PRE 2010 DOCSBUILDING PERMIT
i
Village of Fridley, Minn.
Date ...... .. ,•, .
Owner ...... - of -4.
Address , , , ,�. , .. .. .
Builder .. %< F
Address
1�To 2583
p T d
LOCATION OF BUILDING
................. .......................
No. ..... Street... Part of Lot
Lot ............ Block ................ Addition or Sub -Division ....... „............
Corner Lot .. ......... Inside Lot .. .... Setback ............ Sideyard ...... ,
DESCRIPTION OF BUILDING
To be Used as:
r" w. Front . , Depth .. . fl'eight ......... Sq. Ft. Cu. Ft........ .
.. Front . Depth ........ Height ....... Sq. Ft......... Cu. Ft, ........
Type of Construction ... Est Cost F:' ,... , . , ... To be Completed'
In considerate n 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 and in compliance with all provisions of
ordinances of the Yellage of Fridley.
4z= con
done in, around
Fridley, Minns
in the village lv
ordinances.
NOTICE:
............: ....:far ... .
10 the payment of a fee of $....'?permit is hereby granted to ....
,.e.. to construct the building or addition as described above. This permit Is granted upon
in that the person to whom it is granted and his agents, employees and workmen, in all work
I upon said building, or any part thereof, shall conform in all respects to the ordinances of
regarding location, construction, alteration, maintenance, repair and moving of buildings with -
and this permit may be revoked at any time upon violation ''of any of the provisions of said
Inspector
This permlt'lldoes not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. I Be sure to see the Building Inspector for separate permits foil these items.
SUBJECT
P
City of Fridley
15.5.0 6
AT THE TOP OF THE TWINS
BUILDING PERMIT
� t
• COMMUNITY DEVELOPMENT DIV.
6 rr ______
w
r I � PROTECTIVE INSPECTION SEC.
/�
1 (
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
612-571-3450
910-F15
10/5/79
JOB ADDRESS 4641 - 2�i Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
25,26
10
Plymouth SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Vincent Karpowicz 4641 - 21� Street N.E. 560-4461
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
S DESCRIBE WORK
Reroof house
9 CHANGE OF USE FROM TO
STIPULATIONS
Roof can be second but not third roof. Install ridged galvanized
valleys.
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
$•'50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$700
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SACCHARGE
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
SI N `UREOF CONT CTOR THORIZED AGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS. YOUR PERMIT
SI NATURE OF OWNER() O ER ILDERI (DATE)
BLDG )NSP ATE
CITY OF FRIDLEY
APPLICATION FOR RESIDLNTIAL BUILDING PERMITS v
(New, Alterations, Additions; or Repairs)
OWNER: � ������ CaG� CC BUILDER: S'(f
ADDRESS: 21 ADDRESS:
TEL NO:- � TEL NO. .
• Construction Location
. STREET NO: :ZL0 7L_ STREET: 0
LOT: BLOCK: ADDITION:
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of .Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: Depth:. Height:
Squane.Feet. Cubic Feet:
Front: Depth: Height:
Square -Feet: Cubic Feet:
Type of Construction: Estimated Cost: $
Rb Be Oompleted:
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 .re true and correct.
DATE:.
SIGNATURE:
Stipulations:
SUBJECT
-
City of FridleyQ27546
AT THE TOP OF THE TWINS
BUILDING
PERMIT
i?
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
-7
_
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY $$432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
19/2/98
JOB ADDRESS
4641 2 1/2 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
25, 26
10
lPlvmouth
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Vincent A. Kar owicz572-8964
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Owner
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
faC NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 10' x 16' utility -shed
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
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. OWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
499
• 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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$21.00
Fire SC
PLAN CHECK FEE
TOTAL FEE
SIGNATURE OF CONTR CT R OR AUTHORIZED AGENT IDATEI
WHEN PROPER VALIDATED THIS IS YOUR PERMIT
SIGNAT RE OF OWN IIF NER BUILDERI IDATEI
BL -G INSP GATE
NEW - 4 ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: l ®2,
Legal Description:
Owner Name & Address: GlI A&« A✓7Z!g!, 4,0® 4Z -'/C Tel.
Contractor: MN LICENSE #
Address: �� f`— Tel. #
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: �ii�i `� 1/ C5 -x r-( '%® % x 16,
Construction Type: b6�-' 0 c Estimated Cost:
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: " �?�'APPLICANT: r 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
$1000 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 [ ]
SUBJECT
City of Fraley
30015
AT THE TOP OF THE TWINS
BUILDING
PER 1T9
r
1 s
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
SEC.
r � � PROTECTIVE INSPECTION
1 �
= CITY HALL FRIDLEY 55432
NUMBERDATE
178/6/99
PAGE OF
APPROVED BY
612-571-3450
910415
JOB ADDRESS 4641 2 1/2 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
25, Z6
10
lPlymouth
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Vincent Kar owicz
572-8964
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Owner
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 O ADDITION ❑ ALTERATION REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage (22 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 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
1923
S.96
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
PLAN CHECK F
TOT FEE
7
If
2.13
S� NATUREOFCON•RA T ORAUTNORiZEOAGENT IDATE�
EN R
VALID THIS Y R IT
® � `
s ✓
j/iiDDATEi
Bl0 NSP AOAtE
S-GNATURE OF Ow RnF NER BWIDER
NEW [ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FA J9LY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: f z5— ,
Legal Description:
Owner Name & Address: P IL 7, Tel.
Contractor: A5-&—_ G, MN LICENSE #
Address: y/ S x �!� ,�` Tel. #
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:
/Z' /lam®
-
i ns CY
,6
Construction Type:/'�
® p r
Estimated Cost: $
7�3
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Ft x $
=R�
DATE:APPLICANT: c Tel.
Permit Fee
$ L, C2S
Fire Surcharge
$1,9-1
State Surcharge
$ �o
SAC Charge
$
License Surcharge $
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL $ o�
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 [ ]
CITY OF FRIDLEY
7071UNIVERSITY AVENUE NE
FRIDLEY, MN55432-
//
ISSUED:10012008
(763)572-3604FAX: (763)502-4977
Permit #2008-01639
4641 2 1/2 ST NE
ADDRESS:
PIN:263024330030
LEGAL DESC:UNAVAILABLE
:LOT BLOCK
PERMIT TYPE:SEWER & WATER
PROPERTY TYPE:RESIDENTIAL
CONSTRUCTION TYPE:SEWER REPAIR
NOTE: CALL 763-572-3552 FOR INSPECTION AFTER UNCOVERING THE LINE, BEFORE ANY REPAIRS ARE MADE, AND AGAIN
WHEN THE REPAIR IS MADE BUT BEFORE RECOVERING THE LINE.
SEWER LINE REPAIR/RELOCATION40.00
APPLICANT
STATE SURCHARGE, OTHER SEWER0.50
T & J CONCRETE
TOTAL 40.50
17720 HWY 65
Payment(s)
HAM LAKE, MN 55304-
CHECK2610940.50
OWNER
KARPOWICZ VINCENT A & K
4641 2 1/2 ST NE
FRIDLEY, MN 55421
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction authorized
is not commenced witin 180 days or if construction or work is
suspended or abandoned for a period of 180 days at any time after
work is commenced.
I hereby certify that I have read and examined this application
and know the same to be true and correct. All provisions of laws
and ordinances governing this type of work will be complied with
whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any
other state or local law regulating construction or the performance of
construction.
Applicant____________________________Date________
Bldg Insp____________________________Date ________
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY
7071UNIVERSITY AVENUE NE
ISSUED:10/01/2008
FRIDLEY, MN55432-
(763)572-3604FAX: (763)502-4977
Permit #2008-01639
4641 2 1/2 ST NE
:
ADDRESSPERMIT APPLICANT:
PIN:263024330030T & J CONCRETE
LEGAL DESC:UNAVAILABLE17720 HWY 65
:HAM LAKE, MN 55304-
PERMIT TYPE:SEWER & WATER
PROPERTY TYPE:RESIDENTIAL
CONSTRUCTION TYPE:SEWER REPAIR
BUILDING INSPECTION RECORD
24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS.
CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 4:30 PM
INSPECTION TYPEDATEINSPECTORCOMMENTS
SEE ENGINEERING DEPARTMENT FOR INSPECTION RECORD.
SEWER INSPECTION01/05/09POTHR
INSPECTION COMMENTS:
IN ACCORDANCE WITH CITY ORDINANCE, NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL
WORK HAS BEEN APPROVED, AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT.
THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE.
Building
WATER OR SEWER
Permit No.• j
Inspections
PERMIT APPLICATION
Re 'B
763-572-3604
CITY OF FRIDLEY
De �o
763-502-4977 fax
ate
EFFECTIVE I -I-08
APPLICATION DATE: to I U YOURE-MAIL ADDRESS: 1 C.
THIS APPLICANT IS: CONTRACTOR ❑OWNER C�
JOB ADDRESS: 4-1 �z 4I,2,, c `e -d wS
NEW CONSTRUCTION PERMIT # (IF APPLICABLE):
PROPERTY
NAME
OWNER/
ADDRESS: CITY: STATE: ZIP:
TENANT
PHONE:
CONTRACTOR
NAME: "-"
SUBMIT A COPY OF
ADDRESS: 1-1-17-1-D,H �5 CITY: o 1 ` STATE: ZIl':
YOUR STATE LICENSE
PHONE: 2 U Oc 6, CELL HONE: 2 Ki,;z5 � bj
AND BOND
STATE LIC: STATE BOND: EXP:
PERMIT TYPE
❑ SEWER CONNECTION PERMIT $50
❑ WATER CONNECTION PERMIT $50
❑ WATEWER L REPAIR PERMIT $40
ADD STATE SURCHARGE $.50 ,
❑ SAC CHARGE @ $1825
TOTAL
OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING
NEW WATER METER COST SEE UTILITY BILLING
SPECIAL ASSESSMENTS SEE FINANCE
WATER TAP SEE ENGINEERING
NOTE: WATER METER REPAIR, INSP OR SHUT-OFF / WEEKENDS & HOLIDAYS $125 / HOUR -BILLED
THIS IS AN APPLICATION FOR A PERNUT--NOT VALID UNTIL PROCESSED
I hereby apply for a water or sewer (new connection or repair) 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. I understand this is not a permit but
only an application for a permit work is not to start without a permit.
SIGNATURE OF APPLICANT: , PRINT NAMEs 61(� VI �° n DATE C l� 6 t� i
APPROVED BY: DATE
COPY GIVEN TO: ❑ UTILITY BILLING
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
EFFECTIVE: January 1, 2007
City of Fridley
6431 University Avenue N.E.
Fridley, MN 55432
(763) 572-3604
WATER AND SEWER LINE INSTALLATION REQUIREMENTS
WATER SERVICE LINES:
TYPE K COPPER
PLASTIC PIPE WITH TRACER WIRE
6D Polyethylene D2239, D2737
6E Acrylonitrile D2282
6F Polyvinyl D2241, D1785
6G Polybutylene D2662,.D2666
1. Flare fitting in yard area or silver (brazed) fittings underground, within building or yard area
2. Approved AWWA compression fittings permitted on existing lines.
3. Valves at meter to be gate or other full -way valve
4: Curb stop with rod must be used.
5. 7 foot minimum bury (only dense foam insulation allowed if needed).
6. 1 foot minimum separation of sewer and water.
SEWER SERVICE LINES:
Cast iron with matching fittings
Plastic ABS
Schedule 40, D2661
Foam Core, F628
Thin Wall, D2751
Plastic PVC
Schedule 40, D2665
Foam Core, F789
Thin Wall, SDR -35, D3033, D3034
All PVC requires a two step process of joining; first a colored primer; second the solvent
cement.