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PRE 2010 DOCSCity of Fridley, Minn. r BUILDING PERMIT N® 3062 Date: ...0 ...... � ®s ..... ............... Owner Builder.... .. ... ........... Address :Sb.. 6?. ...... Address ..... ....... t....... ..... ...... .. f 0CATION OF BUILDING I No. .�'�'�Street _ .... ..................... Part of Lot .......... r . ....... Lot ..... . ... Block ..,t ................ Addition or Sub -Df ' 'on . .... ... .. .?/.. . Corner Lot ............ Inside Lot ... •�..... Setback . � .... .. Side ar y ... �® . r �.• ®� DESCRIPTION OF BUILDING To. a Use as ...... ... Front ®. r . Depth .°t .. Height . � Sq. Ft. . !. 4. ? Cu. Ft. ....... . . ..... Front 3 f � Depth .J eight ... Sq. Ft. . Al2 /Cu. Ft. ...... 9ATe of Construction ................... Est. Cost....1. �d O!� . o be Completed In consideration of the issuance tome of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description abov s t f h d in co provis' of ordinances of the city of Fridley. O 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 with- in the city limits and this permit may be revoked at any time upon violation of the the provisions of said ordinances. 1 NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. F . . . . . . . . . . . . . . . ATVs! in ............ _7 z v . . . . . . . . . . . . . . "'TIM _n Q 1-0 J- ....... .... �; ITS g�'A V11. RAN �Jj ISM AS MCM-0.as wt w t 00 --low '05, a 1 pop 1; All is- 0 qAMj*>v--4r �v�qv MM, v took MAIM= - M it, WA "aw IN IF— FF+ ON 14 �41 TO� 4—Tv 5109 ............... 0 mom SUBJECT P City of Fridley 2 33 2 3 AT THE TOP OF THE TWINS BUILDING PERMIT � RECEIPT NO. `� -------COMMUNITY DEVELOPMENT DIV. SEC. r PROTECTIVE INSPECTION CITY HALL FRIDLEY 55432 NUMBER pEv DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 4/28/99 JOB ADDRESS 5956 6 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 4 4 1 Bonny Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ward 5956 6 Street NE 586-9772 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Northern Exposure Exteriors 8944 181 Ave N, Forest Lake, MN 55025 20173814 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 274-5763 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Cj REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof House & Garage (21 Sq) XXXXKlq= Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,799 $.90 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS F ANY OTHER STATE OR LOCAL LAW REGULATING CON- $56.75 Fi a SC $1.80 STRUC 0 R THE RMANCE OF CONSTRUCTION PLAN CHECK FEE T,6,YAL FEE Licens SC $ .00 $64.45 SIGNATURE OF CONTRACTORON UTHORIZED AGENT iDATE, E P O L VAE THIS IS O R PERMIT IV'-- 8 G'NSD gAfE S-GNATUREOFOWNER,iFOWNERBiDATE� - NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 5 Legal Description: Owner Name & Address: Tel. # ®r-/2 - SIS r 9?7Z Contractor: A/dZ Z ,10d1rrXt-r Gj?7Zf&1,01 s MN LICENSE # Address://' !L/`� ��- S'�d lam- Tel. # 6S/- z7�/-s;;9,f Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length GARAGE AREA: Length DECK AREA: Leirgai OTHER: DESCRIPTION OF IMPROVEMENT Width Height Width Height Width HRVGj Sq. Ft. Sq. Ft. Sq. Ft. 0- Construction Type: 27K Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: APPLICANT: Tel. #CS/ �'�� S 7�2 CIWUSE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: 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 [ ] WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Shines to Well and Borff WELL AND BORING SEALING RECORD Minnesota Unique Well No. 