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PRE 2010 DOCSBUILDING PERMIT Wage of Frid-le Minn. N° 2002 4 n Date'' ..+.... . R Builder .�✓.. Owner'"'.' ............................ Address ......... .............................. Address ......................................... LOCATION OF BUILDING #7907qNo.�l ... � .... °Street 46 ............... :............... Part of Lot ....................... f.; .. Lot ......,A 7. Stock' .......... Addition or Sub -Division Corner Lot .. Inside Lot . Setback !'�".► Sideyard l.,,r. ...... . DESCRIPTION OF BUILDING To be Used as: . � .... ° Front ... Depth ... Height J Sq. Ft......... Cu. Ft........ . ................:.. Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft......... Type . Est. Cost . y'�.:i�A'A...��......... To be Completed 4..4& of Construction i .� �,�'. In consideration f the issuance to me of a permit to construct, the building described above, I agree to do the proposed work in accord4nce with the description above set forth and in compliance with all provisions of ordinances of the vill ge of 1iridley. ............................................... In eration c I the payment of a fee of ,$• i f A$ , permit is hereby. granted to .. ... . .ryl. .. to construct the building or ad dation as described above. t Is granted upon e express condition t the person to whom it is granted and his agents, employees , d worlmaen, in all work done in, around and said building, or any part thereof, shall conform in all respects to the 'ordinances of Fridley, Minmesota re axdimgJocattion, construction, alteration, maintenance, repair and moving of buildings with- in the village limits d this permit may be revoked at any time upon violation of any of the provisions of said ordinances.' J! Building Inspector NOTICE: ,Thls permit d not cover the oonstructlon, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Bestirs to see the Building Inspector for, separate permits for these Items. i -. 7� 0 City of Fridley, Minn. BUILDING PERMIT Date: Sept. 4, 1969 Oar; Frank M. Waks Builder Same Address 7574 4th St. N. E. Address Same LOCATION OF BUILDING No. 7574 Street _.•_ 4th St. N. E. _ Part of Lot Lot _27 __Block 2 Addition or Sub.Division .._.__Osborne Manor Corner Lot — x Inside Lot — Setback _ - Sideyard Sewer Elevation _ Foundation Elevation DESCRIPTION OF BUILDING AIA�?,j N4 10393 To be Used as: Addition Front 18' Depth 24' Height 20' Sq. Ft 432 Cu. Ft 8640 Front Depth Height -- Sq. Ft. Cu. Ft. Type of Construction Frame Est. Cost --,•000.00 __ To be Completed Approved by the City Engineer 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 a'l1 provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $___13. 00 , permit is hereby granted to Frank M. Waks 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 F dley,hin inances `lei &o � Buildipg Inspector Clarence Bels ile • NOTICE: Ste permit does not cover the constroettoe, leslaWan for wiring, plumbing, gas henthM serer or water. Be sire to no the Building htgmftr for mparnle permits for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER 's _�� BUILDER ADDRESS �'/ S -t Jul_ ADDRESS LOCATION OF BUILDING NO. 7 c- ! " / STREET J% f H 8 e &1—= LOT BLOCK �. AUDITION OR SURUIVISION 0500AIVE J'Y( 3 ffo + CORNER LOT INSIDE LOT SETBACK SIDEYARD SEWER ELEVATION TOP OF FOOTING Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: fiQQ /iI® W, Front Depth _ Height Square feet Cubic Feet Front Depth Height Square feet Cubic Feet Type of Construction ' Estimated Cost baa To Be Completed /70 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 of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE 9�✓G / SIGNATURE GY! loL/QdJ (Schedule of Fee Costs can be found on the Reverse Side.) ;r W - v1 AC p, i f.. .x 4 iii A Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and1 Air Conditioning Systems and Devices U PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ..........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ /4 e) each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water ............. .... 3.00 $ OIL. BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ................ over 199,000 BTU See Fee Schedule GAS FITTING FEES: N 1st 3 Fixtures ...................... Additional Fixtures ................. Gas Range to 199,000 .......... AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTr- 'S & REPAIRS O RATE TOTAL x$ 2.00 $ x .75 $ X$ 5.00 $ See Fee Schedule TOTAL FEE Dept. of Bldga. Phone SM -3480 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 aretrueand correct. Fridley, Minn / 197 Ownerf�Z2 Kind of Building Used as To be completed about Estimated Cost, $ / Old—New. Building Permit No. Permit No. 4 DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name JB1 SizeNo;& 'sal Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of FueL' 'ydd'e1 BURNER — Trade Name / Size No- / r Capacity Sq. Ft. E.D.R BTU H.P. 17 CY s 41-7 SignedJPLAO- � By ° 42 Business Phone No- ' F! (REMARKS -OVER) Original PERMIT for Power ,ants and Heating. Cool- ing. Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. o f Heating Plan69 )Q-4-TYA (1-t-1 to b installe ltered—repaired Make ' ,Size /-�a Oil fired—,- Coal fired --L, Gas fired ; Gas Authorization No. Remarks An .Py o z.6.Q F Gt-QJ s.A-/vt fie, Approved Final Inspection Date , 19_ , Inspector Pert N° - 480'7 Fee $ s7f, Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. -22 , 191`12 Owner ' Location 9,5294 Kind of Building�� How Occupied Work to be Commenced—, 19 To be Completed ,19_ Estimated Cost, $ (Dew, Building Permit No Permission is hereby granted tosj) . CAA, ,e ) IAQ 1 b %:� L? to install—erect—use the material and devices described in the above statement. This permit is granted 'upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specificat' ns se forth in the approved application for this permit on file in the office of the Inspector of Buildings. ( ® Ail �/�.l - /c� � .f �� , Inspector of Buildings 01�42 sM 11-67 v WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Sealing to Well and Boring I„' 257382 County Name WELL AND BORING SEALING RECORD Minnesota Unique Well No. Minnesota Statutes, Chapter 1037 ° seaees No. Hennepin rownship Name Township No. I Range No. Secdon No. Fraction (am. -+ Ig.) Date Sealed Data Well or Boring Constructed Fridlev 30 24 11 SVS NV N° 04/16/2007 1 Unknown ,S Latitude degrees_ minutes_ seconds Depth Before Sealing 105 ft. Original Depth 101 ft. )CATION: Longitude_ degrees_ minutes_ seconds AOI ®'Singleingle A Aquifer ❑ Muidaqulfer ❑ Yes ❑ No ❑ Unknown STATIC WATER LEVEL y l l imerical Street Address or Fire Number and City of Well or Boring Location r I� WELLIBORING cured El Estimated Date Measured 7574 4 St. N W 2<ater-Supply Well ❑ Mond. Well iow exact location of well or boring section grid with °X." Skqjqhjmep of well or boring I ation, owing property ❑Env. Bore Hole ❑Other 47' Blow L] above land surface N nes, road and buildings. CASINGTYPEIS) NONE Annular space I ally grouted? El Yes V0 e NONE EN ❑ Yes ❑ No ❑ Unknown NONE ❑ Yes ❑ No ❑ Unknown �-- t Mlle P RTY OWN FJCOMPP comas War s Property owners malling address d differei 7574 4" Street NW Fridley, MN 55432 ' Steel ❑ Plastic ❑ Ttle ❑ Other WELLHEAD COMPLETION Outside: ❑ Well House ❑ At Grade ❑ Pitiess Adapter/Und ❑ Buried ❑ Well Pd ❑ Other CASING(S) Merril Depth n above in. from 0 to 961L In. from to ft. In. from to ft. Inside: Basement Offset ❑ Well Pit ❑ Burled ❑ Other Set In oversizeehho�9? Annular space I ally grouted? El Yes V0 ❑ Yes o ❑ Unknown ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown OWNER'S NAME/COMPANY NAME SCREEWOPEN HOLE wner's mailing address d different than property owner's address Indicated above Screen from t0 ft. Open Hole from 96 to 101 n. OBS CTIONS Rods/Drop Pipe ❑ Check Valves) ❑ Debris ❑ Fill d No Obstruction Type of Obstructions (Describe) Jet & P-rp OLOGICAL MATERIAL COLOR HARDNESS OR FROM TO Obstructions removed? ZY1. ❑ No Describe , ' - FORMAMON P known, Indicate estimated formation log from n -- P.UML- nearby wed or boring.- _ _ Jet ,, TvPe and Brown moved ❑ Not Present ❑ Other USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE: No Annular Space Exists ❑ Annular Space Grouted with Tremle Pipe ❑ Casing Perforation/Removal In. from to ft ❑ Perforated ❑ Removed la-y-Ssand Brown 1 185 00— In. from to ft. ❑ Perforated ❑ Removed IEMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING Geology From: 7620 University Ave N Water Level in Above Well: 40' Date Water Level Taken: 06/24/1969 Map Codc: E I I Type of Perforator ❑ Other GROUTING MATERIAL(S) (One bag of cement - 94 lbs., one bag of benton to - 50 Ibs.) Grouting Material Neat Grout from 0 to 101 ft yacs4 bags from to ft. yards bags from to ft. yards, ----bags OTHER WELLS AND BORINGS Other unsealed and unused well or boring on property? ❑ Yes ❑ No How many? LICENSED OR REGISTERED CONTRACTOR CERTIFICATION This well or boring was sealed In accordance with Minnesota Rules, Chapter 4725. The information contained In this report Is true to the best of my knowledge. E H Renner & Sons, Inc 1431 Contractor Business License or 1eg11 No. e V �f4ty� 04/26/07 CerBBed Rep. No. Date IMPORTANT -FILE WITH PROPERTY ��� Kevin Scheiterlein PAPERS -WELL OWNER COPY JH ( Name of Person Sealing Well or Boring HE -01434-09 IC# 14D-0423 nn 6/06R