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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT N° 4 6 3 3 Date: Owner: .... .._ .... Builder Address _ _ _ __.� __ _ i .._._ Address _...._.... ``"....,�� LO,!TI N OF BUILDING No..__%__'. Street __1114 /-_. �+i..+r_.•-.••• ........ -... _....... ........... Part ^Lot �.... .. Lot ........._..; ................ Block ._._......._. ._................. - Addition or Sub -Division Corner Lot -----------...--------------- Inside Lot ......... ........... Setback .. ,,''�... . ............. _........ Sideyard --.._. '............. -............. -....... ........ _....... Sewer Elevation .................. _.......... ........ _........ _.... .......... _......... ...._...._ Foundation Elevation DESCRIPTION OF BUILDING To Used as: Front ._:.__-- Depth ..... _ �_ Height ... .: Sq. Ft, -, Cu. Ft. .g. .-_,r r(' .... . .............. _...................... _..... _.....:. Front _.........._.. Depth ................... ,. Height ... .._............. Sq. Ft. ...... ............... _ Cu. Ft. .................... _.. Type of Construction .......... Est Cos ....... To be Completed .... _........... _..................... ....... THIS ; j;_) -i' AUTNOR1ZE VIOLAT- ION OF ANY Pi- iAlLAND COVENANTS AND BUILDING RESTRICTIONS. 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 and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee o $.�._..r� 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 within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. •" Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 �� APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners NameBuilder.-� r Address Address - 7` LOCATION OF BUILDING No. Street r! o Part of Lot Lot Block------/ Addition or Sub,Div. - Corner Lot Inside Lot—IL set Back Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: Front Depth_, ✓ ,.,,� Sq. Ft. Cu. Ft: Sq. Ft. Front Depth Height Cu. Ft, Type of Construction __7,_ 7,,,,,e Estimated Cost To be completed t The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in this application are true and correct., DATE �,�� SIGNATURE ,.c % �- ..._.....�. (A Schedule of Fee costs can be found on the Reverse Side.) Application for Power Plants and Heating. Cooling. Ventilation..Refrigerafion and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ........................ 2.00 $ Replacement of Furnace ............................. 0.00 $ Repairs & Alterations—up to $500.00 .... ............ 5.00 -0- Repairs Repairs & Alterations each add. $500.00 ............... 2.50 $ STEAM or HOT WATER SYSTEM NO RATE TOTAL 1st 3 Fixtures ...................... Furnace Shell & Lines—to 400 sq. ft. EDR Steam....... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) .............. I ........ 5.00 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH Dept. of Bldgs. Phone SU. 4-7470 Locaifon -5:3ZQ 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 Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, *n 5!: Owner Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No.Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade Name Size Capacity. FINAL (REMARKS -OVER) Sq. Ft. E.D.R BTU A.P. By. �4E 2M 7-59 Business Phone No City of Fridley, Minn. BUILDING PERMIT Date: Owner•'. !-.!� -�' �. _: _..._--•-_-•- - _.. __ _. _..... Builder Address'3 ... . ^ _ Address LO TION OF BUILDING No.. Street _. ''�.... _.:................... ... _..__..._ Part of t ...__.._ __.__—......_.-- Lot .....� .......... .... ....... Block --......_ ................. Addition or Sub -Di on ... _ ...._.. ...... CornerLot ...... ................. ...... ... inside Lot ....._' ............ �tback .. _.:�•._. Sideyard....._....._............._.................---........_.._....... SewerElevation .............. ..--.--..._-----._.._...-......._...._.......... _._..._....::__.._ Foundation Elevation _...._. .................. ... ._.._....... _..... ..... __...._................... DESCRIPTION OF BUILDING TZbe Used Depth s��^" .%Front _-- Height ---•--_-. Sq. Ft._r!._.. Cu. Ft. t�'e. - - ..�...,�.�.�...... Front ......�...... Depth .....�ieight ........... Sq. Ft. �. Cu. Ft./.R! Type of Construction ................._ st. Cost _...................__........ To be Completed ....._...........-------.......