ONLY
�D
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1. Existing Floor Plan
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used i�h'I
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS.
❑ Vinyl
❑Soffit
ADDITIONS, & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASID ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
Sq '5/ (USING TIDE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION S 6, (, ® 0, `'� OCCUPANCY TYPE
Permit Fee
Plan Review
Surcharge
Fire Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
See Back Page for Fee Schedule
65% of Building Permit Fee
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks navable to: Citv of Fridlev Attach
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 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 all work w i equires r A d approval of plans. _
SIGNATURE OF APPLICANT '`e PRINT NAME 07 -AXI S /A • DATE // -7-
��
Building
Inspections
7.63-572-3604
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
DATE YOUR E-MAIL ADDRESS
SITE ADDRESS SS; -1 w g �- Yt Q\O
THIS APPLICANT IS: ❑ OWNER 11CONTRACTOR
PROPERTY N,Mg: 175- ,
OWNER/ ADDRESS:
TENANT PHONE: �b3-s-i
CONTRACTOR I COMPANY
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
CONTACT PERSON:
TE LICENSE #
JOAN ZTNKEN
EXP DATE
Permit No.:
Received By:
Date Rec'd: '7
ATED-0 ZIP5Sla I
STA
ADDRESS: 13562 CENTRAL. AVE NE CITY ANORA STATE NZIP 55304
PHONE 763-757-6202 FAX 763-757-6701
TYPE OF WORK: 1 ❑ NEW
FAMILY ❑ TWO FAMILY
DETAILED DESCRIPTION OF WORK
REPLACEMENT
❑ TOWNHOUSE
❑ ALTERATION/REMODEL
PER MS 1613.6651he permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures.
(This should reflect only the cost of labor)
Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor—x.05
=
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FDCrURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)�� �� � � SIZEBTU zi _
MODEL: , 3 SAF
Equipment Installed MFG:
MFG: MODEL:
SIZE/BTU
MODEL:
$25.00 FIREPLACE (GAS) $15-00
SIZE/BTU
_GAS RANGE/OVEN $10.00
NEW GAS GRILL $10.00
,�A/C
$35.
AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00
$35.00
— GAS UNIT HTR $10.00
BOILER $35.00 _FURNACE
LINER $10.00 —GAS DRYER $10.00
POOL HEATER $35.00
VENTILATOR $15.00
_CHIMNEY
DUCT WORK $10.00 _GAS PIPING $10.00
. .. ;.: ...., : . � d.�';l'��4'�u/uv+. " ..`vls;53P=e,• '.,[.:;..w': .,::w. m.,, .. -. ,_.. .:._,.. .-,:.a _.,.. ._
Permit Fee $ u
Nmber of fixtures @ $10.00 x $10.00 =
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ Number of fixtures @ $25.00 X_ x $25.00 = $ R5• 013
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Total = $ 6-26,S-6
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; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
�h �.
SIGNATURE OF APPLIC PRINT NAME ROGER. HoyFHETN DATE,--�1 0 %
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMESADDITIONS EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEWIEXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propan&UGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a_ TMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a Required on new construction IMC 1346.0312
S. Ventilation .
a Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
.a. ACOA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up air calculations