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PRE 2010 DOCSTH AC TH AN VEI City of Fridley SUBJECT 1939 AT THE TOP OF THE TWINS BUILDING PERMIT !70 r RECEIPT • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r, i j ��'-';•, CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ---. L J\ 612-571-3450 910-F15 4/15/88 JOB ADDRESS 645 - 5647 finXNn1 4th Street N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 28,29,30 3 Hamilton's Additiozi to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Darwin Petersen 5255 Washington Street N.E., Columbia Heights, MN 55421 572-8201 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 USEOF BUILDING construct 1-23' x 20' Garage; and Construct e Foundation (5316" x 321) for House to he Moved In: 23' x 20' Slab for Moved In Garage 7 CLASS OF WORK l NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK See Above Duplex and Two Garages (Duplex and One Garage to h oved i • o arae 0 Be construcMd on site. - •213 SV9 - 91919313' 3N10HdTi."31 9 CHANGE OF USE FROM TO S2! l 1 IewIII05 Suinip 535y0 3 A71' M xR. n, STIPULATIONS1 ` Building must meet all current Codes after relocating' o &%" `�he City with copy of verifying survey after capping. Provide a hard surface driveway. Provide sod in the front and side yards. SEWER LOCATION: (Services off 4th. Street) 110' S. of M.H. @ 57th & 4th (Inv. 839.12) WYE ELEVATION: 840.17 TOP OF FOOTING: 843.17 Minimum WATER LOCATION: 121' S. of M.H. @ 57th & 4th: llt S. of Sewer Service DRIVEWAY DEPRESSION COST: (2 Drives)44' x $13.50 = $594.00 CITY OF FRiDLEY DOES NOT GUARANTEE THE URACY OF UTILITY LOCATIONS AND ELEVATIONS. SEPARATE PERMITS REQUIRED FOR S DATA IS FOR INFORMATION PURPOSES ONLY, WRING, HEATING, PLUMBING AND SIGNS. PERSONS USING THIS INFORMATION SHOULD VY IT ON THE SITE. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 2 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 $30,650 $] 5.33 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- $197.50 $1,100.(2 SAC's) STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $49.38 $1,362.21 + DW SIGNATURE OF CONTRACTOR R AUTHORIZED AGENT WHEN PROPERLY LI DATED THIS IS YOUR P(:RMIT �1 CIDATEI BLDG INSP pT SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI 01 NEW [� ADDN. [ ] ALTER. [ ] Construction Addr4 Legal Description ,"t ,�, ,,�p� Owner Name & Address: ® 4� �Z�S �� MA Tel. # - ZZ -R2, Contractor: S E MDI- E U.1 !" Q l�1 G m OV a RS Tel. # 77'y IN 2-1 Address: 122.51 QQC6A If ST t' AMe City of Fridley R-1 AND R-2 Building Permit Application Effective 4/1/86 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. O: )L"tt DESCRIPTION OF IMPROVEMENT 0u-/jbA-0 LIVING AREA: Length 5-3((o'0 GARAGE AREA: Length 23 Z_ ' e -MRA Length 2 OTHER: S - Width 3 2L Width 20 Height g Height d Sq. Ft. Sq. Ft. ,e/� Sq. Ft. 411610_ dAJ J# Corner Lot pC] Inside Lot [ ] Ft. Yd. Setback 36" Side Yard Setback 7, Type of Construction: �YQr► 0-T-EstimatedCost: $ �-GS. oy Approx. Completion Date: Sq 40G Alt. A Alt B Proposed Driveway Width If New Opening Is Desired �2 Zl�f$ $ See Back Page for Explanation DATE: - 2 APPLICANT: -bGs � Tel. CITY USE ONLY Permit Fee $ IT7.wo Fee Schedule on Reverse Side Plan Check $ 4 y. 25$ of Building Permit Fee State Surcharge $ 1 J�.�J3 $.50/$1,000 Valuation `72) SAC Charge $ $ 5,59 per SAC Unit Park Fee $ Fee Determined'by Engineering Sewer Main Charge $ TOTAL $ Agreement Necessary [ ] Not Necessary [ ] � � 21 STIPULATIONS: Q2 W*4 •� Mu16 q-? A & c. CV tMkA4- CWS IQs • 1 , 24 h'IP�JA,7,wllur�iia1� r: 1 e:wi„1,''1 `qtr rrra.�a>ra�3ll �i�r�;. Q- R•o.2-4�'8h Cw I N. 1 I I i Q'0 36"cove APPO MoD Tu SLAB i i BIN 9-'0" g pve<�I�Y91 Oil 8 all I + W \D j1 H ip TRU sses a 2400E n 8” TEX ALUM LAP To MAttN- Y2" L3UILi@IT6 I�irr. 2x4" s7uDs 16"oc Vii"GuiRb 4"Low SLAZ Ww e Co AGL StG 1-40 NoTe - No H"cuRb ON MOV 0n GAaaF-K NZT \n ~O1 %n 241no As PM ALT SMAWL9 I j I"... . —, 415 FELT PAPC-I-' ' 0 ALUM FACetA ALUM soMT l �r TRt'b 214"SiLL PLPITE I 'o I � I Q" CoA)L C UR a l LJ#JEXcA VAT€b I I I � l Q- R•o.2-4�'8h Cw I N. 1 I I i Q'0 36"cove APPO MoD Tu SLAB i i BIN 9-'0" g pve<�I�Y91 Oil 8 all I + W \D j1 H ip TRU sses a 2400E n 8” TEX ALUM LAP To MAttN- Y2" L3UILi@IT6 I�irr. 2x4" s7uDs 16"oc Vii"GuiRb 4"Low SLAZ Ww e Co AGL StG 1-40 NoTe - No H"cuRb ON MOV 0n GAaaF-K NZT \n ~O1 %n 241no As PM ALT SMAWL9 I j I"... . —, 415 FELT PAPC-I-' ' 0 ALUM FACetA ALUM soMT l �r TRt'b 214"SiLL PLPITE I 'o I � 32-' o (w.M. TZR(L)G) - I 13-o v nr, ail WALLS w//xi ilk CiEDROOM N �N R -MAX INSDL I'ANELI6 _ FINLSAa B,El RM `2n SR SPRAYED o L'W [Is- � �^ ` -;.r . I CSG = OFy "SR /I I r S`�CONC Sal a"conic Fr/, I ` !! CARETCO r5 \ 2s, i CARPET 24 REBA 6X6 llz-vD 'TIMBER. I � W I Nibbd W 6L,L AU LAI� r4 p - I I s dD s� 98"MIS• Z�Ep w/ p;:° L 4' o' ��alni n�E• LT LT / n GEMENT Voll 3 2 — (2� -5 REBRRs To �M CONC SLAG FLK DRN t II o• ' �6 O NW k Faw I \ �— M T 12 x Y ACE Ess Z0- 2 X" -2x 4"e 16 o c 44 cuaa sm 1 -r - I 2oz8 �Cot&FIM ' 16x8'Cmuc Fre I vN I I � I I , I M t I 13 ► I �- I rI I N _ I I (%Tt( .Sibs) #5 IZEBALS T- FL - CEMEMI VOID N6TEC. ANDrIcsEu P-IeMA• 5141111, W/rvj)uus- � i llt*C �•Z I � I Lav 7� 8-'Sn 8 �5„ I 7 32= o " BAMEMENT PIAN %4" M�� 32'0' - LEFT tLtV. P,16 14 -r 5LEV , li -rje't% SOIL ATE tSEALZP- Furz our RV 10 3/4"IrSX p. -MAY 3- I NSUL WATER Pe"FG C a. L 4- 3P76 uoa7. 201 ave&K rr/, l.%j,.rww-nLr wIA6t. UAZE-H EMT SEc- 'bAR-WIM PETE-2SOM KAM 1�lo�ttM Lots 2A1 24, AND 3o BLnck �3 ' L NAMILtom fiUU►T16N To m FPzID1.EY I MN 6MOKA CouuTY 119.5' � ci14.s FL 1-7.s' 20.0 12.s :22,or /2.g + -Lo -01 � � q�E•o�e►. � I o _ o u ° I hoe h 41 �r ARAM EW M GA e c conic N �F cI80-►E1 �A 478 tL 978 5 @f 1 dWe bidV(.WAY I 97LS�EL ` 119.5' 97f.. EC f I T REE PLOT PLAw M'All E t 0=20.0 �1 i r 1�lo�ttM Lots 2A1 24, AND 3o BLnck �3 ' L NAMILtom fiUU►T16N To m FPzID1.EY I MN 6MOKA CouuTY 119.5' � ci14.s FL 1-7.s' 20.0 12.s :22,or /2.g + -Lo -01 � � q�E•o�e►. � I o _ o u ° I hoe h 41 �r ARAM EW M GA e c conic N �F cI80-►E1 �A 478 tL 978 5 @f 1 dWe bidV(.WAY I 97LS�EL ` 119.5' 97f.. EC f I T REE PLOT PLAw M'All E t 0=20.0 (its �QAAol,, , 2 O l�pl3 = moi% X I �(, �Co � (0160S.40 ao lam = y`o xaao a, a.00 , ZS,00a ( 9 q.60 so n Form No. 28-M—QUIT CLAIM DEED Individual It) to Corporation or Partnership Minnuota Uniform Conveyancing Blanks (1878) No delinquent taxes and transfer entered; Certificate of Real Estate Value ( ) filed ( cjjwLrequired CertiRe to of Real Estate Value No. o by �. Auditor STATE DEED TAX DUE HEREON: $ — a — Date: April 18, 1988 ohne►-Dew. Co., ohnnespo ss 806035 t (reserved for recording data) f FOR VALUABLE CONSIDERATION, Darwin B. Peterson, A single p& -sen (marital status) Grantor (s), hereby convey (s) and quitclaim (s) to City of Fridley a . municipal corporation , Grantee, under the laws of Minnesota real property in Anoka County, Minnesota, described as follows: A street and utility easement described as follows: Beginning at the northwest corner of Lot 30, *Block 3, Hamilton's Addition to Mechanicsville. Thence east along the north line of said Lot 30 a distance of 25 feet; thence deflect to the right in a southwesterly direction 135 degrees to a point on the west line of said Lot 30; thence north along said west line to the point of beginning. I v' Y a �I�a v 'l5• P z4vo The City of Fridley hereby accepts this easement for Street and Utility purposes. SHA7LF.'Y A. HAAPALA - CITY (' •.. w w.s. o',� ' • ., a --.• r - • i -e • . (if more space is needed, continue on back)e: together with all hereditaments and appurtenances belonging thereto. TLt ;;tamp Heti' - — STATE OF MINNESOTA ss. COUNTY OF Anoka The foregoing instrument was acknowledged before me this 1 Ri-h day of Az ril by 'lanai n A Reterson — D ai »;1 a percnn Grantor (s). NOTARIAL STAMP OR SEAL (OR OTHER TITLE OR RANK) CLYDE V. MORAVM PUBLICWrARY ANM A MY Qafflm. E4L def. at Ini; THIS INSTRUMENT WAS DRAFTED BY (NAME AND ADDRESB): City of Fridley 6431 University Ave., N.E. Fridley, MlV 55432 1 8I ATURE OF PERSON TAKING KNOWLEDGMENT Taz Statements !or the real yroperty doscrlbad !o this Instrument should Im sent to (Iaciudo tome and addron o! Grantee): F /�7«-If City of Fridley AT THE TOP OF THE TWINS ;,. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. l1 = � ---- A ��'--,•� CITY HALL FRIDLEY 55432 L J ` 612-571-3450 SUBJECT MOVING INTO FRIDLEY xBUIDING P E R M I T P RMIT 19431 ECEIPT NO. /� NUMBER 910-F15 REV. DATE 4/29/88 PAGE OF / / APPROVED BY JOB ADDRESS 5645 - 47 411h Street N.E. (Duplex) 1 LEGAL DESCR. LOT NO. 28-30 BLOCK 3 TRACT OR ADDITION SEE ATTACHED Hamilton's Addn. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Darwin Peterson 5255 Washington Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Semple Movers Inc. 1257 Barclay Street, St. Paul 22494221 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Duplex and Garage 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR IR MOVE ❑ REMOVE 8 DESCRIBE WORK Move Duplex and Garage Into Fridley 9 CHANGEQFUSEFROM TO STIPULATIONS Stipulations on corrections to be made to duplex and garage to bring structures up to Oode are listed on Foundation permit for Duplex. Route: Washington Street to 49th Avenue to Main Street to 57th Avenue to 4th Street 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 AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION ZONING SO. FT. CU. FT. 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED VALUATION SURTAX WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PVI IONS OF ANY OTHER STATE OR_.LOCAL LAW REGULATING CON- ST U TION OR THE PERFORM E CONSTRUCTION. PERMIT FEE $100.00 SAC CHARGE PLAN CHECK FEE TOTALFEE $100.00 SIGNATOR FCONTRACTORORAUTHORIZEDA T (DATEI WHEN PROPERLY^A LI DATED THIS IS YOUR PERMIT BLDG )NSR OA SIGNATURE OF OWNER OF OWNER BUILDER) (DATEI [� Moving k1 -14� [ ] Wrecking X� e J City of Fridley • t • • •05I • r vs_ cr,l January, 1988 Job Address: Y,7 - , '/' /v Legal Description: SO/ -7//f g m s'//aim° 177 0 G77i'NGc z7o Owner Name & Address: 5-':91V 15-19 SS" �as�i, �''�if/Y To # s`7z . �2 / Contractor: 5`eM v �I Tel # A7- Address: yAddress: _SocS7 /� G��e1 5-7- State License # "Z / DESCRIPTION OF LDIWa Living Area: Length 5"-4 Width 7-7-- Height Sq. Ft. _ Cu. Ft. Garage Area: Length ;2-d— Width 2-0 Height Sq. Ft. Cu. Ft. Other Length Width Height Sq. Ft. Cu. Ft. OEM— Estimated Cost of Wrecking/Moving eLk�79:V d ---1 Approx. Completion Date x'03- Utilities to be Notified: City Water/Sewer Mpls. Gas Com Northern States Power 571-3450 372-4720 566-9120 Northwestern Bell Tel Co. 293-0665/2y3-1.119 Water Bill Paid: Yes Amount To Be Collected P ] Initials Moving Route: .i cJ� . !� i9� � �v -- �� ec"jY � % FEES Moving: Principle Building into Fridley . $ 80.00 Accessory Building into Fridley . . . . � 20.00 Through, within or out cf City . . . . $ 15.00 MINIMLTM FEE: $15.00 Wrecking: For each 1,000 cubic feet or fraction . $ 1.25 For structures which would be impractical to cube, the fee shall be based on the total cost of wrecking at the rate of $6.00 for each $500.00 or fraction. The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Building Department, and the State Code which requires any water well on the property to be sealed by a State licensed water well driller, and hereby declares that all facts and representations stated in this application are true and correct. ./ Signature PFd2MIT /:4-22:; � Stipulations: V1 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT N N N 1 u 14 5 q roro P4 NG +i �y IA Y y m t, E.C• 3 br C a O W rn W �i N 14 a Chi o4n -oi B� � 3 .i a og07� .x4 w t P t7 o Water Heater s lec S 2 $ 5.00 $ R $ 5.00 1�- Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 S Sump or Receiving Tank lst 2 $ Z $ 7.00 Z Hot Water Heater $ 5.00 $ 2 $ 10.00 $ Gas Dryer 7 -- 10.00 2nd 2nd ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance $ State Surcharge $ .50 Reinspection Fee $ ($15.00) TOTAL FEE $ % 3rd 4th (R) d Future Connection Opening Connected with Sewer (*) a New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New' Fixtures $ 5.00 Future Fixtures $ 3.50 Old Opening, New Fixture $ 1.50 $ Beer Dispenser $ 4.00 S Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 S Sump or Receiving Tank $ 5.00 $ Water Treating Appliance $ 7.00 $ Hot Water Heater $ 5.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance $ State Surcharge $ .50 Reinspection Fee $ ($15.00) TOTAL FEE $ % Effective Aug. 1, 1981 Job Address 5(-,416--41-7 T Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. OWNER Si i w � KIND OF BUILDING USED AS TO BE COMPLETED ABOUT 7:75 &&4NQ,,. ESTIMATED COST , 0 0 OLD - NEW BUILDING PERMIT NO. PERMIT NO. O017 0 Company / Signed Tel. No. _ ROUGH INSP. Date 4 FINAL INSP. "O Date APPROVAL FOR PERMIT \ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE SUBJECT P IT NO. City of Fridley o 19 6 4 8 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. •COMMUNITY DEVELOPMENT DIV. LU -------- r PROTECTIVE INSPECTION SEC. '30094 1 ; � 1 1 CITY HALL FRIDLEY 55432 ".j NUMBER REV, DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/26/88 JOB ADDRESS 5647 - 4th Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 28,29,30 3 -Hamilton's Addition to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Darwin Peterson NN 5647 - 4th Street N.E. 572-8201 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton Johnson Co. 2513 Central Avenue N.E., Minneapolis, MN 55418 781-9548 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 ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside, Soffit, Fascia 9 CHANGE OF USE FROM TO STIPULATIONS 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 2 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX ANDoRDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3,500 $1.75 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- $63.00 UCTION OR THE PERFORMANCE OF CON TRUCTION. AN CHECK FEE TOTAL FEE $64.75 SIGNATURE OF CONTRACT RORAUTHORIZEDAGENT IDATEI rO WHEN PROPERLY A IDATED THIS IS YOUR PERMIT BLDG INSP OA 1 SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] City of Fridley Effective 5/L88 ADDN [ ] R-1 AND R-2 ALTER [ l Building Permit Application Construction Address:_ S6 5`% — ST. ti -,f . Legal Description: Owner Name & Address:_�i4.°�vdJ�iG✓�s�n� �-�� _ Tel. # Contractor: 70 Tel. # ;2-f/ - s Su d Address:s/� L� ,x.14 G eS� ✓�� _ ili E,. �� S'i �' Attach to this application, a Certificate of Survey of the lot, with the proposoed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sg. Ft. QMRAGE AREA: Length Width Height Sg. Ft. ' DECK AREA• Length Width Hgt/Ground Sq Ft. Corner Lot [ ] Inside Lot [ l Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: Approx. Completion Date: 7-/ S- - Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ Width + 6' See Back Page DATE: APPLICANT: Tel. - CITY USE ONLY Permit Flee $ 6 State Surcharge SAC Charge $ Driveway Escrow 5 Park Flee 5 Sewer !lain Charge 5 TOTAL BIONS: Flee Schedule on Reverse Side $.50/511000 Valuation $550 per SAC Unit Alt. 'A" or Alt. 'B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] City of Fridley AT THE TOP OF THE TWINS SuBjECT BUILDING PERMIT 7711 IT NO. r `v ______ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 = � CITY HALL FRIDLEY 55432 A-01 01 "'j 612-571-3450 R EI �5 NUMBER 910-F15 RE7 DATE 8/16/99 PAGE OF APPROVED By JOB ADDRESS 5645 - 47 4th Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 28,2 30 3 1 Hamiltons Addition to Mechanicsville lle SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Darwin Peterson 2323 145th Ln NE Ham Lake 55304 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Milton Johnson Co. 525 Lowry - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential - Duplex 7 CLASS OF WORK 0 NEW 0 ADDITION 0 ALTERATION 7CE REPAIR 0 MOVE 0 REMOVE 9 DESCRIBE WORK 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIREO 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION ZONING SO. FT CU FT 