PRE 2010 DOCSI
my coadmad" SYMM MW 06TIGGS
PAR7 6 L RATIZ SCHEDULE
4--MAVTff WARM AIR-
&ATE TOTAL
7uenaor Shell A Duct 'rah ....
..... ..$10.00 $
Replacement of Furnace ...
6.00 $-
Repairs & Alterations—up to $S00.00
6.00
Repairs & Alterations each add. W00.03
3.00 �L—
Shell & Dutct T c z „- 3�—
each add. 6O.M. L,sJ'
Replacemed of F lumce �.� A to '
Repairs & Alterations—up to $50000 600 �--
Repairs & Alterations each add. $500.00 3.00 $
rurnace Shell & Lines—to 400 sq. ft EDR Steam
$10.00
S. --
]Furnace Shell & L4ne-4o 640 sq. ft. MR. Hot Water
10.00
�.
Each add. 300 sq. ft. EDR Steam
3.00
Each add. 330 sq. ft. EDR Hot Water
3.00
$_ _
OIL BURNER—to 3 gal. per hour
600
$ _
over 3 gal. per hour --See Fee Schedule
GAS BURNER (up to 199,000 BTU)
6.00
$___S --
am 195,000 BTU Se* roe
GAs rrrnNG FEES:
NO RATE TOTAL
Ist 3 Fixtures
x$ 100
$
Additional Fixture
x ,75
$
Gas Range to 199,000
X$ 600
$
AIR C---- IOXMG
rAN HEATINQ sTSTM
1IEZIT LATING STSTM
ALTERATIONS & REPAIRS
rI MY -/9- 73-
lose roe adwade I
TOTAL 71M
., :..1'.
I
City of Miley:
The undersigned hereby makes application for a permit for the work bereb
specified, agreeAng to do all work in strict.0goardance, with the My Chthieneft
and ruling of the Department of Buildings, and hereby deckww that an Me fad
and representations stated in this application are true and evnwL
Fridley, 43nn
o r"
Owner 9S -44,x -P_ tit�Z
Kind of Building--__:-e�
Used as
To be completed about
Estimated Cost,$-.�..._ __---
Building Permit No.
or WOBr
HEATING or POWER Hot Water. Warm Air—No
TiradeNam ` Ske wte_ t5 %
r
Capacity. J c °� 4 Sq. FL E.D B BTU—
Total
TU Total Connected Load Riad of Fue 44aA
BURNER — Trade — Size No
capacity Sq. Ft E.D A BTQ Hr.
(SMA {-OYtR]
J
SUBJECT
E21039
City of Fridley
AT THE TOP OF THE TWINS
BUILDING
PERMIT
�
ECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r 1 v PROTECTIVE INSPECTION SEC.
1
1 i
,S
NUMBER
REV
DATE
PAGE OF
APP OVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
8/30/91
JOB ADDRESS 7542 - 4th_ Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION .
SEE ATTACHED
DESCR.
23
2
Osborne Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Kathryn Treanor 7542 4th Street NE
784-3328
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
S>me
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 Dwelling (19 Squares) 2nd Layer
9 CHANGEOFUSEFROM TO
STIPULATIONS
Roofing can be 2nd layer but not 3rd.
I
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
$9.88
$•50
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-
$25.00
Fire SC $.99
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN -CHECK FEEALFEE
T
26.49
GNATU�E OF CONTRACTOR OR THO IZED AGE�N,T�/ IDATEi
WHIEN PRO
I T S IS YOUR PERMIT
BLDG NSP
DATE
iGNATURE OF 0 ER IIF OWNER BUILDER) DATEI
J
MW [ )
ADM [ ]
AIS [ )
•. e=i+t n . •I1:,
Legal Descr i_ ion:
Owner Nam & Address:
11-ftr-Tft./
R-1 AMID R-2
Building Permit Applioatian
Effective 1,/1,/91
mal- i*
41- 33,�?a�
Attach to this a1pplicaticn, a oartificate of Surveyof
lat, with the prcposed am= xuctim drawn co it to scale.
UVM AM: Length Width Hoicilit sq. Pt.
GMUM AM: Lezxjth Width sq- Ft.
.}M' MWidthh • n • sq.
• Y•131- / I I A I �
b•) - • .�- . ► • - •. • - • - ..
