PRE 2010 DOCSDate: - AUGUST 24, 1965
DONALD SAVELROUL
t COMPANY, INC.
Address 916 West Moore Lake Drive Address 7101 Highway YP65 N E.
Fridley 21, Minnesota Fridley 32, Minnesota
No, 916 street- WEA MOORE LAM DRIB Part of Lot
Lot _ Block
Corner Lot _ Inside Lot
Sewer Elevation
To be Used as:
Type of Construction
Addition or Sub -Division
Setback Sideyard
Foundation Elevation
DESCRIPTION OF BUILDING
Front Depth Height Sq. Ft. Cu.. Ft
Front Depth Freight Sq. Ft Cu. Ft
Est Cost _. $8, 0.00..0.0_ — To be Completed
REPAIRS AFTER STORM
In consideration of the issuance to me of a permit to construct the building described above I agree to do
the proposed work in accordance with the description above set forth airn�m ce visions off
ordinances of the city of Fridley. O
In consideration of the payment of a fee of it 10.00 , permit is hereby granted to D- Jnr. FEARSTAD
COMPANY INC. to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work.
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
ALLEN G. JENSEN Building Inspector
NOTICE:
Tbb permit doss not cover the construction, humileflon for wlrh & plumbing, gas heating, sewer or water. Be sura to as
the Building kgmftr for separate permits for these hem
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER t 5 NAME .,0e,sd/ z.,9 BUILDER W�- C,
ADDRESS_C716 /,�E s � �®`� y.L/�/<< ®�z_ ADDRESS :Z�,, ti/� C-5- �`
LOCATION OF BUILDING
Part of Lot
LOT )LOCK ADDITION OR SUBDIVISION
Corner Lot Inside LOT Setback Side -Yard .
..SEWER ELEVATION FOUNDATI0N ELEVATI0N.
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*
6-P4///C7
/IC 5 j�/z 5 l®s��si %sem �i49z90%)
Front Depth Height
Sq. Ft.
Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Coste^
To be completed
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.
DATA_ /9'l' S— SIGNATUREof
_
(Schedule of Fee Costs can be found on the Reverse Side).
Y
SECTION 2. The Inspector of Buildings shall, before issuing any permit for the
erection of any building or structure, or for any addition to any existing build-
ing or structure, or for any alterations or repairs to any existing building or
structure, upon application therefore, require the payment by the applicant for
such permit of fees to the amount herein below set forth and in the.manner'hereiu..
provided to -wit;
2.1. For any such permit for the erection of any fire -proof building,
other than a garage, warehouse, factory or grain elevator, or for the erection
of any fire -proof addition,..for similar occupancy, to any existing building,
shall be at the rate of $1.40 for each one thousand cubic feet, or fraction
thereof, in such cubical contents.
2.2. For any such permit for the erection of any fire -proof garage,
Warehouse, factory or grain elevator, or for the erection of any fire -proof
addition, for similar occupancy, to any existing building shall be at the rate
of $1.25 for.each one thousand cubic feet, classified as "fireproof" by
Section 502 of the Minneapolis Building Code.
HOUSES
2.3. For any such permit for the erection of any non -fireproof building,
other than a garage, warehouse, factory or grain elevator, or any non -fireproof
addition, for similar occupancy, to any existing building - permit $1.00 for each
one thousand cubic feet.
GARAGES
2, 4. For any such permit for the erection of any non -fireproof garage,
warehouse, factory or grain elevator, or for the erection of any non -fireproof
addition, for similar occupancy, to any existing building or for each such
building or addition - ninety cents ($0.90) for each one thousand cubic feet
or fraction thereof, in the cubical contents thereof with the minimum of $4.00.
For the purpose of computing fees for building permits, the cubical contents
of any building or addition to.a uniform height throughout by multiplying the
ground area covered from a point six (6) inches below the floor line of the
basement or cellar to the average height of the upper surface or to the average
height of the roof surface of the main gable of a pitched roof.
2 5: For repairs or alterations to an existing structure, the fee shall
be at the rate of $3.00 per.each Five Hundred Dollars ($500.00) or fraction
thereof in the cost of all proposed work.
2-6, In no case shall -the fee charged for any permit as set forth in
Section 2 be less than $4.00.
a
PERMIT for Power Plants and Heating.
Cool-
ing. Ventilation. Refrigeration and Air Pa-mit
N° 4764
Conditioning Systems and Devices p
DESCRIPTION OF WORK
No. of / Heating Plants L U 0—LL! to be installed--altered—repaired
Make �,E. c 1, x� C� y'l� , Size Alp
Oil fired—,- Coal fired ; Gas fired ; Gas Authorization No.
Approved
Final Inspection Date , 19_
Inspector
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn. /6 , 1920
Owner
Locat' Q/Co Uk&b Yh Os o , Ln1
Kind of Building
How Occupied�-
Work to be Commenced—,19—
To
ommenced ,19_
To be Completed (q1 1,0 ® ,191
Estimated Cost, $ -
Ld- r few, Building Permit No.
Permission is hereby granted to ° to install– erect—use the material and devices described in the
above statement. This permit is granted upon the express condition that the person to1whom, it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the operation of the devices herein ntioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set Aorth in the approved application for this
permit on fele in the office o f the Inspector of Buildings. 0 �
_ ���, Inspector of Buildings
aQW42 2M11 -67V
App5cafto for Power Pkmb and HewhM Cooling, Venhilafte, ReM9amfto cmd
Air Conditioning Systems And Devices
PARTIAL RATE SCHEDULE '
GRAVITY WARY! AIR:
RATE TOTAL
Furnace Shell & Duct Work .........:.................
$10.00 $
Replacement of Pinnace .....I .......................
6.00 $
Repairs & Alterations—up to $500.00 ............'
6.00 $
Repairs & Alterations each add. $500.00 ...............
3.00 $
CH. WARM AM
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $
each add. 60,000 BTU ....................... 3.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 ................. 6.00 $
Repairs & Alterations each add. $500.00 .............. 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... . $10.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 10.00 $
Each add. 200 sq. fi. EDIT Steam ...................... 3.00 ' $
Each add. 320 sq. ft. IDR Hot Water ..... ............ 3.00 $
OIL BURNER --to 3 gal. per hour ..... ' ....... 6.00 $
over 3 gal. per hour-ASee Fee Schedule
GAS BURNER (up to 188,000 BTU) .......:...... '.. 8.00 $
over 189,000 BTU See_ Fee .Schedule ;
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures x$ 200 $
Additional Fixtures 'a .78 $
Gas Range to 199,000 ........... x$`&W $
AM CONDITIONIIfG�`
FAN BEATING SYSTEM See Fee Seh�dab
VENTILATING SYSTEM $ _��T
ALTERATIONS & REPAIRS TOTAL FEE $ �
Lq 2/-7/
Dept. of BldgL Phone 560-3480
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinancft
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
I& —
Owner W-421-7vr'
Kind of Building
Used as _.
To be completed about
Estimated Cost, $
Ol 1 New. Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—N
Trade Name Size No
Capacity Sq. Ft. E.D R- BTU H.P.
Total Connected Load Kind of Fuel
BURNER — Trade Name Size-
Capacity Sq. Ft. FxD.R BTU H.P.
(REMARKS -OYER)
Rm asaxe',�'b . va- rlas P.ZV�a?om a ,r,n
Aid" o
GRAVrrY WARN Awls
RATZ
TOTAL .
mace Shell & Duet Work
. $l0.00
$
Replacement of Foram
6.00
$__
Repairs & Alterations --up to $500.00
6.00
$
Repairs & Alterations each add. 9500.00
3W
�
BMCDL WAS AIM
Furnace Shell & Duct Work to 120,000 BTU
..$10.00
each saki. eO.Wo BTU .. ......
3.W
Replacement of Furnace
&00
3-1,
R paiira & Alterations --up to $500.00
6.00
$
Repairs & Alterations each add. $300.00
3.00
$
Furnace Shell & Lines—to 400 sq. ft. FMR Steam $10.00 $
Furnace Shell & Line --to 640 sq. ft. EDR Hot Water 10.00 $,
Each add. 200 sq. ft, EDR Steam
Each add. 320 sq. ft. EDR Hot Water 3,00
OIL BURi'Z M—to 3 gaL per hour 6.00 g i�
over 3 gal. per hour—fie Fee Schedule
0
GAS BU (up to MA0 BTU) 5X0 $
wmr 199,0M BM Sas Fee Schedule
GAS F11MNG FEES., NO RATA TOTAL
1st 3 Fixtures 7,00
Additional Fixtinw x .75 $_T
Gas Range tb up= 600. $
State Surcharge .50
Fee
TOTAL
D*Pt. of Slaw.MOMgo
City of Fxddley:
The undersigned hereby makes application for a permit for the crork herein:
specified. agreeing to do all work in strict accordance with the City Ordlxiarictm:
and ruling of the Department of Buildings, and hereby declares that all the fac.L,
and representations stated in this application are true and coact.
Fridley, Pian—jq
In a _ I
Owner
Kind of Building
Used as r rTQ J
To be completed about.._�G
Estimated Cost; $
` !d New. Building Permit No. _—_ Permit No.
DZECRUT1017 or WORM
HFUTING or P0 PIANTS—Ste-am, Hot Water� NO--
,
Trade Narfie— size
apacity—,- Ft &D.R
Total Connected Lwd of Fuel---
�—
BURNER -- Trade No glo
Capaci Sq. n Z.D.R _ I mpt
PMTECT: Shoreland Improvement Plan for riprap
of residential lot riparian Moore Lake, Fridley
Permit Application No. 85-53
Date May 24,, 1985
Applicar e Donald C. SAvelkoul
1 t l o (ji Moor c k' (r,
RICE CREEK WATERSHED DISTRICT
NOTICE OP PERMIT APPLICATION STATUS
At their meeting on May 22, 1985 the Board of Managers of
the Rice Creek Watershed District took the following action on your
permit application:
❑Denied
®Tabled
(_]Tabled with authorization for administrative action
®Pending receipt of ;
1. Lot Plan showing location of proposed riprap.
2. Detail of proposed riprap including location of Ordinary High Water Level.
r
If you have any questions, please call 483-0634
9
1�
cc: City of Fri dley ,
E.A. Hickok & Associates
RCWD File
Bonnie Torpe
Administrative Assistant
FORM Ell -78
RICE CREEK WATERSHED DISTRICT
SUITE 177, ARDEN PLAZA
3585 NORTH LEXINGTON AVENU
ARDEN HILLS, MINNESOTA x112
CC C,1, i4 k416
r: c_w D .
(For Ottice u
PERMIT APPLICATIO �0.
Rec' d Office �`f 6 98K��
Notice Sent -tom-
8
Agenda S-2 Z
Administrative Fee
PERMIT APPLICATION
To be completed by the applicant
Owner:
Address: q!4 41f- �4o�•fvL�l� R'
city: r ---A r t,M "'i -
zip code
Permit Application for Approval of:
se Only)
SS -s3
Rec'd Engr.
✓,
Date : 13
Telephone No.:
Sig tan ure'6f Owner
[� Comprehensive Stormwater
Management Plan
Land Development Plan
Final Site Drainage Plan
Use and/or Appropriation
of Public Waters
Bridge and/or Culvert Construction
Wetland Alteration
Shoreland (Riparian) Improvement
S t
Remarks:
-w Q. A RAP s .4 0P- Aai
Private Drainage ys em
Individual Sewage Treatment System C -PI �p 2
Other (explain in remarks) /1 A� �- w -v
Name of Project: A ! A'�e ✓F
Purpose of Project: ^
Location of Project -Address:
Municipality or Township: IFti i �PiY
1/4 of Section Township Range
Call 483-0634 if assistance in completing this form is required. Please
attach drawings, plans and other data as outlined in "Rice Creek Watershed
District Permit Information Brochure, available upon request:' Mail or
deliver this form along with a $10.00 administrative fee and appropriate
exhibits to the above address.
"A field inspection fee on this permit shall be charged to cover actual cost
related to a field inspection including the investigation of the area
affected by the proposed activity, analysis of the proposed activity,
services of a consultant and in addition, a fee will be charged for any
required subsequent monitoring of the proposed activity." M.S.A. 112.88,
Subd. 2. Applying for this permit to RCWD does.not preclude your applying
for any necessary permits that may be required from other governmental
agencies.
Revised 2/2/9
AS -78
SUBJECT
PERMIT
City of Fridley
42 18 5 23
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
REC
------- COMMUNITY DEVELOPMENT DIV.
1 PROTECTIVE INSPECTION SEC.
r i
1 �
S "t CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
' 612-571-3450
910-F15
6/27/86
JOB ADDRESS 916 West Moore Lake Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
3
Moore Lake Highlands
SHEET
2 PROPERTY OWNER MAILADDRESS
ZIP PHONE
Don Savelkoul 916 West Moore Lake Drive
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Barkley Construction 1111 -24th Avenue N.E., Mpls. 55418 789-5633
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 Ij ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Cover Soffits
9 CHANGEOFUSEFROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
ISTALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,100
$.55
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-
$19.00
STRUCTION OR THE Pp9FORM NCE OF CONSTRUCTION.
LAN CHECK FEE
TOTAL FEE
$19.55
SIGNATURE OF CONTRACTOR OR AUTHORIZED AC NT IDATEI
WHEN PROPERLYL
ATED THIS IS YOUR PERMIT
•
!%
BLDG INSP
27 v
.CJfa
GATE
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI
NEW [ ]
ADDN. [ ]
ALTER. [ ]
Construction Addre
Legal Description:
Owner Name & Adm
Contractor:
Address:
City of Fridley
�R-1 AND R-2
Building Permit Application
k
Effective 4/1/86
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width __ Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft. _
OTHER: _-o I) /t J7, -F—" i
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback __ Side Yard Setback
Type of Construction: Estimated Cost: $ //60
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation
DATE: APPLICANT: Tel.
CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$475 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
Effective Date January 1, 1991
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT /�^
U Water
u d
a Job Address 0� t v�� ® aRt
RATE SCHEDULE
qg�
RATE TOTAL
N
a
7.00 - $
q
$
4.00 - $
Beer Dispenser
$
5.00 - $
Blow Off Basin
S
7.00 - $
%
.ei
F
m
$
E;
a
e
7.00 a $
y
V s,
aa',
1
�
7.00 - $
Neater
$
10.00 - $
Gas Range
$
10.00 - $
Gas Dryer
$
10.00 - $
Back Flow Preventer Required ( ) Yes
( )•
No
Type
$
�
m
a
u
m
�3
r3
7i
c3
lec
let
2nd
3rd
4th
(R) - Future Connection Opening
Connected with Sewer
(*) - New Fixture, Old Opening
Water
RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE TOTAL
New Fixtures
$
7.00 - $
Old Opening, New Fixture
$
4.00 - $
Beer Dispenser
$
5.00 - $
Blow Off Basin
S
7.00 - $
Catch Basin
$
7.00 = S
Rain Water Leader
$
7.00 - $
Bump/Receiving Tank
S
7.00 a $
Water Treating Appliance
$
10.00 - $
Water Heater - Electric
$
7.00 - $
Water Heater - Gas
$
10.00 - $
Gas Range
$
10.00 - $
Gas Dryer
$
10.00 - $
Back Flow Preventer Required ( ) Yes
( )•
No
Type
$
5.00 - $
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
It of Value of Fixture or Appliance $
S .
REIN5PECTION FEE $30.00 State Surcharge So
TOTAL FEE $
Building Inspection Div. 6431 University Ave NE
Tel. No. 572-3604 Fridley MN 55432
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
go ! /� . 19-2/ IL
OWNER
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT /ydV
ESTIMATED OAST Ree f
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company .1 F -L- ` 4r- a,�_�i/4-ti- 5(�
Signed By r
Tel. No. v - -T-?4 9
ROUGH INSP.
Date
FINAL INSP. s V - Cl -Z-
Date Date
APPROVAL FOR PERMIT
L12F� Mo+ -c y -I®1'1-
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT I8 $15.00
PLUS THE $.50 STATE SURCHARGE
0®
Effective On May 10 1999
;,ITY OF FRIDLEY INSPECTION DIVISION
5431 University Ave NE
=ridley, MN 55432 APPLICATION "FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
372.3604 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 IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
JOB ADDRESS—!
1�'19U2-,
"Air Conditioners can not be placed in a side yard without Approved By A0 Rough -In Date Final Date
written permission from adjoining property owner. � / Uf a
� � /a ���� _ �n4 6LZj96� FILL. OUT BACK SIDE FCS STACK VERIFICATION ON REPLACEMENT FURNACE
OWNER
TOTAL
►
BUILDING USED AS
ESTIMATED COST ' �" PERMIT NO. 1 �
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heatin UnitsCircle One (Steam) (Hot WateAir
Trade Size No. J6PL 6Ear�m-�
$
acme _k_K
$
BTU HP EDR
Fuel ClQ`� tAr CSS Total Connected Load
J
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 ar
$ .59
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
- INC.
$ AJC
RMIMAROLK"
261 AN" BOULEV
RAPIDS, M�1 5!5433
12 757x040
:EATING
ed- �:
"Air Conditioners can not be placed in a side yard without Approved By A0 Rough -In Date Final Date
written permission from adjoining property owner. � / Uf a
� � /a ���� _ �n4 6LZj96� FILL. OUT BACK SIDE FCS STACK VERIFICATION ON REPLACEMENT FURNACE
CEMMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes 0 No .( )
List ALTEMUONS-Being Done: "
to6r
DEPENDABLE INDOORAIRGUAUTYr INC.
2619 COON RAPIDS BOLN"ARD
COON RAPIDW.iM 55433_
HEATING CO: (612) 757-5*
Signed By:
Date:
0
'2.
Is free from rust or deterioration
Yes K).. No
( )
3.
Has no foreign objects lodged within
Yes O No
r1®1'1_
4.
Is securely supported
Yes _.No
5.
Meets all current Code requirements for size
and total BTU's connected
Yes. No
( )
6
Has total heating BTU's of / , ®C9
All other BTU's_ �o
TOTAL BTU's
7.
Has a liner been provided for water heater
Yes No
( )
8.
Has combustion air been provided for water heater
Yes Q� . No
( )
Remarks:.
List ALTEMUONS-Being Done: "
to6r
DEPENDABLE INDOORAIRGUAUTYr INC.
2619 COON RAPIDS BOLN"ARD
COON RAPIDW.iM 55433_
HEATING CO: (612) 757-5*
Signed By:
Date:
0
916 W. Moore Lake Drive
Fridley MN 55432
April 24, 2002
Northern States Power Company
PO Box 59
Minneapolis MN 55440-0059
Qwest
PO Box 9351
Minneapolis AST 55440-9351
Dear Sir•or Ms:
I live at 916 W. Moore Lake Drive in the City of Fridley.
The pole which supports power and telephone lines in
my backyard close to Moore Lake is "listing" quite a bit.
You might want to check it out before it falls, and
causes some damage.
Very truly yours,
Donald C. Savelkoul
DCS/jcb
c: City of Fridley
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: `� � � Ua juloore, Lake__ V /) 0
Legal Description:
Owner Name & Address:�!� •Tel. # - 71 - 3(0 7
ContractorTLIA0 SUArODMS MN LICENSE # Z b 3 z I g 7
Address: Ny) sl®rn Nut, llwwood n • 5 117 Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
111ntic: APPA. Length ]5.3- Width S Height Sq. Ft. 0"��--�
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type:) sQ..( son Su,U om Ali A 1.110 -Estimated Cost: $ 2_ J , ®00
Driveway Curb Cut Width Needed:+ 6 Ft = F $ _ $
DATE: ��U J APPLICANT: S 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
-.2-2 -1-4 133
TOTAL $ 7o 3f—_-
CITY USE ONLY -
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 [ ]
Footing and Bell Size
Per R401.4.1 International Building Code
Load Bearing Pressure
Per SQFT
Footing Size
1500
2000
3000
Diameter SOFT
Load
Load
Load
10" 0.554
818
1090
1636
12" 0.785
1177
1570
2355
14" 1.068
1603
2137
3206
16" 1.396
2094
2792
4188
18" 1.767
2650
3533
5300
20" 2.181
3271
4362
6543
22" 2.639
3959
5278
7917
24" 3.141
4711
6282
9432
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Building
BUILDING
Permit No. - S
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572=3--604
CITY OF FRIDLEY
DEMUR 200'
Ld - ~ J
DATE C
SITE ADDRESS (U
YOUR E-MAIL ADDRESS
C7 f [C e
THIS APPLICANT IS:
❑ OWNER J*ONTRACTOR
PROPERTY OWNER/
NAME: rj 5 0-11—
TENANT
ADDRESS: Ot ( CQ I e i CITY --%
STATl IP Scfj 2
PHONE: 7 QQ 3 ( —7
CONTRACTOR
NAME: v
STATE LICENSE # a 0LA 93aSo EXP DATE 3 Q
SUBMIT A COPY OF
p
^, ((� (Q U� %�-
UZIP 63I3OZ
YOUR STATE LICENSE
ADDRESS: I<S -{1 v► !� CITY
r( STATI
WITH APPLICATION
PHONE -703 -(Q -7Q- FAX S i (
PROPERTY TYPE
RSINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS
❑ BASEMENT FINISH R ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER .
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
°Ia MAINTENANCE/REPAIR ❑ REMODELING
rr
DESCRIBE WORK BEING DONE: +'P o'. rr O C - G -' r�-e r () 0 T
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING❑ HOUSE ONLY
NUMBER OF SQUARES as, HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
2•
Existing Floor Plan
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
[]Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other .
❑ Fascia
and proposed project.
WINDOWS
2.
Two sets of construction plans
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
3.
Energy Calculations
OR FOR NEW OPENINGS -DESCRIBE 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 MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ 3, � �9 OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
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
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1675 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks Davable 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 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 vAich requires rr6evjiew/ and of plans. n r j J J� ,, _ /
SIGNATURE OF APPLICANT lnn�1 I� • �J \ PRINT NAME +" 1 Yi^-F t/li°C' KJ'�l� DATE �-