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PRE 2010 DOCSSUBJECT PERMil2lilS City of Fridley AT THE TOP.OF THE TWINS f I I L D I� I i� D[ D w A I T BUILDING r DlJ IVv rGR�Y� RE S • COMMUNITY DEVELOPMENT DIV. INSPECTION r PROTECTIVE SEC. t � = CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 5/4/73 / JOB ADDRESS 4607 2md Street N:E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 17,1$ 11 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE William McKnight 4607 2nd Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Salitros Roofing 2 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK rmft re -roof 8 CHANGE QF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Shingle THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. $500• X3= $.5 0 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- 5.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE m yr,i $5.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE( S IS YOUR PERMIT OeHEN PROPERLY9u;� 11CZ� / 5/4/73 SP DATE SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) Y APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAM: W", 1� °e e� s� Chc ` �. g � BUILDER - �Q ��� JCt Uq ADDRESS: ��,�� SDA N, E ADDRESS: 5233 NO:. q �'ta7 STREET:_ aA. LOT: 17.4 it _BLOCK : I J ADDITION _ Y,'i Gln c� � k . CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this format Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: � Front: Depth: Height: Square Feet: Cubic Feet: -Front: Depth: -eight: Square Feet; Cubic Feet: Type of Construction: .tea �� - Estimated Cost; $ To Be Completed: S - The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stfict 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, 0 DATE: - " 73 SIGNATURE: (See Reverse Side For Additional Informa ®n.) . SUBJECT City of Fridley F11605. AT THE TOP OF THE TWINS D I' I L D I� I G D [DAA I T BUILDING R'v, r ' v r L 1 RECEIPT NO COMMUNITY DEVELOPMENT DIV. INSPECTION r PROTECTIVE SEC.CK 1 =� /---1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ---- ,`� 612-560-3450 910-F15 16/24/74 JOB ADDRESS 4607 2nd Street N.E. 1 LEGALLOT NO. 17-18 BLOCK 11 TRACTOR ADDITION SEE ATTACHED Plymouth Addition SHEET DESCR. 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 4607 2nd Street N.E. Jerry McKnight 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 9 CHANGE OF USE FROM TO STIPULATIONS PERMITS REQUIRED FOR WIRING, SEPERATE HEATING, PLUMBING AND SIGNS- 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. $2,000 1.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 12.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $13®00 SIGNATURE OF CONTRACTOR ORAUTHORIZEDA ENT (DATE) H N PROPERLY VA A ED THIS IS YOUR PERMIT BLDG INSP DATE k IGNA R FOWNER(IF OWNER BUI ER) - (DATE) � ,v ` vt LZI Al, APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: ►' �-/ U / c /1 h i �61/L BUILDER: �5h-rn ADDRESS: -,9602 c5� _ ADDRESS: s4 m NO:. -4160 % S TREET : c;214 -ST IVC LOT: BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: 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: /ylOCie fFront: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: l ®--Z� Type of Construction: Estimated Cost: $ o O 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. DATE: .2 y - %4f SIGNATURE: (See Reverse Side For Additional Informdbion` r 10 City of Fridley SUBJECT ,r � -1 65 AT THE TOP OF THE TWINS PERMIT r BUILDING fi 10EIPT _-- COMMUNITY DEVELOPMENT DIV.+/ L ------ - - r PROTECTIVE INSPECTION SEC. 1 ; � CITY HALL FRIDLEY 55432 NUMBER REV.. DATE PAGE OF APPROVED BY 812-560-3450 910-F15 11/8/76 JOB ADDRESS 4607 - 2nd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16,17,18 11 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jerry McKnight 4607- 2nd Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. The Sussel Company 1850 Como Avenue, St. Paul 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 241 x 241 Garage 9 CHANGE QF USE FROM TO STIPULATIONS Provide a hard surface driveway. rIOTIFY THE FRIDl:EY ENGR. DIVISION REGARDING CURB REMOVAL AND REPLACEMENT AT DRIVEWAY OPENINGS, 9EPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGN& Before digging call local afiifiiles TELEPHONE - ELECTRIC - CAS EtC REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 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 $4,262.40 $2.13 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 ONSTRUCTION. $23.04 PLAN CHECK FEE TOTAL FEE // W EN PR P $25.17 LI TED THIS IS YOURPERMIT•0 ' SIGNATURE OF O TRACTOR ORAUTH RIZEDAGENT 1 T I BLDG. INSP DATE " SG ATURE OF OWNER (IF OWNER BUILDER) (DATE) CITY OF FRIDLEY APPLICATION FOR. RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER'S NAME :_Jer"-Y � ' 1' 441 COT BUILDER : / /�� Jy.S V � L �® ADDRESS: 4 b a 7 2 '�`�S?'. /t - F` ADDRESS: 1657-0 (f0,V ©- ' X ✓(5 TCL. NO.: NO:. 06® % STREET: 2 Jr-, A/,/-", LOT: 16 17, BLOCK: li CORNER LOT: ,e_ INSIDE LOT: ADDITION: yAfO 0 7-,-1 SETBACK: SIMARD: Applicant attach to this form Trio Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: 6,¢e4e;C Front: 2. -�- Depth: Z'`- Height: A f Square Feet: -5-76 Cubic Feet: —Front: —Depth:. Square Feet; Cubic Feet: Height: Type of Construction: :,d / F Estimated Cost: $ 0 2 6 5z 0 T Be Completed: .3® D"P_ SSS The undersigned hereby makes applicatian 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. DATE: � SIGNATURE: (See Reverse Side For Additional Information.) s i 7 City of Fridley SUBJECT ®142 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION r SEC. 1 . � "1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 8/5/77 JOB ADDRESS 4607 - 2nd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17,18 11 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jerry McKnight 4607- 2nd Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASSOFWORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 6 DESCRIBE WORK Construct 6' x 4' Entryway onto dwelling 9 CHANGE OF USE FROM -TO STIPULATIONS Variance approved to reduce front yard setback to 30.18 feet on 7/19/77. Call for inspection of existing foundation before constructing. WAR A Before digging calf fQm# utilities S�PERATE PERMITS REQUIRED FOR WIRING, TELEPHONE - ELECTR16. GAS Efo. REATINGo, PLUMBING ANIS SIGN'S. REQUIRED BY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. $1,000 $•50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE . SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $7.50 PLAN CHECK FEE TOTAL FEE $8.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AG NT (DATE) .PROP RLY VALIDATED THIS IS YOUR PERMIT � . ZWHEN 17 / t- a. -2 � 1 77 SIG RE OF OWNER IIF OWNER BUIL 1 (DATE)'-- v BLDG. INSP DATE MA Ll I Y UI f IM)LLY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIns, ADDITIOINS, OR REPAIRS) OWNER: je_Rc + BUILDER: ILI Address :6,® 7, `o c$ -AJ.E, Address: Tel. No.: Sze - C08(o, No.: J-16® rJ Street: c- rV6 9i % � e—T' LOT: — BLOCK: ADDITION: PO CORNER LOT: INSIDE LOT: SETBACK: 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: Uu/%2y W4 14 Front: Depth: � � Height: ✓� , Square Feet: Cubic Feet: Front: Square Feet: Depth: Height: Cubic Feet: Type of Construction: -( ocij iP �_— Estimated Cost: $ /a,'W-&& To Be Completed: �� `D . . Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse si e for additional informatio . DATE: f >;SIGNATURE: Stipulations: t Fl2G&� 7 14leA 'S' 6-764 lC 6j- 30./, p WELL DRILLING FOR FOUR GENERATIONS ® ® sons 15688 JARVIS STREET N.W./ ELK RIVER, MN 55330/(612)427-6100 INCORPORATED MINNESOTA DEPARTMENT OF HEALTH 717 SE DELAWARE STREET DIVISON OF ENVIRONMENTAL HEALTH MINNEAPOLIS, MINNESOTA 55440 ATTN: Mr James Nye (612) 623-5339 SUBJECT: WELL ABANDONMENT RE: NOTIFICATION Dear Mr Nye, �1\ N DATE: OCTOBER 12th, 1987 rL_I 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 requirements 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 this area to seal their 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 to assure the abandonment report is submitted. PROPERTY OWNER: MR. JERRY MCKNIGHT PHONE # 5 v 2 - i ti o -, 14 - ADDRESS: ADDRESS: 4607 2nd St. NE, 780-1420 W. Fridley, MN. 55432 WELL LOCATION: SAME WELL DIA." WELL DEPTH ilj ' Sin rely ubmitt eLr Raymond T. Renner, CWD/PI Vice President E.H. RENNER & SONS, INC. State License #71015 CC: CITY OF FRIDLEY 6431 UNIVERSITY Ave. NE. fridley, mn. 55432 ATTN: ark ---57 RER/rr 21/13 I. LOCATION OF WE'LL STATE OF MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO. cww.r N.w. WATER WELL RECORD` ANOKA Mi—o snows 1344.01• w to Wm SmP& ABANDONMENT To.aMtp Nwme FRIDLEY T.wm" N.w1b. 30 S RMSs NuadwN 24 M Sesta. N°. 27 It'.lwro SE RSE SSE" AME MR. JERRY MCKN Add.w. 4 6 0 7 2nd St. E . 0*18M. Md tu..ttw. Nun R..d tnt—KIiwro W SIMS Add—I Md City of W.R L«ato. 4607 2nd ST. NE_ 32 S...0 -11-40-.f WA 1. .ntk. pW .Nb -11.- sk.t.b .p of W." Ia..It-. 4. WELL O Dan of Ceepla Addili-K— 44 R. Novembef 6th, 87 Rb,.Y 11-1w T igc bk and 40R.wta 700rW.. 1000" 2011.11—ml SOAM 40Bd.0 11[3 JO Rw .rr °Olmrd 90P—+r Aopr I.a N.°tM. s. USE t t t 1 I�1>mtattk .Oromm s wr 70 toddy F-1 dt. 30Mmma— s❑Mo.klpM &Mcomm—w JO Te. WT 60AMCw.dR1wMS 90 L FORMATION LOU COLOR AA ��qqpp ►(1RN4ATIONE EAOM TO SAND BROWN 6 20 7. CASING HEIGHT, AbOW 10d..b 40TWS&d 30G.N. s0weld.d suff«e d n - HOLE DIAM CLAY BROWN 20 60 JO Pknlit 60 Dri vesbml Y.0 —X N. _ 3 I. I. 40n. we*" 7.576 FINE SAND GRAY 60 190 — R. -Ism Itd tn. In. to n. W.I." Ib..m. —1i- to --.JL —h. to�fl. SHAKOPEE-DOLOMI PINK 190 225 M,,w PROBABLY r — ft. to -- n. Trw UHKNOWN -_ Sbt/Gmu -- LwStb -- FITTINGS: S.1 bo— -- It. tol -- n.w.d -- n. 9. STATIC WATER LEVEL 35 n7Cft.1w.. 0wbww. MI. M --.d ll -6-87 I..d .Ntw.. NOV 6 10. PUMPING LE'VEL(bNo,. I" -,(W.) . NOT m.n.r . PUMPE paS L.p m fl. was bm ponpMS S.P-. 11. WELL HEMI COMPLETION ,o ptU_.d,. M..f a.M JET TER X�3 at. --i arm 30 At t..o Ir- Mc— v,.d. IS. WELL GROUTED? X-1. ON. According to M 4 State legulations 30 N.wi C --I 308.o1mit. JO 2 Rang D..wt.w PORTLAND 1— 44 SIIRGA('& Yd.. NEAT GROH-T W. NEARS= SOURCES Or POSSIBLE CONTAMINATION 7n Im RA $ T dMxek.t c T TFT live W.0 dMnNa.d nV--plato.7 Y..O Nwtp SEWER i.. PUMP REMOVED & WAS GONE ON ARRIVAL Pa.19wMRw 11-6-87 pNwt.M.e.d M.wfw.tumf li Now well log taken from: Model N1,aba Hp —_ V."-- Ii.11bordmP000 -- rt "palsy MR. LENNY E. COR ORAN Ma bil of d1°p p" -- Type: IOS9bfflW M. 301-S.Turbhv sORmprwltdhS 3olt1 4mc-ow-0 60 FRIDLEY, MN. U51 W.L. 4 T 1946 Uw.—and .Newt It Luded 16. WATER WELL CONTRACTOR'S CERTIFICATION TEk W.0 Www dr0kd w I nr to.ldk*mw d Ibk report M trw to UL REMARKS. ELEVATION. SOURCE OF DATA .t . IM byte of nr booMdp .Rd bdkf. E. -H. RENNER & SONS_ INC-- 71075 LIo MB.iweM AV~ Lens Na 15UB JARVIS ST. N.W. , ELK RI , MI 55330• sw•a c� � .71 T7C,RT.TAT n t. _7_'L—Ci—a7 W O K 0 _P y New. of DION CER WELL ABANDONMENTS FOR ANOKA COUNTY LISTED BY CITY NUMERICALLY BY ADDRESS FOR THE CITY OF *** FRIDLEY *** F A21113 v 6431 UNIVERSITY AVE. NE. B.I. MR. DARREL CLARK & MR. DON 9ARRIGAN 574-3450 NO PERMIT FEE OR INSPECTION DRILLER SIZE OWNER -CONTRACTOR SITE ADDRESS DATE SEALED TORGERSON 1% BORDEN 260 Longfellow.St. Jan. 88 E.H. RENNER 2 SHARON ANDERSON 380 Longfellow St. May. 86 MORK 3 ANOKA CO. COMM. ACTION 400 OsbormeRd. 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 It HARLIN & MAXINE SUND 776 -63rd Ave. NE. Sep. 87 TORGERSON 3 Robert Knudson 1322 Hillcrest Dr. Jul. 88 E.H. RENNER 1-t LOIS HLAVINKA 1500 Osborne Rd. Apr. 88 E.H. RENNER 1% 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 1% SYLVIA McGUIRE 5928 Oakwood Ave. Sep. 87 E.H. RENNER 3 BINCKNER BUILDERS 5980 Stinson Blvd. Apr. 88 E.H. RENNER 3 TIM FAHS 6105 Woody Lane Feb. 88 E.H. RENNER 4 TIM FAHS 6105 Woody Lane Feb. 88 DON STODOLA 4 ENEBECK CONSTRUCTION 6222 Old Oensurf Rd. Aug. 88 MORK 2 CLARENCE GRAVES 6229 Sunrise Drive Oct. 87 LUDWIG 2 CARL CHRISTENSEN 6509 East River Rd. Jun. 88 E "• RENNER 1% ANOKA COUNTY PARKS DEPT. 6666 East River Rd. Jul. 88 E RENNER It RICK MALACHER E._. RENNER 1% BOISE CASCADE CORP/BARR E.H. RENNER 1% BOISE CASCADE CORP/BARR E.H. RENNER 1% BOISE CASCADE CORP/BARB E.H. RENNER 13k BOISE CASCADE CORP/BARB E.H. RENNER 1% BOISE CASCADE CORP/BARB E.H. RENNER 1% BOISE CASCADE CORP/BARB E.H. RENNER 1% BOISE CASCADE CORP/BARB E.H. RENNER 1% BOISE CASCADE CORP/BARB E.H. RENNER 1% BOISE CASCADE CORP/BARB E.H. RENNER 1% BOISE CASCADE CORP/BARB (10 WELLS..FP7, FP10, FP18, FP11, FP13, FP9, [ALL OF THE ABOVE 10 WELLS FOR NATIONAL POLE E.H. RENNER 1-t JAMES L. SCHLEY A -WELL 2 JIM HAM ANOBA/018 END NOVEMBER 16th, 1988 NEER 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 SUBJECT P City of Fridley 4 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV PROTECTIVE INSPECTION SEC. qoq r � � I NUMBER REV DATE P AGE OF APPROVED By /-"S CITY HALL FRIDLEY 55432 ,�� 612-571-3450 910-F15 3/22/95 JOB ADDRESS 4607 2 Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17,18 11 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Rekuski 4607 2 Street NE 574-1934 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION J7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Garage 9 CHANGE OF USE FROM TO STIPULATIONS Smoke detectors to be installed adjacent to all sleeping areas in duelling. 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $850 $.50 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- Fire SC $.85 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $23.00 PLAN CHECK FEE TOTALFEE $24.35 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI HES PAOP LY ALiDATED THIS IS YOUR PERMIT E SIGNATURE OF OWNER pF OWNER BUILDER) IDATEI BLDG INS' DATE NEW i ] ADDN [] ALTER [] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 1 �o o'er% � !� Effective 1/ 1/95 Legal Description: Owner Name & Address: J ofho C.c. �f� � R, Tel. # Contractor:MN LICENSE # Address: 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 GARAGE AREA: Length Width Height DECK AREA: Leah Width. Hgt/Ground OTHER: Corner Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: _ Ft. Yd Setback Side Yard Setbacks Estimated Cost: $ Tel. # Sq. Ft. Sq. Ft. Sq. Ft. (Cost on Back) Driveway Curb Cut Width Needed: Ft. + t = Ft x DATE: APPLICANT: h,qi L_ Tel. #�-/9� 5� _ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ 15� 3; 00 Fee Schedule on Reverse Side $ � .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $$50 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 [ ] pu_ d r r . c1'HN REKINS USIQ 'FRI0DLEY hST55421-2120 �'� 01 SUBJECT PERMIT NO. City ®f Fridley 25 361 AT THE TOP OF THE TWINS BUILDING P E R M I r ' , RECEIPT �` __���_ COMMUNITY DEVELOPMENT DIV. ~ PROTECTIVE INSPECTION SEC. r c NUMBER REV DATE 8/12/97 PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 9104 JOB ADDRESS 4607 2 Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 17,18 11 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Rekuski 4607 2 Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Midwest Siding & Roofing 18979 Gladstone Blvd N, Maple Grove MN 55311 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 416-4804 20010277 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Ck REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (23 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $1,773 $.89 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- $54.00 Fire SC $1.77 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. zi ® LPI, S '1/1 j PLAN CHECK FEET Lice n SC $5 01 AL FEE $61.66 _ SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT tDArEI HE PROP VALI AT�jD THIS IS YOUR PERMIT V ✓� SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI DG INSP MATE 01 NEW [ ] Effective 1 / 1 /97 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 n���� BUILDING PERMIT APPLICATION pl ConstructionAddress: �� , U -C , JrdDpio Legal Description: ' f Owner Name & Address: G IA J( �� Tel. # Contractor: R MN LICENSE #_2W(� Address: Gd Tel. # Ll Attach to this application, a Certificate of Survey o e 'SS 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:"1 6LS1 1 11 U . : i96 Win_ mDa h- i i n e-- ri r -in n rN n n n r, . Construction Type: 1?3100 Driveway Curb Cut Width Needed: Ft. + 6 Ft = DATE:/ ` -Al APPLICANT: ( h1j (S Tel. # 1-11 to. . 4KM "j 3341, 'd CITY USE ONLY Permit Fee Estimated Cost: $ �$ o (Fee Schedule on Back) Ft,;x $ _ $ TOTAL $ IL(% STIPULATIONS: CITY USE ONLY Permit Fee $ , 0-0 Fee Schedule on Reverse Side Fire Surcharge $ (� > `� .001 of Permit Valuation (1/10th%) State Surcharge $ ` $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ 5 $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 $ IL(% STIPULATIONS: SUBJECT City of Fridley 310 0 6 AT THE TOP OF THE TWINS BUILDING PERMIT , r • ___ _ COMMUNITY DEVELOPMENT DIV. e INSPECTION SEC. r PROTECTIVE NUMBER REV DATE PAGE O� APPROVED 8Y �'j CITY HALL FRIDLEY 55432 612-571-3450 910-F156/1/00 JOB ADDRESS 4607 2 Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 17,18 11 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Quy & Ut Tran 4607 2 Street NE 763-571-2584 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Sears Home Improvement 8823 Zealand Ave N, Brooklyn Park, MN 55445 1-800-903-4176 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 20090017 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 7 windows 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $7,000 $3'50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE E SAC CHTISC PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $139.25 Fi$7.00 STRUCTION OR THE ANCE OF CONSTRUCTION PLAN CHECK Fg TOTAL EE �241� ez _6Licen S $5.00 $154.75 ZNATUOADAGENr i0g IEN I ROP R ALIDAT SLOG SP TZ IS YpU,R PERMIT /�Jp ✓ sU.c OA TE S,GNATyIgE OF OWNER OF OWNER BUR DERi IDATE- NEW [] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Effective 1/1/2000 (763) 572-3604BldgInsp oT 4-Vj n � Legal Description: 2,- ptcj, r );,A1V�1F Owner Name & Address: eZ, =t-- e ���, c.�'i Tel. *K753)'S-7l-;n34{ Contractor: MN LICENSE # 2!12D Address: 5`�s�_� ?� 4�_ K)./�. s.s?iG .�Tel. # AGch 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 Widths Hgt/Ground Sq. Ft OTHER: 'Rez> P<,/��a d i � ® �eS Construction Type: Estimated Cost: $�f �-- Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: - APPLIC Tel. # CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ ,39.,r� Fee Schedule on Reverse Side Fire Surcharge $ `-G�® .001 of Permit Valuation (1/10th%) State Surcharge $ ••S -b $.50/$1,000 Valuation SAC Charge $ $1100 per. SAC Unit License Surcharge $ E`06 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ ASV 9-4— STIPULATIONS: CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2000 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work JOB ADDRESS "7(�� o� �✓ OWNER ' Rate TOTAL BUILDING USED AS 0LJ' $ 30.00 A00� ESTIMATED COST PERMIT N0. $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) EEAir $ 10.00 $ Trade Name P.L.P;_b Size No. BTU FJ HP EDR $ 25.00 $ Fuel AJ -4-T-- ,:::-A-5 Total Connected Load Burner Trade Name Size No. $ BTU HP EDR 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 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the -City Codes an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE 6V HEATING CO;P C -1e ce0-* &a4WA-e-77_0` 3 Signed Approved By®(�:J Rough -In Date TEL # _%L -a ,32- `fY Final Date COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No The undersigned also verifies that the replacement unit is a listed assembly e and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes( No( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes No When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes j No ( ) Appliance Tvpe and Size/Common Vent and Vent Connector Information Appliance #1 Type RUun BTU Input 2S dO(D 6ar Nat Appliance #2 Type BTU Input Fan ssis ed or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent T e ,GI,cJ yp Vent Height I� Diameter � inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) /--v'RIJA-e- �- P6601 A-c-�� /--t *- Pel -'-06- J,i� HEATING CO: YLJ tom �7-i2�4-t.t�r Signed By: Date : -O-02- Building $ BUILDING Plan Review Permit No. Inspections Fire Surcharge RESIDENTIAL APPLICATION 3, 3 .001 times the total job valuation Received By: 763-572-3604 .0005 x Permit Valuation Minimum $5.00 CITY OF FRIDLEY $ D ACT 1 2010 763-502-//4977 FAX $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ EFFECTIVE 7-1-2010 $ $450 Conservation Plan Review DATE O U YOUR E-MAIL ADDRESS LC tdJ�®' rte, SITE ADDRESS R01) Ive Agreement necessary ( ) Non Necessary ( ) THIS APPLICANT IS: ❑ OWNER WCONTRACTOR %, Make checks vavable to: Citv of Fridlev Attach Stipulations PROPERTY OWNER/ NAME: (�IJUDY Vi TRAP ADDRESS:LltoD-7 .2yop S , r r A) _rrY FWwLEY STATERn O ZIP TENANT PHONE: CONTRACTOR NAME: ©0-714 I SUBMIT A COPY OF STATE LICENSE # J EXP DATE YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS.'?/ NotikeuC; �- CITYA)EWa D STAT II ZIP 02 INSURANCE PHONE - —" FAX J " PI PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED RLWINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION M MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: bU L I N 0 0 6"' C s TZ J — E Ztr5 77 - SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project 2. Two sets of construction plans WINDOWSAA,,, 6. J' L f o l i1 i 3. Energy Calculations IN EXISTING OPENINGS []No LOCATION OF WINDOWS K.l' dh (� FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ 1-71 '15 See Back Page for Fee Schedule Plan Review $ — 65% of Building Permit Fee Fire Surcharge $ 3, 3 .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $5.00 License Surcharge $ IS, ® $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ %, Make checks vavable to: Citv of Fridlev Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case o a ork which ires r w and approval of plans. n /� j� SIGNATURE OF APPLICANT _ PRINT NAME KIc y CPC.. ATZ- DATE / o b l /l o PLEASE NOTE: SEPARATWPERMITS AREMEOUIRED FOR PLUMBING. ELECTRICAL AND MECHANICAL WORK