- - 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 and in compliance with all provisions of ordinances of the city of Fridley. 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 within the city limits and this permit may be revoked at any time upon violation ofb any of the provisions of said ordinances." /. lye' Building Inspector NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas hosting, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 1,,„_F r 4 fiH c� %r 1 Owners N Address APPLICATION FOR BUILDING FERMT CITY OF FRIDLEY, mMESOTA LOCATION OF BUILDING No.Street_ fz Af�d Part of Lot 0 Lot. Block . Addition or Sub.Div. Corner Lot Inside Lot Back SEWER ELEVATION `FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used ass : Front Depth He3.ght ,�Q Sq.Ft. Front 112 DepthIF Sq. Ft.--�, Cu. Ft. Type of Construction Estimated Cost„_, :ca To be completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in striet accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in this application are tr orrect. _ (A Schedule of Fee costs can be found on the Reverse Side.) %j SUBJECT City of Fridley 2 2 6 0 8 AT THE TOP OF THE TWINS BUILDING PERMIT r - REEtPT COMMUNITY DEVELOPMENT DIV. _ L PROTECTIVE INSPECTION SEC. r CITY HALL FRIDLEY 55432 NUMBER PAGE OF APPROVED BY 612-571-3450 910-Fl S TRE71)ATE 6/14/94 JOB ADDRESS 5370 4 Street NE 1 LEGAL LOT NO.BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 2, 3 13 Hamilton's Addn to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard Rappes 5370 4 Street NE929-5206 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 ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Garage (9 Squares) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in dwelling unit adjacent to all sleeping areas and in basement. 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 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 $720 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SACCHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $31.00 Fire SC $,58 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $32.08 ORI DAGENT IDATEI WHEN PROPER VALIDATED THIS IS YOUR PERMITSIGNATU FTUREAu LD INSP OATE UIL IDATEI NEW [ ] Effective 1/1/94 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ' ConstructionAddress: __9 >' Z6 Legal Description: K Owner Name & Address: Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Tel. # / � 9 — Z__T� 6 MN LICENSE # 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 Length Length Corner Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: _ Ft. Yd Setback Width Width Width Height Height Hgt/Ground f�, ) a1� v Sq. Ft. Sq. Ft. Sq. Ft. Side Yard Setbacks Estimated Cost: $ -� C -2D (Cost on Back) Driveway Curb Cut Width Needed: "Ft. + 6 F = Ft x $ _ $ DATE: APPLICANT: Tel. # ,®F0/ --,Y� Permit Fee $ 3 `, o0 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 $800 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 INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 672-3604 Effective On August 1, 19% APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMRFR OF MYTI. IRRA Tn RF INATAI i i=n nki i=&r%w m rinR PLUMBING FIXTURE RATES: NO, RATE TOTAL New Fixtures $7.00 N (-U Wash Floor Auto. as § ;Water Heater Stories C $7.00 Shower Tray Sump/Receiving Tank Washer Water Treating Appliance JEW Water Heater —Electric U.h'M 1111al. Water Heater — Gas** $10.'00 Gas Range" Drain Gas Dryer** =Range Gas Basement Type $15.00 Rip Nil Floor I HT Floor 2 pffm T1 30. 111Floor 3 NN; J!R, T ."i NO PLUMBING FIXTURE RATES: NO, RATE TOTAL New Fixtures $7.00 N (-U Old Opening, Now Fixture $4.00 Beer Dispenser $5.00 Blow Off Basin $7.00 Catch Basin $7.00 Rain Water Leader $7.00 Sump/Receiving Tank $7.00 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 $15.00 JOB ADDRESS 53 7* S7-' -Af - 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 Building Division, and hereby declares that all the facts and representations stated In this application are true and correct, I Owner _41+16 • Building Used As Estimated Cost PERMIT NO. i ` ,_ "'.17 PLUMBING COMPANY 0 W 0 C INS+ Reinspection Fee $42.00A-ir SIGNED 8Yf1.L—zPjt TEL NO, f'610 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS V 1.5% of Value of Fixture or Appliance Approved By Rough—In Date Final Date 41�C