. • • s c • Driveway • New Opening Desired:
Width-- Back Page
M' �� ,� -�� L- -, T- •
Permit Fee $
Fire Surcharge $ - �'1
State Sur ii&rye $ . S7'
SAC Charge $
Driveway Es=vw $
Park Fee $
Sewer Main Charge $
sr�viAzza$:
Fee Schedule an Reverse Side
.001 x Permit Valuation (1/10th $)
$.50/$1,000 Valuation
$650 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Mqineering
MAY [ ] Not wry [ ]
ON c- (T" W (-rT£ K - -Oi-° -11 � t"m
LOCATION
MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring123329
No.
AND BORING SEALING RECORD
H
eWELL
Mnnlesota Unique No.ng
rWE�LLORBORING
Minnesota Statutes, Chapter 1031 or W -series No.
(Leave blank ff not known)
a
Township No.
Range o.
Section No. Fraction (sm. -s Ig.)
Date Sealed
Date Well or Boring ConsWcted
30 123
Lt VE NW;,
TUNE 20, 1997
1950's
Numerical Street Address or Fire Number and Pity of Well or Boring Location
'7542 4TH ST NE
Depth Before Sealing 15—ft
Original Depth 2 ft.
Show enact location of well or boring Sketch map of well or boring
AGUIFER(S)
STATIC WATER LEVEL
in section grid with °X°. location, showing property
lines, roads, an buildings.
Ingle Aquifer ❑ Multiaquffer
NW
LUBORING
Measured [I Estimated
�(1��18 ('
1�-Water Supply Well ❑ Montt. Well
I I I
[1Env. Bore Hole ❑ Other
2 ft. below ❑ above land surface
-'f- -T- -Y- --'I--
yy E
CASINO TYPE(S)
eel ❑ Plastic ❑Tile ❑Other
Yo mile
_ �- -�-- -�-- _-�--
CASINO
Diameter Depth Set in oversize hole? Annualar space Initially grouted?
S I114
�J"� W r mue
0 12
in. from to ft. ❑ Yes No ❑ Yes ❑ No ❑ Unknown
in. from to tL ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown
PROPERTY OWNER'S NAME
TRAINER
In. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown
Property owners mailing address H different than well location address Indicated above.
7542 4TH ST PSE
SCREEN/OPENHOLE
FRI DLEY , NN 55432
Screen from 12 to 15 ft. Open Hole from to ft.
OBSTRUCTIONIDEBRISIFILL
❑Obstruction ❑ Debris [IFHI A No Obstruction
WELL OWNER'S NAME
SAME
15;1
Type of Obstructlon/DebriefFlll
Well owner's mailing address H different than property owner's address Indicated above.
Obstruction/DebdalRll removed? Yes ❑ No
PUMP
Type SHALLOW JET
❑ RemovedNot Present ❑ Other
GEOLOGICAL MATERIAL
COLOR
HARDNESS OF
FROM
I TO
FORMATION
If not known, Indicate estimated formation log from nearby well or boring.
METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE:
PNo Annular Space Exits
SAM
BROWN
8
❑ Annular space grouted with tremle pipe
1-4
❑ Casing Perforation/Removal
BIn.
from to R ❑ Perforated [3Removed
In. from to fL ❑ Perforated ❑ Removed
Type of perforator
❑ Other
GROUTING MATERUU4S)
PORTL 15 SURF �
Grouting Material from ft yams bags
from to ft. yards bags
from to fL yards bags
from to fL yards bags
REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING
UNSEALED WELLS AND BORINGS
GEOLOGY FROM: % 3 40TH ��
Other unsealed well or boring on property? ❑ Yes No
LICENSED OR REGISTERED CONTRACTOR CE CATION
WATER LEVEL IN ABOVE WELL: 441
DATE: WATER LEVEL Tom: 05-20-8!
This well or boring was sealed In accordance with Minnesota Rules, Chapter 4725. The information contained in this report Is
true to the beat of my knowledge.
E.H. RE:NNER & SONS, TKC. 71015
rN
EA L
Contractor Business Neige lJcense or ReglsUatlon No.
According to {� N StatO Reg11'ationS
LU 6! y� a ea °A
6/27/97
Authorized Rep ntativeSignature Date
KEVIN SC ITERLEIN/KEVIN HOPPE
LOCAL COPY
H 2 3 3 2 9
Name of Person Sealing Wag or Bcdng
HE -01434.02 10UH5R
l
SUBJECT
City of Fridley
2 7 977
AT THE TOP OF THE TWINS
BUILDING
PERM 1 T
r
E ,
NO.
iCOMMUNITY DEVELOPMENT DIV.
v ------
INSPECTION SEC,
E PROTECTIVE
1
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
612-571-3450
910-Ft5
9/25/98
JOB ADDRESS 7542 4th Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
23
2
Osborne Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Brenda Schultz796-2114
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
O NEW O ADDITION O ALTERATION )M REPAIR O MOVE - O REMOVE
8 DESCRIBE WORK
Reroof house and garage 21 S Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
D
,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING It
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
$1799
.90
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
$56.75
FiA SC $1.80
PLAN CHECK FEE
T AL FEE
S59.45
SIGN, RE OF CONTRA
PR
H
LY VA E
D THIS IS UR
0-`rR
OEIL
N TUREOFOWNER,-FOWNEBUILE
OG IN$
OatE
l
a
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address (& f/
Contractor:
Address:
Effective 1/1/98
A
Tel. # "7W-, —,::� //
MN LICENSE #
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 _
GARAGE AREA:
Length Width
DECK AREA:
Length Width _
OTHER:
$
Construction Type:
SAC Charge
Driveway Curb Cut Width Needed:
DATE: v�
Ft. + 6 Ft =
Tel. #
Height Sq. Ft.
Height Sq. Ft.
Hgt/Qround Sq. Ft.
Estimated Cost: $ Zf ej r
(Fee Schedule on Back)
Ft x $ = S
CITY USE ONLY
Tel. #
Permit Fee
$ 'S (o• %f
Fee Schedule on Reverse Side
Fire Surcharge
$ A P
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$
$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
$
STIPULATIONS:
July 18, 2000
Doreena Cisewski
7534 — 4t' Street N.E.
Fridley, MN 55432
City of Fridley
6431 University Avenue N.E.
Fridley, MN 55432
RE: 7542 — 4t' Street N.E.
To whom it may concern,
I am writing this letter in regards to my neighbor. She has requested that I put in
writing that the addition to her driveway will not infringe upon my yard. I do not
foresee a problem with the removal of snow.
Thank you for your patience,
6104t 04,A--
Doreena
Cisewsid
SuB.IECT
PEPMMNO. ,
City of Fridley
'�' �4T
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT VO.
COMMUNITY DEVELOPMENT DIV.
41
r PROTECTIVE INSPECTION SEC.
06
1 • •
NUMBERpEV
DATE
PAGE Oi
A PROVED BV
CITY HALL FRIDLEY 55432
L 612-571-3450
910-F15
2/13/01
JOB ADDRESS 7542 4 Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
23
2
Osborne Manor SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Brenda Schultz 7542 4 Street NE 763-786-2114
CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Volk & Sons Construction Inc 489 Halsey Ave SE, Buffalo, MN 55313 2062
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
763-477-4777
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION O ALTERATION REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replace windows within existing openings; replace two doors; plumbing &
electrical work
9 CHANGEOFUSEFROM 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
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 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
$3.44
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$6,885
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL EGULATING CON-
PERMIT FEE
SACCHARGE
STRUCTION ORJTHE PERFORMANCE OF CONS ON
$139.25
Fire SC $6.88
PLAN CHECK FEE
TOTAL E
E
License $5.00
$1 4.57
$-GNA TURF. OF CON'RA pap Au OR.Z A ,DATE,
ENP OP RL IOAT D IS IS�UR PERMIT
-�•(/ —V/
s—
S-GNATURE OF OWNERdF OWNER BUILDER, ,DATE,
BLD ,NSP - DATE
NEW [ ] Effective 1/1/2001
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:...
Legal Description:
Owner Name & Address: 4Lr'2d Tel. #'J"/�
Contractor y MN LICENSE #�
Address: S)' - Tel. # 7�
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
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
Evaa,tj�
Construction Type: Estimated Cost: $ 6 86 S
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$
DATE: -��� -/O� APPLICANT: � a Tel. #��%��
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$ /3� ��� Fee Schedule on Reverse Side
$ c� .001 of Permit Valuation (1/10th%)
$ $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ S-.00 $5.00 (State Licensed Residential Contractors)
"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
572-3604
1
Effective On January 1, 1999
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS -1644 9 t4 +% 8nc-rA K) F
New Fixtures $ 7.00
Old Opening, New 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
.bd 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.
10 1, 1
Owner
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
$ .50
Building Used As C=,. .
Estimated Cost %00 100 PERMIT NO. /oJ (, -,(D( i
PLUMBING COM
SIGNED B
Approved
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
TOTAL FEE $PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES.