PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N® 3 3 5 8
Date: .17 6.... ...............
owner........... . .. ..... ........
................
Budder ......
Address / ,.... ...._...... ... s� ..� Address .............................................
OCATION OF BUILDING
T e o.VA?... Street ...... .. ..... .............. Part o t ......... ......... ....
.....
of ... Block .... .... ...... Addition or Sub -Division :..
y®. ®� Corner Lot ............ Inside Lot .. ....... Setback :1 S eyard .. ��: ir�'..� .............
4ore
DESCRIPTION OF BUILDING
T be sed as:
'�A ....4�. Front . "al.. Depth 4.4. Height .. /. 0. Sq. Ft. ®. Cu. Ft:—N?!r9
.................... Front ........ Depth ........ Hei ht ........ Sq. Ft. ........ Cu. Ft. ........
q
Type of Construction ................... MgtCost.. ./.. y.......... To be Completed ...................
In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley. ®� �- -� -01
d�
In consideration of the payment of a fee of $.........., permit is hereby granted to ...................
......................... 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 with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Building Inspector
a
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
SUBJECT -722122'
City of Fridley
AT THE TOP OF THE TWINS
I \\''
BUILDING I PE MIT
V
R O.
� t
-------COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
1 �
1 I
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i
1 "1 CITY HALL FRIDLEY 55432
612-571-3450
910-F15
9/21/93
JOB ADDRESS 4732 2 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
6i 7 i 8
5
Plymouth. Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Chester Levander 4732 2 Street NE 572-8991
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Western Construction Co 4301 Hwy 7 is, M.55416 920-8888 4238
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
�{7 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct a 26R x 261 Detached Garage and Remove Existing 141 x 241 Garage
9 CHANGE OF USE FROM TO
STIPULATIONS Oldarae to be removed within 34 days of completion of new
g g y p garage.
Provide a hard surface driveway. See notations on plan.
WAN
all
SQUIRED By LAV
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1Qf816
$5.40
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
TRUCTION OR THE PERFORMANGf OF CONSTRUCTION.
$126,00.
Fire SC $10.82.
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$147.22
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WH5NXOP VALIDATED THIS IS YOUR�'7PpERMIT
Com/SIGNATURE
CDG DATE
OF OWNER OF OWNER BUILDERI IDATEI
NEW [ ] CITY OF FRIDLEY Effective 1/1/90
ADLN [ ] R-1 AND R-2
ALTIER [ ] Building Permit Application 05
-
Construction Address: 4732 -2 -STREET N. E
Legal Description:
Owner Name & Address:
CHESTER LEVANDER
Tel.
#
572-8991
Contractor; AIESTERN
CONSTRUCTION COMPANY�412 �,)8
Tel.
#
920-8888
Address: 4301-HIGH4AY .SEVEN MINNEAPOLIS, 1_ N, 55416
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to sole.
- DESC RIMC K OF nartomew
LTVIM AREA: Length Width Height _ Sq. Ft.
GRRAM AREA: Length Width Height Sq. Ft.
DECK AREA: Length WidthGround Sq. Ft.
Off: 261.26 -DETACHED GARAGE - 4 mnoT w y-ILI 047
Corner Lost [ ] Inside Lot [ ] Ft. Yd Setback 3 Side Yard Setbacks
Type of Construction: iRX E Estimated Cost: $ 0
Approx. Cmipletion Date: 11/1/93 16 eg
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
Width + 6' See Back Page
DATE: 9/3/93 APPLICANT: C.,4L&� Tel, C_920-8888
M i LT DIN CHAZitl
Permit Fee
fs0
Cre S 5-.0 0
Park Fee $
Sewer Main Charge $
$ /q'%. C�A
SI'IPUTATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$600 per SAC Unit
Alt. "A" or Alt. °BP1 Above
Fee Determined by Engineering
Agreement Necessary [ ] Not 7[ ]
7
�
MIT N
City of Fridleydz'T�349SUBJECTP
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
` COMMUNITY DEVELOPMENT DIV.
v______
INSPECTION SEC.
n
r PROTECTIVE
�
1 . �
i KJUUU
i ��"" ,•� CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
_-_-
L J\ 612-571-3450
9
4/29/99
JOB ADDRESS 4732 2 Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
6,7,8
5
1 Plymouth Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Lester Levander 4732 2 Street NE
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Kodiak Construction 2607 Brighton NE, M ls., MN 55418
781-0286 8608
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 Ek REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK
Reroof House (8 Sq) Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building
Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday;
9:00 am to
9:00 pm on Saturday; No work on Sunday.
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 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
$685
$.50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CH RGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
Fi SC $.68
STRU TIO OR THE PERFORM CE OF CONSTRUCTION
$26.50
a
C
PLAN CHECK FEE
TO L FEE
Lice S $5.0
2.68
SIGNATURE OF CON ACTOR OR AUTHORIZED AGENT IOaiEi
MEN PR P V LI
G INSP
��
�I$ I$ 0 o/i•
BATE
S,GNATURE OF OWNEROf OWNER BUILDERi i0ATE'B
NEW [ ] Effective 1/1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION 0� Q
ConstructionAddress: 9-7 3 Z f @4EZI a'
Legal Description:
Owner Name & Address: Tel. #
Contractor: K-0,0 'YA--r Ct'ej S V-. MN LICENSE # ® S'
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:.
#,A 4 44 _ C<�S. —VY/Al Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
OTHER:
8' s�`A-k-e—_
Construction Type: ' 4-r $ ®rr— Estimated Cost: $ �; a
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: 2 APPLICANT: Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]
I' MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring �"""
ION f WELL AND BORING SEALING RECORD Sealing No. No. �i�wi
jI Minnesota Statutes, Chapter 1031 (L— blank kR etskNo. 1 �}
e owgnshhi_p No. Range No. Sectiionn No. Fraoil (sm. –� lg.) Date Sealed Date Well or Boring Constructed
11 _ ; $!
GPS Latftude degrees. minutes_ seconds Depth Before Sealing ft. Original Depth
Pr LOCATION: Longitude_ degrees-- minutes seconds
AQUIFER(S) STATIC WATER LEVEL
Numerical Street Address or Fire Number and Cit of Well or Boring Location ;Single Aquifer ❑ Multiaquifer
qw�t WELL/BORING ❑ Measured Dj Estimated Date Measured
XWater-Su 1
ppy Well ❑ Mortit. Well
Show exact location of well or boring Sketch map of well or boring
in section grid with "X - location, showingg property E:1 Env. Bore Hole El Other ft. ❑below ❑above land surface
N II lines, roads, and buildings. CASING TYPE(S)
w
V
Steel ❑ Plastic ❑ Tile ❑ Other
WELLHEAD COMPLETION
E T C { F L Outside; ❑, Well House ❑ At Grade Inside: ® Basement Offset
'h M7e ❑ E]Pitless Adapter/Unit Buried ❑ Well Pit
1 i ❑ Buried
Well Pit
s !i
�, Mne_
❑ Other
F-1 Other
PR ERTY OWNER'S E/COMP Y NAME
CASING(S)
" 'r
Dia eter Depth Set in oversize hole? Annular space initially grouted?
in. from to ft ❑ Yes [R No ❑ Yes ❑ No ❑ Unknown
Properly owner's math g address If different than well ocati n a . rasS indicated above
`4L
;V4 L
in. from to ft. ❑ Yes [_]No ElYes ElNo ElUnknown
t I 11
In from :... to — —ft El Yes ElNo El Yes [INo ❑Unknown
WEVJ OWNER'S NAME/COMPANY NAME
$CREEFUOPEN HOLE
_,
r ofi+Zn,, "i s� s i t }!a
Screen ir4-m ,� to ft. Open Hole from to - ft.
Wetl owner's mailing address if different than property owner's address Indicated above,
OBSTRUbTIONS ;.
RodsiCitop Plpe❑ Check Valves) El Debris ❑ Alf, [INo Obstruction
I'
Type of pbstructtons (De ritie * F`r4' P 4 411- � +c f
Obstructions removed? E]Yes DiNo Describer �fl -• `. 5 f ,
GEOLOGICAL MATERIAL. ,
COLO
R
HARpNE$S OR'
FORNAnON
FROM
TO
If not known, indicate estimated formation log from nearby well orbdfing.
PUMP '
. ,
T�
Removed jNot Present ❑ Other
METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2'CASINGS, OR CASING AND BORE HOLE:
Space Space Grouted with Tremie Pipe El Casing Perforation/Removal
NOAnnularS ace Exists ❑ Annular
In. from IDto ft. ❑ Perforated ❑ Removed
in.,trom---. —to ft.El Perforated [j Removed
_
l
Type of Perforator
Other
GROUTING MATERIAL($) (One bag of cement c 94 lbs., one bag, of bentonfte = 50 Ibs.) /� /
4—
Grouting Material vi4 of -A, Lam, from to ft. yards"Y bags
from to _ ft. yards bags
from to ftL yards bags
I,
OTHER WELLS AND BORINGS
REMARKS, SOURCE OF DATA, DIFFIOUL71ES IN SEALING
{ t c 1
Other unsealed and unused well or boring on property? ❑ Yes [*No How many?
LICENSED OR REGISTERED CONTRACTOR CERTIFICATION
[n
(
4L_ .' k )
This well or boring was sealed in accordance with Minnesota Rules, Chapter 4725. Thg information contained in this report
is true to the best of my knowledge.;~;
#i tA-
;
r2fA LL
censee Business Name o �r License or Registration No.
R Lt.l 2
#
Cert+ Representative Signature Certified Rep. No. Date
r
LOCAL COPY
F S 30000
Name of Person Sealing Well or Boring
HE -01434-12 IC# 140-0423 !
9f09R