State Surcharge $ .50 .11949 MINIM UM -FEE FOR ANY P"BINGIGAS PERMIT IS $20.00 TOTAL FEE $ PLUS THE $.SQ STAT SURGE "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. SUBJECT City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 2 3 8 96 Ir � R CEIPT�NpO. • COMMUNITY DEVELOPMENT DIV. `v------ r PROTECTIVE INSPECTION SEC. NUMBER REV DATEPAGE P OF APPROVED By CITY HALL FRIDLEY 55432 ' 612-571-3450 910-F15 11/27/95 JOB ADDRESS 5370 4 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 2, 3 13 Hamilton's Addn to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Keith Rodgers 7313 University Ave NE Fridley, MN 55432 786-4610 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 IV ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Basement bath remodel 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Structure is not to be used as a two family dwelling and owner is to provide letter to City stating such. 'SEPARATE PERMITS Pi7n ►IRED FOR WIRING, HEATING, PLU-Br,;ING 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 1 STALLS I 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 $1,650 $.83 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 PLAN CHECK FEE TOTAL FEE $56.48 SPNATURE OF 0 TRACTORORAUTHORIZEDAGENT (DATEi n 4%LGNATURE WHEN PROPER VALIDATED THIS IS YOUR PERMIT ZV OF OWNER OF NER BUiLDERi �DATE� BL iNSP GATE NEW (] Effective 8/l/95 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Fire Surcharge Building Permit Application Construction Address: 6� 3 ?:0 - y 7� ST- N. 9 _ Legal Description: $ Owner Name & Address: t ,� c A t/ S Tel. # Contractor: h10 N e 3 / r�' / - r 2-� LICENSE # Address: Tel. # Driveway Escrow Attach to this application, a Certificate of Survey of the lot,, with the proposed construction drawn on it to scale. $ Park Fee DESCRIPTION OF IMPROVEMENT Sewer Main Charge $ Length Width S Height Sq. Ft.. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Len Width HgtlGround Sq. Ft. OTHER: i AA7-/ A Looe` te-14a r Corner Lot [ ] Inside Lot [t. Yd Setback Side Yard Setbacks "Type of Construction: Estimated Cost: $ Approx. Completion Date: r (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = � Ft x $ _ $ DATE: y- Jj' — 3' APPLICANT: Tel. # ' G G / O CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $850 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 [ ] 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 $850 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 [ ] 1A` 4�V�' ACJ oved exrp 27,- &1,k — Remove bvfs4 *6--s ,bA , Wrf� `rwa Mew W;4-L,S,, Are ® \ 4 /MS7WLLe orf FufA%At�IDay aO Lf S�c e 7 A ,i 8.I �I 1� CITY OF FRIDLEY INSPECTION DIV, Effective On August 1, 1995 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 �e p�� c e ,Fa OW,4 e e Rate TOTAL Furnace Shell and Duct Work, Burner — Also Replacement Furnace $ 30.00 (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) $10.00 $� Il/e w S� &t Gas Range Otic i/hL11e_$10.00. $ Gas Dryer $10.00''. . $ *Air Conditioning — All Sizes $ 25.00. $ All Others/Repairs & Alterations (LIST ON BACK 1 % of Value of Appliance or Work ; $ Commercial/Industrial 1.25% of Value of Appliance or Work $ State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/CO OLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $26.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner, JOB ADDRESS -5 3 7 D' • y *S; �$_ A 9 , 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 Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. A/4 ✓ J 91995 BUILDING USED AS OL T ESTIMATED COST PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No, of Heating Units Circle One (Steam) (Hot Water) arm .Trach -Name .'CL Size No. BTU loop o -no HP EDR Fuel GAS Total Connected Load Burner Trade Name Size No. BTUHP EDR HEATING COMPANY_ Signed By Tel No. Approved 7-SIDE FOR Rough—In Date Final Date %/ 7-` FILL OUT BACKTACK VERIFICATION ON REPLACEMENT FURNACE su6JECT PERM City of Fridley 8 8 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT COMMUNITY DEVELOPMENT DIV. I V SEC, r , PROTECTIVE INSPECTION t//1 NUMBER REV DATE PAGE OF APPROVED BY I = /---1 CITY HALL FRIDLEY 55432 ti--"� , �'� 612-571-3450 910-F15 9/21/98 JOB ADDRESS 5370 4th St NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. pt2, All 3 13 Hamilton's Addn to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Reith L Rodgers 786-4610 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION %l REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house (squares unkown) 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 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 $2,000.00 $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. $62.25 Fire SC $2.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $65.25 g0RO SI�ATuaE OF CON'aACluTH�GENT �DATEIWHEN PRpPERLV LIDATED THIS IS YOUR PERMIT BLOCIINS(//P1d/'/I �l4As/T7E GNATURE OF OWNER.-FFOVVNNA BUILDERI IDATEI NEW [ l ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION j(A ConstructionAddress j Effective 1/1/98 Legal Description: Owner Name & Address: IlP�� ®��r Tel. # 7S1G —q to Contractor: MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Grou d Sq. Ft. OTHER: C.� %� 5 Construction Type: 116e P a e r _ Estimated Cost: $ U U 0 ° c' (Fee Schedule on Bark) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: �1� ® 9 F Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge APPLICANT: e• ,I W IY&r Tel. # CITY USE ONLY $ �� 1' Fee Schedule on Reverse Side $ . DO .001 of Permit Valuation (1/10th%) $ 1.00 $.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 [ ] TOTAL $ 6 STIPULATIONS: NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: % b /v Legal Description: Owner Name 8 Address: a Tel. # Contractor. MN LICENSE # Address: 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: Construction Type: Estimated Cost: $ O G Driveway Curb Cut Width Needed:_,5 Ft + 6 Ft = _e Ft x $ /f = $ l87, DATE: l ® APPLICANT: j!re Tel. # %ti -SS4 • o SSo Call (763) 572-3604 for Permit Fees if mailing in application or 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 Driveway Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - P Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ ] TOTAL $ STIPULATIONS: BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair 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 herein provided to -wit: Q1T7:irfi $1 to $500 U44,.o � m°2, $501 to $2,0(—_-- _ 00 or $2,001 to $25,----- --- - -- -_ --1�,---�-------1$1,000 91 $25,001 to $50 -- -- - -- --- --- _eKWN_z_-nal $1,000 $50,001 to $101 _ --- --- 4b—pal $100,001 to -A/" 54t 16Y -)nal - — ----- --- -7 $500,001 to $1--- --- - - additional — - — - 00 $1,000,01 ani --- - --;h additional Removal and i-_ -- )0. Permits for cc _ ttion to allow for proper review of the I__ A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only Commonwealth Land Title Insurance Company Suite 1780 8500 Normandale Lake Blvd. Bloomington, MN 55437 Regarding: 37144R 5370 - 4th Street NE Fridley, MN 55421 Anoka County. Minnesota Date: August 15; 1995 DISCLOSURE PURSUANT TO MINNESOTA STATUTE §507.45 (To Be Made At Least Five Business Days Before Closing) TO THE PART' TO BE CHARGED Keith L. Rodgers 5370 - 4th Street NE Fridley, MN 55421 The charge for closing services of the above - referenced transaction will be $250.00* Please Note: You will be required to execute the following contract at closing. CONTRACT FOR CLOSING SERVICES The undersigned hereby contract for closing services in conjunction with the above referenced transaction for the above -stated charge. Minnesota Statute 507.45 requires the following notice to be given: "The.real estate broker, real estate salesperson, or real estate closing agent has not and, under applicable state law, may not express opinions regarding the legal effect of the closing documents or of the closing itself." Furthermore, the undersigned acknowledge receipt of the above stated disclosure at least five business days before closing.* Keith L. Pdgers * Payment not required until closing. NOTICE OF DECLARATION AND DESCRIPTION OF EASEMENT NOTICE IS HEREBY GIVEN, that the undersigned, Florence M. apes, Richard H. Kappes, and Rose M. Kappes, are the owners of following described real estate located at 5370 - 4th Street in the City of Fridley, Anoka County, %Iinnesota (the Dminant Estate"): DOMINANT ESTATE Lot Three (3) and the South One-half of Lot Two (2), Block Thirteen (13), ".Hamilton's Addition to Mechanicsville", Anoka County, Minnesota, d that such owners of the Dominant Estate declare and affirm at they have acquired and own an easement by prescription for cess over and upon the following described real estate situated Anoka County, Minnesota (the "Servient Estate"): SERVIENT ESTATE Lots Twenty-eight (28) and Twenty-nine (29), Block Thirteen (13), "Hamilton's Addition to Mechanicsville", Anoka County, Minnesota, )gether with access over and upon the dedicated alley right of iy adjoining the Dominant Estate and the Servient Estate, for irposes of ingress to and egress from the Dominant Estate and 11 rights incident thereto pursuant to the law .in such case made 1d provided. That the said owners of the Dominant Estate further declare ad affirm as follows. Burkhar.d F. Kappes and Florence M. Kappes, ssband and wife, acquired tee title to the Dominant Estate as Dint tenants with right of survivorship by warranty Deed from ENMU :.IYti::?,.7la+Jvac:✓%u!':.:=:s.ttl;�ar#'. .« ,i^ ....rr. Bankruptcy in the office of the County Recorder, Anoka County, Minnesota. 22 EXCEPT for Religious Corporation, if any, where conveyance has been shown running from or to a Corporation, only Corporate records which indicate mergers or name changes during the ten years searching period here been shown. •Clayton John Charley and Beatrice S. Charley, husoand and wife, dated May 25, 1971, and recorded on May 25, 1971, as Document No. 349481 in Book 911 of Deeds, page 465, in the office of the Anoka County Recorder. Clayton John Charley and Beatrice S. Charley acquired fee title to the Dominant Estate as joint tenants with o Warranty Deed dated October. 19, 1960, right of survivorship Y ;NLand recorded on October 22, 1960, as Document No. 215684 to Book 498 of Deeds, page 428, in the office of the Anoka County ;.Recorder. Hurkhard F. Kappes and Florence M. Kappes (the Fee Owners") sold the Dominant Estate to Richard H. Kappes and Rose 'M. Kappes (the "Contract Vendees") pursuant to Contract for Deed �q rded on August 31, 1981 as ``dated April 28, 1981, and reco Dcoument No. 577138 in the office of the Anoka County Recorder. Burkhard F. Kappes died in 19J and Florence M. Kappes is the .surviving joint tenant and fee owner of the Dominant Estate (the "Fee Owner"). The Contract Vendees entered into possession of the ril 28, 1981 and have continuously possessed Dominant Estate on Ap the Dominant Estate since that date. The Fee Owner and the Contract Vendees declare and affirm that they, and each of them, and any persons claiming by or through each of them, have used and exercised use of and over and upon the Servient Estate for purposes of access and for ingress and egress from the Dominant Estate continuously since at '1'easr. May 25, 1971, and that such use and user has been open, visible, continuous and unmolested, exclusive to Fee Owner and Contract Vendees, and hos-tile and adverse to the lee owners of i i -2- Y . C 1 ,R Mrlr a�;g}g9� ` 1- •aA•• ... ., �t•:,.�,'•4?:i .,, ,.. y •o;,t'�x7�{�.'ti.-_:•s•a}�rpst t�flAM Y_ . r .' ti ' I?vf•'"'.9 •,"i. i ;•�+4^i�:�4�';1�•n'CiVA�% The Fee Owner and the Contract vendees the servient Estate. such purPoses.The Fee Owner maintained the Servient Estate for ton John Charley and e ►. that Clay declares and affirms of and over Further .:sed and exercised use Charley simi.arly s and for ° Beatrice S. urposes of access and upon the Servient Estate for P ant Estate for a number of ingress to and egress from the Domin the time the Dominant 25► 1971 and during years prior to May and that such use and user was owned and occup pied by them Estate exclusive to them► and unmolested► 4 visible► continuous Servient Estate, ,o was open► fee owners of the and adverse to the and hostile � same for such purposes* Vendees ti and maintained the Owner and the Contract the Fee tion of ' IN WITNESS WHEREOF, and Descrip this Notice of Declaration have executed day Of July, 1993- '• as of the ,a Easement r3 • ;:n CONTRACT vENDEES ' .t. FEE OWNER ► 1.1 / `� fy, «• 17 Ric ar Kappas I g orence• M. app e$/ JANELL S1A1► '\ W0U S0tA U se M. Kapp ` � •• � µo SON 0CN IIVM�if �U •t' .F �utv to.taot ST ss.i. /•, �: a. Notary COUNTY OF tore me► ► ` 1993eSr the surviving day of/' KapP On this mare' or ce M. acknowledged " '• Public:► personal y appear Kappe9r who executed and i joint tenant of Burkhart as her free act and deed. the f, going instrume t i IN ry Pub ic► -3-