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 I STALLS GARAGES 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 VALUATION $3845 SURTAX $1.92 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE F CONSTRUCTION PERMIT FEE $97.25 SAC CHARGE Fir SC $3.84 PLAN CHECK F TOT L FEE l6 SS Lic S $5 0 $ 08.01 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEi HE VALID TE THIS IS_WUR PERMIT SIGNATURE OF OWNEROF OWNER BUILDER, iDATE, BL INSET ( MATE NLW Ix ( Effective 1/1/97 ADDI* ,[ ( ' CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConsttuctionAddress• 5645-5647 4th Street N. -E. D® I4 Legal Description: Owner Name & Address: Darwin Peterson 2323 145th Ln. N.E. Tel. # 434-2766 Contractor: Milton Johnson Co HLCLILL MN LICENSE # 2 0 8 3 Address: 525 Lowry Avenue N.E., Mpls. 55418 Tel.# 781-9548 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEj%jENT LIVING AREA: Length Width _ Height Sq. Ft. GARAGE AREA: Length _ Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Tear off and re -roof house & ��/� C0nsft=d0n Type: (2) garages; Aluminum tri Estimated Cost• $ •10,,500.00 ryc�� .(Fee Schedule on Back) Driveway Curb Cut .Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: /" ' APPLICANT: J Tel. 781-9548 A CITY USE ONLY Permit Fee ~ire Surcharge State Surcharge SAC Charge License Surcharge driveway Escrow =sion Control 'ark Fee ewer Main Charge TOTAL TIPULATIONS: $ ��--Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $ $950 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 [ s o � 11 M N�wa� Building BUILDING Permit No.: Inspections D RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE zo —! S� YOUR E-MAIL ADDRESS S 7 Yf SITE ADDRESS -S r THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME:(R ADDRESS: CITY STATE—ZIP TENANT PHONE: CONTRACTOR NAME• v �- c L 7-0 STATE LICENSE #2QCj 693 6 EXP DATE SUBMIT A COPY OF r �-o� J I ®I � �S STATE ZIP SS yw YOUR STATE LICENSE ADDRESS: r`� CITY P' WITH APPLICATION PHONE 7(-3 — 715 ( —5r 75- FAX PROPERTY TYPE ❑ INGLE FAMILY/NEW CONSTRUCTION SIZE O FAMII Y/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑0�E/SHED ❑WINDOWS ❑ BASEMENT FINISH ROOF DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION �zr ❑ MAINTENAN AIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH ` WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE I. Existing Floor Plan 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 ❑ and proposed project 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WS OR FOR NEW OPENINGS-DESCRIB E OF OPENING CHANGES & TYPE OF WINDOW TO BE INS T ED OF WINDOWS ALL FEES ARE BAS)KD ON V TOTAL JOB VALUATION Permit Fee Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due -INCLUDING THE COST OF LABOR AND MATERIALS: 1997 U.B.0 FEE SCHEDULE) ) OCCUPANCY TYPE $ $ D $ $(�D $ $ See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) times the total job valuation — Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach 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 applicatio or a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all wor h requires review and approval of plans. /�( lam_ \ % _ SIGNATURE OF APPLIC PRINT NAME ! � (`a °c' c z //V r'` DATE /� `