'tg H 2T8� --{ County Name ANOKA Minnesota Statutes, Chapter 1031 or W -series No. tisw. emir t � nvwnl Township Name Township No. Range No. Section No. Fraction ism. i Ig.) Date Sealed Date Well or Boring Constructed FRIDLEY 030 24 23 f. NE% NK Thursday, March 23,2= Numerical Street Address or Fire Number and City of Well or Boring Location 16 5956 6TH STREET NE Depth Before Sealing ft. Original Depth ft. Show exact location of well or boring Sketch map of well or boring in section grid with X.. location, showing property lines, roads, aid b ildings. N AGUIFER(S) Single Aquifer ❑ Multiaquffer y�yyELL/BOgIN(i STATIC WATER LEVEL Measured El Estimated -T- -•1-- -1-- ga-�yv 19water Supply Well ❑ Monit. Well ❑ Env. Bore Hole ❑ Other 14 �[ ft. Abelow ❑ above land surface W - 'r- i -i-- -i- E CASING TYPE(S) ' -7-- ---- -�-- --�-- fi i i i Attila 4- -%- - I-- -i - house w �tttL""� S imHe� � Steel ❑Plastic ❑Tile ❑Other Galvanized T&C ,. CASING(S) Diameter Depth Set in oversize hole? Annular apace initially grouted? 2 in. from 0 to 16 ft. ❑Yes [i¢No ❑Yes ❑ No ❑Unknown in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown PROPERTY OWNER'S NAME WARD, TERRIANN E. in. from to ft. - ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown Property owner's mailing address if different than wag location address indicated above. 5956 6TH STREET NE FRIDLEY, MN 55432 _ SCREEN/OPEN HOLE 13 16 Screen from to ft. Open Hole from to ft. OBSTRUCTIONS ❑ RodsVop Pipe ❑ Check Valve(s) ❑ Debris - ❑ Fill No Obstruction WELL OWNER'S NAME Type of Obstructions (Describe) NO Otstfl1Ct10fIS..: Wan owners wailing address n different than Property owner's address indicated above. - Obstructions removed? ❑ Yes '-Q No .Describe PUMP t. Type Prior Removed Shallow Well Jet Pump... ❑ Removed L? Not &writ . ❑ Other GEbLOOICACMATERIAL , hiGLOR, , HARDNESS OF FORMATION FROM TO - H not Mown, trdMaleeettinateA formation log from nearby wen or boring. METHOD USED TO SEAL , OR CASING, AND BORE HOLE: ANNULAR SPACE BETWEEN 2 CASINGS .y . Iwo Annular space Exists drift 0 16 Z Annular space grouted with trende pipe ❑ Casing Perforatlon/Removal in, from to ft. D Perforated ❑ Removed in. from to ft. ❑ Perforated ❑ Removed Type of perforator ❑_ Other GROUTING MATERIAL(S) (One Ing of cement = 84 lim, one lag of bentonite - 50 lbs.) Neat Cmt 0 .5 0.0004 Grouting Material from to ft. yards bags Enviroplug .5 16 0.0124 from to ft. yards bags 0 from to fl. yards bags from to ft. yards bags REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING OTHER WELLS AND BORINGS Well Located On West Side Of Basemer)t... �[ Other unsealed and unused well or boring an property? [I Yes l_l'No How many? LICENSED OR REGISTERED CONTRACTOR CERTIFICATION Measured From Top Of Casing 5' Below Grade Level... 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. Malenke Water 27600 Contractor Business Name Lkamwe or Regis Wri Pio. Myron Malenke 144 March 23, 2000 23 030 24 21 0054 A'nhortzed Repres-"aure SfplaftA Daft LOCALCOPY H X 3278 NarrreofPersonSealbtgWell orSwhV FA SUBJECT City of Fridley 7'494 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. %�J��"✓f PROT CTIVE INSPECTION SEC. 6i/�✓ 1 NUMBEN REV DATE PAGE OF APPROVED BY i �721�6"ALL FRIDLEY 55432 L _".j 612-571-3450 9t0-Ft5 10/18/00 JOB ADDRESS 5956 6 Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 4 4 Bonny Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Terriann Ward 5956 6 Street NE 763-537-5533 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO North Central EXXXXXXg Builders Inc 7401 42 Ave N, New Hope, MN 55427 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 763-533-6168 3763 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION 57 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace windows 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 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 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 $5,251 $2.62 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- $125.25 Fire SC $5.25 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FE TOTAL FEE Licens $5.00 38.12 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT IDATEI HEN/PROPE ALID TE THIS IS YOUR PERMIT klf _ SIGNATURE OF OWNERIIF OWNER BUI�OERI IDATEI 810 NSP MATE FA NEW [ ] Effective 1/1/2000 ADDN (] CITY OF FRIDLEY 612-572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 5! 1(-2 A) E i� TW Legal Description: Owner Name & Address::fE t�� lav It) 5'1,510 ASC , 6-rff rgg2 ,T Tel. # -72,� 5 37 "55.33 Contractor: L -)02T# 06MMll� S�/,,• _ MN LICENSE # y . > _ Address: 7t/®i AM &C- /i% �/� AJo �lP6 . Y A) 555 Tel. # -76,7— Attach � 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. BECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type:, U'L'Q D (t) �L �1'i'lC�y�stimated Cost: $ 1jr ®c. Driveway Curb Cut Width Needed: Ft. + 6 Ft= Ft x $ _ $ DATE: / APPLICANT: Tel. # CITY USE ONLY - ball (612) 572-3604 for Permit Fees if mailing In application Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ , (o $.50/$1,000 Valuation SAC Charge $ $1`100 per S�C Unit License Surcharge $ D ® $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 [ j TOTAL STIPULATIONS: r Building PLUMBING Permit No. SZ16t6 5q Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date M c @: A P�2 2 FAX 1763-502-4977 EFFECTIVE 1-1-2010 1/ — Z"1P/ - / 6 i ® C,e,44-`K dl ! /h DATE YOUR E-MAIL ADDRESS j"(b� !! SITE ADDRESS C, S� THIS APPLICANT IS: 11 OWNER )CONTRACTOR PROPERTY NAME: -Ur, -,aA C __(' OWNER/ (Btu R IUF r` �% ZIP Z TENANT ADDRESS: �� CITY STATE PHONE: %(� 3 ��- ?ILI CONTRACTOR NAME: C� �` d/ dz rn�% SUBMIT A COPY OF O 7 O 5 5 P Z 16' YOUR STATE YOUR STATE LICENSE # DATE LICENSE, BOND AND :K G 2 Z EXP DATE 12- V-10 STATE BOND # ? Ct G 0 S_ CERTIFICATE OF ADDRESS: 70 / Z C- C v e1_ / M -e Sfi CITY L Ik !✓-tk STATE Af ZIP .S37 INSURANCE PHONE ?6 -S �� - Z %s FAX PERMIT TYPE ArS NGLE FAMILY O TWO FAMILY O TOWNHOUSE TYPE OF WORK: O NEW ctRREPLACEMENT . DETAILED DESCRIPTION OF WORK P-e?1`te < (^.-c.a f{r // FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. BATH SINK/LAV _FLOOR DRAINS _ SHOWER _ WATER PIPING _ _ BATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFTNER ($35) _ _ _ CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREY. ($15) _ _ _ _ DISHWASHER _ LAUNDRY TRAY ,YWATER HEATER ($35) FOR IRRIGATION WATER METER OTHER S ;gwN GI�.. ..T �., 5 d+ ice' tii_a� ..X"��ly �6 .� 'a° l 4 N }i L'fF,rC S"'✓: �Ffi zF �. %yVy� i a a r 2a a k -x a� � � °5 ;__�' rx � � �r �:ry ..sx ?"� G�"9 ��`.'�} w * ��R � � a- x:• "r; � F" i �,. �.L. �} 6 .i5�0 ek�� $�i�}„f- �.dt"`� ��.f�.��: i.�•E” _ �, oT'.� > f2 "fT^ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. �� eS Lodz' �`'� SIGNATURE OF APPLICANT PRINT NAME DATE ]"MMAr '