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PRE 2010 DOCSCity of Fridley Application for Ph mbing and Gas Fitting P@rndt Dept. of Bldgs. Phone SU 4 - DESCRIPTION OF WORK (�/y Number. Kind and Location of Fixtures Locaiio PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 Future Fixture Opening ................ x 1.20 $niZc New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... Z x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE let 3 Fixtures ..........................i x $1.50 /TOTAL $� d Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ ZbJ R ; N WATER HTR. GAS ELEG o� O Base 1st 1 2nd _ 3rd 4th Future Connection Openings Connected withI Sewer � New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 Future Fixture Opening ................ x 1.20 $niZc New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... Z x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE let 3 Fixtures ..........................i x $1.50 /TOTAL $� d Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE �® City of Fridley: The undersigned hereby .makes application for a permit for the work hereu specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application re true and correct. ��Q� Fridley, Minn S 19 � Owner 4 - 9 Kind of Building Used as To be completed about Estimated Cost, $ OldNew ding Permit ROUGH FINAL S' / C) (0 1 0-01100- 2311=1 O Pei ne r By Business Phone No. PERMIT for Power Plants and Heating. Cool- ing, Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of Z Heating Plants to be installed-altered—repaired Make , Size la h / -/06) ; Oil fired—,- Coal fired Gas fired—Z—; Gas Authorization No. Remarks Approved Final Inspection 19_, Inspector Permit No Fee $ 11,60 Office of the Inspector of Buildings City of Fridley City of Fridley, Minn., 9, 19-2o Owner�cc Location � Kind of Building= /= � � � , How Occupied Work to be Commenced—,19— Approved ommenced ,19_ To be Completed—, 19— Estimated Cost, $ 40106-0 Oew? Building Permit No. Permission is hereby grantedto to install---erect—use the material and devices described in the above statement. This permit is granted upon the express condition that the person to whom 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 mentioned shall conform in all respects tot 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 sett forth the approved application for this permit on file in the office of the Inspector of Buildings. / /) of Buildings .41W42 2M1147V City of Fridley Application for PhnWing and Gs n F'itti'ng Permit 53-84-s915.51 Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location_ 6 5W®Od� ,''axle PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: ii®_ RATE TOTAL Xy x $2:00 i;_ Z Future Fixture Opening ................ Z Z O W Z t O i ` N WATER HTR. GAS ELEG Base Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg. ............ x $gam $ Electric Water Heater x $2.00 $ __ GAS FITTING FEES: NO. RATE TOTALv 1st 3 Fixtures .......................... 1 x $2.00 $ 2®00 1st x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ 2nd 3rd 4th ' Future Connection Openings I New Fixture, Old Openings I I Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: ii®_ RATE TOTAL Number Fixtures ...................... x $2:00 i;_ Future Fixture Opening ................ x $1.50 $ - New Fixture Old Opening .............. x $1.50 $ Catch Basin ..... ...................... x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg. ............ x $gam $ Electric Water Heater x $2.00 $ __ GAS FITTING FEES: NO. RATE TOTALv 1st 3 Fixtures .......................... 1 x $2.00 $ 2®00 Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ......... . install . (1�.. g$S..gr ........$ 3.00 TOTAL FEE $ 5.00 City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn_ NoV, 199 1970 19_ Owner Edward H0r4mann Kind of Building f raine Used as residence To be completed about Nov. 24s 1.970 Estimated Cost, $ 10.00 Old -New. Building Perms PermitNO.__�� BYE Business P1 ROUGH d2 $pHsWELL DRILLING FOR FOUR GENERATIONS ■ ■ 15588 JARVIS STREET N.W./ELK RIVER, MN 55330/(612)427-6100 INCORPORATED Date: 2-10-1988 MINNESOTA DEPARTMENT OF HEALTH DIAGRAM: 717 SE DELAWARE STREET ---� DIVISION OF ENVIRONMENTAL HEALTH MINNEAPOLIS, MINNESOTA 55440 ATTN: Mr Jim Nye (612) 623-5339 SUBJECT: WELL ABANDONMENT RE: NOTIFICATION Dear Mr Nye, This letter is to notify you of a water well in your district that should be sealed according to the Water Well Construction Code MCAR §4725.2500-2900. E.H. RENNER & SONS, INC has been notified by the owner of this property or an interested party and have subsequently submitted to them an estimate for the sealing of this well under our LICENSE #71015. We have also included a copy of the current code with our estimate. In submitting our estimate, the owner may also receive additional estimates and hire any number of Minnesota licensed water well contractors in the area to seal this well. However, there is a possibility that this well may not be properly sealed and thus jeopardize the ground water and Public Health. E.H. RENNER & SONS, INC. wishes to provide you this information for future reference with 0e abandonment report when submitted. PROPERTY OVER: ADDRESS: Or LOCATION: PHONE # &7-1,t1526 DATE 2-1p-19Rs WELL DIA. 3-4" DEPTH: IjK Sincerely Submitted, Raymond T. Renner, V -President E.H. RENNER & SONS, INCORPORATED STATE LICENSE #71015 n/ cc: QffY OF FRIDLEY 6431 UNVER.SI`I'Y AVE. N.E. FRIDLEY, MN 55432 ATTN: DARR,EL CLARK FIIONE:574-3450 STATE OF MINNESOTA DEPARTMENT OF HMTH I LOCATION OF WTm WATER WELL RECORD AUNNESOTA I WELL NO. WATER County Name ANOKA A/irvaelr SLhW 1511A.01,08UNlpUt wows ABANDONMENT o+'nship Namr. owtnhip Number Range Number Section No. Franiat t. WELL DEPTH (completd► to osn none FRIDLEY 30 24 or 13 SW 'ASW "SEA 125 ft. FEB. 26th, 198 D,suner and rrncttonsfrornRb"—_Iht neciiouwr-'•S4rt Addr�eas_ and City of Well Location S. DRILLING METHOD 610 5 WOODY LANE I�Cable tool 4° Raenr 7o Drive" IM Dug 20 Hollow rod 50 Air 80 Bored 110 rua twin' we I in union grid with I. • _-�. , . ..,_ blunch map well tion. - �. N N Addition Name 41 •�- ,- • ; 1 - 30 Rotary 601elled 90 Power Aum W . • s • _ i _ .� •Block umber � t � E 6. DRILLING FLUID NOT APPLICABLE 7. USE I)�Domeatic 40 Monitoring 80 Heat Pump umber 20 Irrigation SO Public 90 Industry 30 Test Well 60 Municipal 100 Commercial 70 Air Conditioning 1 IO S. CASING HEIGHT: Above HOLE DIAM. 2. PROPERTY OWNER'S NAME I�Btack t�jThreaded 5 TIM FAHS Surface rt. Address 6105 WOODY LANE 20 Galv. SO Welded Drive Shod YnA No_, FRIDLEY, MN. 55432 3OPp,tic 60 4 1211? Weigltl 10.7'( q .,Ft• in. to into in. to ft. Weight IbsAt. in. to ft. Weight Ib41. --Jt. in. Io ft. in. Io ft. 3. FORMATION LOG COLOR FORMATION SS N FROM TO FINE SAND BROWN 0. 48 9. SCREEN or often hob YES from It. to fl. Make CLAY RED 48 136 Type UNKNOWN' Dia UK UR [.,`I$FITTINGS: SAND & STONES RED 1361200 Slot/Gaurr .. Set betwern UR fl.and UR ft. CLAY & GRAVEL YELLOW 200 224 10. STA TER LEVE � � 2-26-88 h• )(below 0above Date Measured �- land surface 11. PUMPING LEVEL (below land surface) SANDSTONE GREEN 224 383 NOT PUMPED f, after bra pumping 8.p•m: fl. after hrL pumping g.p.m. SHAKOPPEE RUST 383 393 12 HEAD WELL COMPLETION UNKNOWN 10 Pitless adapter. manufacturer madrl $( Basement offset 30 At least tot•• above ground 40 Plastic Lysing protect E: b 1988 WELL GROUTED? yt3. ETYss 0 No tCXu1 cement 20 Bentonite 30 7 BAGS PORTLAND 125?„ SURFC.� croulmaterial Ira,,, NEAT ` GROUT According to M f ►d• NEAREST SOURCES OF POSSIBLE CONTAMINATION 25 (act We ,ion city type Well disinfected upon completion? 9Yes 0 No sewer 1S. PUMP REMOVED & G E ON ARRIVAL Date installed 2-26-88 0 Not installed Manufacturer's name UNKNOWN UK HP UK Vol,, UK Model number Length of drop pipe UK ft. capacity UK g.p.m. Material of drop pia UK Type: 10 Submersible 30 L.S. Turbine 50 Reciprocating 201et 40 Centrifugal 60 16. EXISTING WELLS THE WATER LEVEL F OM THE #OVE AS: 140' unused writ an property? 9Yes 0 No One 0 Use a sare.d shm. if dtd Abandoned Permanent 0 Temporary O Not sealed 17. REMARKS, ELEVATION. SOURCE OF DATA, etc. THE ABOVE GEOLOGY WAS TAKEN FROM: 18. WATER WELL CONTRACTORS CERTIFICATION CECIL JAMES WELL AT • This well wu drilled under my jurisdiction and this report is true to the best of my 1741 GARDENIA DRIVE knowledge and belief' WELL DRILLED IN 1947 E. RENNER ba.—SONS, INC. 71015 ' 'vas bkour No. 156 V• S. 1S.r °�" Address iJ E R VgR, MN. 55330 4276100 Signed Authorized Representative KEVIN HOPPE Darr 7-26-8i Name of Driller Snot JOY �] W01\ COPY 7n6 ]OM 7/76 lase nK HE -01206.02 (Rev. 10/85) =/82 t04 a County Name A Town.hip Name nahip Number Range Num ow FRIDLEY 30 24 Distance rad Direction Iron Road Interaction or Street Address and Cit, 6106'WOODY LANE .......Show ease kcatxn of well in section urid with "X .• 2. PROPERTY OWNI r Addition Name L- t lock Number - 1- ET Lent umber 0 .4 '1 STATE —r - OF MINNESOTA DEPARTMENT OF HEALTH WATER WELL RECORD MINNESOTA UNIQUE WELL NO. Miaw.afs 54frYs 156A.0148 Iw Wde► Somok Section No. Fraction t. WELL DEPTH (completed) 13 SW D5W SASE 1 100 N Srncn map a a mmcatram. I r� 7 re TIM FAHS Address 6105 WOODY LANE FRIDLEY, MN. 55432 1. FORMATION LOG COLOR FORMATION S Ol CLAY FROM TO CLAY BROWN 0 10 FINE SAND (LIGHT 1 110 178 HARD PAN & CLAY BROWN SAND & CLAY BROWN ST. PETER SANDST. RUST SHAROPPEE I -- THIS SEEMINGLY D Y WELL TO HAVE CASCADING WATER WELL TO HAVE THE WATER LEVEL Ute O THE .......M .«dTHE ABANDONMENT ft. IFEB.26th, 1988 10 Cable tool 40 Reverse 70 Driven 100 Dug 20 Hotlowr rod SO Air 80 Bored 110 70 Rotary 60jetted 90Power,auger NOT 106ornestic 40 Monitoring 80 Hat Pump 20 Irrigation 50 Public 90 Industry 70 Tat Well 60 Municipd 100 Commercial 70 Air Conditioning tic) 1. CASING HOLE DIAM. HEIGHT: Above® I�Blaek OThraded 5 Surface It. 20 Galy. 50 Welded Drive Shad Y Ne_ M Plastic 60 3 in. 1e 9 7 It. weight 7.5 7 C?bL/ft. in. la�Jt. in. to ft. weight lbs./Ft. in. to ---Jt. in. to ft. Weight Ib"t. Iin. to it. 9. SCREEN or "en hole YES from It. to. ft. Make UNxNOWN Dis nx Tye Slot/G.u. 77K lengt IN r7� Set between UR it. and K it. 165 185 --...bRY__.fl krbelow 0above Date Measured. 2-26-88 la surface 11. PUMPING LEVEL (below lard surface) 185 226 ft. ,pier NOT hra. pumping PUMPED g.p.m. ft. after hra. pumping g.p•m. 226 247 12. HEAD WELL COMPLETION JET ADAPTED 10 Pitless adapter. manufacturer t 247 2 6 7 Basement than 30 At Want 12" above ground Plastic wing protection 11 WELL GROUTED? Yee O No (Chat Cement 213 Bentonite 90 4 BAGS Grout material PORTLAND from 10 Ow SU )KA98 NEAT GROUT 11. NEAREST SOURCES OF POSSIBLE CONTAMINATION _29 lam mel-nbeetion rTTV SFWKR Well disinfested upon completion? NY. ON. 15. PUMP REMOVED & GONE ON ARRIVAL H Date installed 2-26-88 O Not installed Mmu(aaurer's name UNKNOWN ELL A Model number UR HP UK Volts A G-00 length of drop pipe UK it. capacity UK 9 - p.m -Material of drop pipe 171K Type: 10 Submersible 30 L.S. Turbine 50 Reciprocating 20 jet 10 Centrifugal 60 16. EXISTING WELLS 7 ` ALS: 1441 Unused well an properly? #Yes O No &Ye Abandoned Permanent O Temporary O Na sealed 17. REMARKS. ELEVATION. SOURCE OF DATA. eta. THE ABOVE GEOLOGY WAS TAKEN FROM: 18• WATER WELL CONTRACTORS CERTIFICATION C.S. LILLEMOEN WELL AT: This sued) suss drilled under my jurisdiction and this report is true to the brat of my 1583 Gardenia Drive knowledge and bend. Well drilled in 1947 A 5" well E.H. RENNER & SONS, INC. 71015 Lin oter BoWnnr Newr Lfterar No. Addreaa 15688 JARVIS ST. NW. EUER, Mi+�. 330 427-6100 Signed Vl�+p Dar• Auth Rorpm Motto - t D;t came car Driller WORK COPY a ""' r772 HE -012116-02 (Ra. 10/85) 2192 IOU tgaA el 46n` ST OF WATER WELL ABANDONMENTS FOR ANOKA COUNTY LISTED BY CITY THEN NUMERICALLY BY ADDRESS FOR THE CITY OF *** FRIDLEY *** 6431 UNIVERSITY AVE. NE. B.I. MR. DARREL CLARK & MR. DON 1ARRIGAN 574-3450 NO PERMIT FEE OR INSPECTION DRILLER SIZE OWNER -CONTRACTOR SITE ADDRESS %,21 �/•J DATE SEALED TORGERSON 1k BORDEN 260 Longfellow -St. Jan. 88 E.H. RENNER 2 SHARON ANDERSON 380 Longfellow St. May. 86 MORK 3 ANOKA CO. COMM. ACTION 400 Osbornf.Rd. Sep. 87 MORK 3 ANOKA CO. COMM. ACTION 401 -76th Ave. NE. Sep. 87 A -WELL 4 ELLEN KARI 511 Ironton St. NE. Mar. 88 E.H. RENNER 2 FRIDLEY SCH. DIST #14 611 Mississippi St. Sep. 87 E.H. RENNER 1k HARLIN & MAXINE SUND 776 -63rd Ave. NE. Sep. 87 TORGERSON 3 Robert Knudson 1322 Hillcrest Dr. Jul. 88 E.H. RENNER 1k LOIS HLAVINKA 1500 Osborne Rd. Apr. 88 E.H. RENNER 1k LOIS HLAVINKA 1500 Osborne Rd. Apr. 88 E.H. RENNER 2 ONAN CORP 1600 -71st Ave. NE. Jul. 88 E.H. RENNER 2 ONAN CORP 1600 -71st Ave. NE. Jul. 88 E.H. RENNER 3 JERRY McKNIGHT 4607 -2nd St. NE. Nov. 87 E.H. RENNER 3 SYLVIA McGUIRE 5928 Oakwood Ave. Sep. 87 E.H. RENNER 1k SYLVIA McGUIRE 5928 Oakwood Ave. Sep. 87 E.H. RENNER 3 BINCKNER BUILDERS 5980 Stinson Blvd. Apr. 88 E.H. RENNER 3 TIM FANS ,,,06105 Woody Lane �- Feb. 88 E.H. RENNER 4 TIM FAHS 6105 Woody Lane Feb. 88 DON STODOLA .4 ENEBECK CONSTRUCTION 6222 Old i Rd. Aug. 88 MORK 2 CLARENCE GRAVES 6229 Sunrise Drive Oct. 87 LUDWIG 2 CARL CHRISTENSEN 6509 East River Rd. Jun. 88 E "- RENNER lk ANOKA COUNTY PARKS DEPT. 6666 East River Rd. Jul. 88 E RENNER lk RICK MALACHEK E._. REN HER, 1t BOISE CASCADE CORP/BARB E.H. RENNER 14 BOISE CASCADE CORP/BARR E.H. RENNER 1% BOISE CASCADE CORP/BARB E.H. RENNER It BOISE CASCADE CORP/BARB E.H. RENNER lk BOISE CASCADE CORP/BARB E.H. RENNER lij BOISE CASCADE CORP/BARB E.H. RENNER 1% BOISE CASCADE CORP/BARR E.H. RENNER 1k BOISE CASCADE CORP/BARR E.H. RENNER 1% BOISE CASCADE CORP/BARB E.H. RENNER 1k BOISE CASCADE CORP/BARB (10 WELLS..FP7, FP10, FP18, FP11, FP13, FP9, [ALL OF THE ABOVE 10 WELLS FOR NATIONAL POLE E.H. RENNER 1k JAMES L. SCHLEY A -WELL 2 JIM HAM ANOKA/018 END NOVEMBER 16th, 1988 NUMBER OF WELLS SEALED IN THIS CITY TO DATE: 2 7136 East River Rd. Aug. 87 7300 Block & Old Central Aug. 84 7300 Block & Old Central Aug. 84 7300 Block & Old Central Aug. 84 7300 Block & Old Central Aug. 84 7300 Block & Old Central Aug. 84 7300 Block & Old Central Aug. 84 7300 Block & Old Central Aug. 84 7300 Block & Old Central Aug. 84 7300 Block & Old Central Aug. 84 7300 Block & Old Central Aug. 84 FP1, FP8, FM8, FP3 Less Than 30') & TREATING SITE/MEDTRONICS SITE] 7512 East River Road Sep. 87 7551 Alden Way NE. Jun. 88 35 Building MECHANICAL Permit No.:, Inspections RESIDENTIAL APPLICATION Received ByW_l 763-572-3604 � R��'�: CI'T'Y 763-502-4977 FAX EFFECTIVE 2-19-09 DATE 5- .. / YOUR E-1vIAIL ADDRESS SITE ADDRESS . THIS APPLICANT IS: &ONAINER CONTRACTOR PROPERTY NAME: 1 OWNER/ ADDRESS: Q 10.q IM ddi . it. CITY h6diev STATEAW01—p: A TENANT PHONE: z6 JJ CONTRACTOR COMPANY NAME: Sharp Heating & A.C. CONTACT PERSON: Floyd Joswick SUBMIT A COPY OF STATE LICENSE # EXP DATE YOUR STATE LICENSE WITH ADDRES9221 University Ave N E ciTYFridley STATE MNZiP55432 APPLICATION PHONE 763-572-0459 FAx763-572-0164 PERNUT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORD: ❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE,`KC'EP� WHERE NOTED. FIXTURES: ( TAL NUMBER OF EACH BE iv Equipment Installed MFG: MODEL: UI SIZE,BTU MFG: ^�� MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU C A C 525.00 _FIREPLACE (GAS) S15.00 RANGE/OVEN S10.00 _GAS _AIR TO AIR. EXCHANGEER S15 FIREPLACE (WOOD) S35.00 _NEW GAS GRILL S 10.00 _BOILER 535.00 FURNACE 535.00 UNIT HTR S10.00 _GAS _CHIIVINEY LINER S 10.00 _GAS DRYER S10.00 HEATER 535.00 _POOL DUCT WORK S 10.00 ' GAS PIPING S 10.00 VENTILATOR S 15.00 Number of fixtures (a) $10.00 x $10.00 = $ Number of fixtures (a). $15.00 x $15.00 = $ Number of fixtures (iU $25.00 J_x $25.00 = $- ON-C4D Number of fixtures @ $35.001 x $35.00 = $ 326-A State Surcharge = $ .50 IJM FEE $35.50 Total = $ • 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 Constriction 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 11 work h ires review and approval of pla . SIGNATURE OF APPLICANT PRINT NAME MAW�DATE PLEASE NOTE: SEP TE PERMITS A REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK City of .Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC NEW HOMES/ADDITIONS :1 EXISTING HOME MAKE-UP AIR 1 . 1jVV211, U!'� 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances I.FGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments ftTKIIN I a 31111' 1 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations.