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PRE 2010 DOCSCITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE �J RESIDENTIAL RATE TOTAL -30(6/Job AddressO&M 421 A 7 Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 $ Department of Buildings, 6431 University Ave. N.E., Fridley, NN 55432 City of Fridley Gas Piping $ 10.00 $ Tel. #571-3450 (piping needed with new furnace) Gas Range $ 10.00 $ 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 ' Gas Dryer $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this applica are true and correct. i i + Air Conditioning (all sizes) $ 10.00 $ Fridley, Minn. , 19W All Others/Repairs and Alterations — OWNER 1% of Value of Appliance or Work $ KIND OF BUILDING I i COMMERCIAL/INDUSTRIAL USED AS is of Value of Appliance Or Work $ TO BE COMPLETED ABOUT 15 ESTIMATED COST State Surcharge $ .50 OLD - NEW BUILDING PERMIT N0. PERMIT NO. TOTAL FEE $� Reinspection Fee ($15.00) $ DESCRIPTION OF FURNACE/BURNER Rough Insp. HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Date h 5 &0 Trade Name size No. Final Insp. Date Approval for Permit 18 Capacity Sq. Ft. EDR BTU /�up �, �I Fuel C/ 'ba4- Total Connected Load Kind of 4UA BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00, 12 Company _ Y PLUS $.50 STATE SURCHARGE Signed By Tel. No. *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Fill out back side for stack verification on replacement furnaces t'1`- 6-1 STATE OF MINNESOTA DEPARTMENT OF HEALTH ABANDONED WELL RECORD 1. LOCATION OF WELL MINNESOTA UNIQUE WELL NO. . (leave blank if not known County Name ANOKA Township Name Township Nu3har, Range Number Section No. Fraction 4. WELL DEPTH (completed) Date sealed RIDLEY - N Er k k of h ft. 30 Sr 23 W 4 ESENW 88 _ 18 199 Numerical Street Address and City of Well Location or Distance from Road S. DRILLING METHOD (1f known) Intersection !d Cable tool 4E3 Reverse 70 Driven 100 Dug 369 66TH AVENUE N.E.--" � � 2❑ Hollow Rod 50 Air 60 Bored 110 Show exact location at Welk 30 Rotary 60 Jetted 9❑ Power Auger (in section -grid with •X•). rj Sketch map of well location ' 6. OBSTRUCTIONS N Well b t ted T N W MENE _a or 7❑ Air Conditioning 110 2. PROPERTY OWNER'S NAME Mailing Address if different than 8. CASING(S) SHARON property address indicated above NEEN Ix Black 917hreaded 7❑ IIS❑3Welded 369 66TH AVE. N.E. a o s Mc ❑ es o Obstructions removed Te ❑ No If obstructions cannot be removed, contact NDN E (� before sealing. T 369 ' 7. USE y me. Domestic 4❑ Monitoring 8❑ Heat Loop '75' 2❑ Irrigation U Public 9❑ Industry IL I 3❑ Test Well G Municipal 10❑ Comsmarcial $� _a 7❑ Air Conditioning 110 2. PROPERTY OWNER'S NAME Mailing Address if different than 8. CASING(S) SHARON property address indicated above Ix Black 917hreaded 7❑ IIS❑3Welded 369 66TH AVE. N.E. 2pGaly. TOOZE RIDLEY, MN. 55432 30 Plastic U Stainless steel 3 in, to 8 5 ft. HARDNESS OF 3. FORMATION LOG COLOR FORMATION FROM TO If not known, indicate formation log from new well or nearby well, in. to ft. LAY 0 14 9• SCREEN Screened well from 8 5 ft. to 8 8 ft. (I! known) SAND 14 40 ❑ Open Hole from_ ft. to _ ft. GAY, SAND, GRAV . 40 110 10. STAjjrWATER LEVEL ft.�balow [3above SAND OWN 4TROWN 110 115 land su ace Date Measured AND,GRAVEL 115 133 11. WELLHEAD COMPLETION 1❑ Pitless Adapter 40 Found Buried SAND 3:33 143 1 6 5 easement offset 5❑ AND .143 3❑ Well Pit 16. REMARKS, ELEVATION. SOURCE OF DATA - CASINGS REMOVED, CASINGS PERFORATED, ETC. 12. GROUTING INFORMATION GEOLOGY WAS TAKEN FROM THE WELL AT: X Heat Cement 220 Bentonite 4 BAGS RIDLEY TEST WELL 43, 69TH AVE. N. Grout materi?,ORTLAND 1 S e_ f£, cu. yds NEAT GROUT WATER LEVEL IN THE ABOVE WELL: 34' ATE WATER LEVEL WAS TAKEN: 2-27-69 13.8%REST SOURCES OF CONTAMINATION feet •b direction a=M °�nR =m type Well disinfected before sealing? A Yes 14. PUMP Imo' Removed ❑ Not Present Type: 10 Submersible 3❑ L.S. Turbine 50 Reciprocating 'XJet � Centrifugal -•6❑ JUN 18 1991 15. EXISTING WELLS (Please sketch locations of abandoned and active wells in remarks section or on back.) - Other unused well(s) on property? ❑ Yes No Abandoned: ❑ Permanent ❑ Temporary [3 N t ealed SEA.LED17. WATER WELL CONTRACTORS CERTIFICATION This well was sealed under my jurisdiction and this report is true to the best of my knowledge and belief. According to MN State Regulations E.H. RENNER � SONS INC. 71015 1591111r8 Y'�iWSe ST. N. Canso No. Addr R I 5 — Signed �- ate '6_19_91 STEVE Date Name -of Driller FFICIAL ABANDONED WELL RECORD (May be used for Property Transfer) LWCRrnerrs FZZN WZ2W Dean MATT/KEVIN HOPPE Engm�Orinq Met : ii � wa�cr;r..t, Parks S itec�s Mainlen;,n ma TO: William W. Burns, City Manager PW97-224 FROM: John G. Flor Public Works Director DATE: August 13, 1997 SUBJECT: Storm Water Complaint At the Council meeting of August 11, 1997, Paul Monson of 369 66'h Ave indicated that he had a flooding problem on his property and suggested that it was a City problem. On the morning of August 12, I inspected the property and found that he had installed a garden with railroad ties around the perimeter as well as a compost pit with railroad ties around it in the northwest corner of his property. Just beyond that on the other side of the fence is a low depression with a beehive manhole which was installed to pickup the rear yard storm water. As a result of the placement of railroad ties and fill material, the water is unable to directly flow off of his property into the storm water system Accordingly, it is retained on his property for a longer period of time. He also indicated that there were holes in his property. Our sewer crew had patched the holes with dirt and seeded it. We had lamped the line and found no problems. The next time the TV crew is in the City, we will TV that line to ensure there are no problems. If a problem is found, it will be repaired. He also indicated that the water on Rice Creek had no affect on the storm water system There are two outlets from this area into Rice Creek. The outlet from the 66`h line is a half a foot higher than the outlet at the Savage property. Accordingly, when the creek floods, both storm pipes essentially are blocked which results in delaying and reducing the flow of water from the storm water system. I did call Mr. Monson late afternoon of August 12 and left a message on his recording machine regarding the garden and compost construction. JGF:cz CITY OF FRIDLEY INSPECTION DIV. D 6431 University Ave NE Fridley, MN 55432 �] U 572-3604 (J' APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR 0 Effective On January 1, 1999 *a o Gas #i*' I Water Heater Range wGas I Elec PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader _ $ 7.00 �� ) Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner �\O'n'N� Water Heater -Electric $ 7.00 _ Water Heater - Gas** $10.00 Building Used As Gas Range** $10.00 60 Gas Dryer** $10.00 Estimated Cost®� PE MIT NO. 1( l Back Flow Preventer Required ( )Yes O No MCGUFF u Type $15.00 PLUMBING COMP Y 605 12th Avenut SOLO hih Reinspection Fee $42.00/Hr . SIGNED BY TEL N0.q 50-A-9- ALL OTHERS AND/OR REPAIRS AND ALTERATIONS_C:)� 1.5% of Value of Fixture or Appliance ''JJ Approved By Rough -In Date Final Date �_%' State Surcharge • $ .50 0 �.. �1 1) MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS 20.00 TOTAL FEE $90 O PLUS THE $.5o STATE SURCHARGE "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES. juilding Inspections" 763-512-3604 SITE ADDRESS 3 (0 C THIS APPLICANT IS: 0 BUILDING Permit No.oA-^-V `V' I RESIDENTIAL APPLICATION Received By: CITY OF FRIDLEY Date Rec'd: (6� zt"o 6 YOUR E-MAIL ADDRESS [�. t LL4, & 110 0 !t O - ')C` "ER ❑CONTRACTOR PROPERTY OWNER/ NAME: t u ' li I A- ) ob 54, ®is- ADDRESS: in 5 (a S NY V1%et \ CITY —" �` / T STATEggIP Z TENANT l -7a , A* 1 PHONE: -Z� - �,R 7Z — OZ6 O a &Y- C - 76 - 7Z- Z Z-06 CONTRACTOR NAME: .001 times the total job valuation STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE—ZIP WITH APPLICATION PHONE FAX $5.00 (State Licensed Residential Contractors) PROPERTY TYPE PSINGLE FAMILY/NEW CONSTRUCTION SIZE 3,113 T $1550 per SAC Unit (Plans to MWCC for determination) ❑ TWO FAMILY/NEW CONSTRUCTI N STORIES PERMIT TYPE ❑ ADDITION GARAGE/SHED ❑ WINDOWS $ ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE Park Fee ❑ DECK ❑ SIDING ❑ OTHER Fee Determined by Engineering ❑ SWIMMING POOL $ TYPE OF WORK: �,,❑,��W ❑ ADDITION Total Due $ eMAINTENANCE/REPAIR ❑ REMOD LING Make checks payable to: City of Fridley Attach Stipulations DESCRIBE WORK BEING DONE: d SIZE OF IMPROVEMENT WIDTH HEIGHT Sq. Ft. tf 6, ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑HOUSE & GARAGE BASEMENT REMODELING SUBMIT: /ATTACHED 1. Existing Floor Plan GARAGES % GARAGE ( ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED SIZE. �� 3. List of structural members to be used PROPOSED HEIGHT: SIDING / FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim M 1. Site Plan/Survey showing the existing structures O'Othei i L9Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION- F WIN�D�W� OR FOR NEW OPENINGS -DESCRIBE SIZE OF 1 OPENING CHANGES & 2� TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS AT T T,W c Ai?F RACED nW VAT.TTA7 ON TNCT.1rMTNC: TAF, COST OF LABOR AND MATERIALS: ALJJ 1'iJJ%.J �uW LY v.aar.v+�-.—.�--.--.� -- ---- _- i.5'©33 --08 (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION OCCUPANCY TYPE ON Permit Fee $ ob 54, ®is- See Back Page for Fee Schedule Plan Review $ l -7a , A* 1 65% of Building Permit Fee Fire Surcharge $ l5 • d 3 .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ / $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Gut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ `VA0 , 'oi l Make checks payable to: City of Fridley Attach Stipulations 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 application for 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 work which requires review and approval of plans. ` - r -10 SIGNATURE OF APPLICANT Ate;_ L�,.c, [��� � PRINT NAME�RR, 4 Luc.' il1A U A&A)& DATE 3 b q 6 6 U t, VOIL c _n t �M 3ti-V 9� q b9C' 4 C� fi -7A t �2- 77'�,�_ a 0 Fe �- fn PC n > 4D -4rno X =,O ca M z rl, 'n C:,cl C) > fn 04 v S'v1e- P, u :5 I I -.- Front Side rn a � 4 ..w .w Ai. • ( .�..�r (A les irony �,c.W 0 P- 9' ml CA a S FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 BUILDING PERMIT APPLICANT: PROPERTY OWNER I, LL,c. ,. u ,A,m-A , understand that the State of Minnesota requires that all residential building contractors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. As the owner of the property at 36q � c { ti ftog N l , Fridley, I am exempt from the state licensing requirement only if I am not building or improving this property for purposes of resale. By signing this document, I attest to the fact that I am improving this house for my own use and do not intend to sell it. I hereby claim to be exempt from the state licensing requirements because I am not in the business of building or remodeling on speculation or for resale and that the house for which I am applying for this permit, isl the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license, I forfeit any mechanic's lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. Furthermore, I acknowledge that I may be hiring independent contractors to perform certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minnesota law, and that I would forfeit my rights to reimbursement from the Contractor's Recovery Fund in the event that any contractors I hire are unlicensed. I have also been informed and acknowledge that by listing myself as the contractor for this project, I alone will be responsible to the City of Fridley for compliance with all applicable building codes and city ordinances in connection with the work being performed on this property. Name L v () , L I Date 86-( 2-o1 06 Arm CIlYOE FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 (763) 571-3450 - FAX (763) 571-1287 - TTD/TTY (763) 572-3534 December 11, 2006 Maria vdana 369 66th Avenue N.E. Fridley, MN 55432 Re: Hazardous Building Located at 369 66th Avenue N.E. Dear Miss Vdana: On June 6, 2006 a building permit was applied for at the above address for the construction of an attached garage. No work has commenced on the garage since the permit was issued. The garage had already been partially framed without proper permit, plans, and surveys. An inspection was conducted on June 21, 2006 and the following violations were noted: 1. Bottom plates shall have proper anchors per R403.1.6, 2000 I.R.C. 2. Proper framing required under openings, nail all double headers together, Min. three studs per comer framing per table R602.3 (1), 2000 I.R.C. 3. Provide proper nailing of wall sheathing per table R602.3 (1), 2000 I.R.C. 4. Roof framing members are under sized per table R802.5.1 (6), 2000 I.R.C. 5. Minimum % inch gypsum and a 20 minute fire rated door are required on the garage side per R3092, 2000 I.R.C. Per State Statue 463.15 the structure located at 369 66th Ave N.E., Fridley will be posted as a hazardous building. The definition per 463.15 states any building or property which because of inadequate maintenance, dilapidation, physical damage, unsanitary condition, or abandonment, constitutes a fire or hazard to public safety or health. You will have 20 days from the date of this letter to respond in writing if you are to complete the garage per building plans or demolish the structure. If you fail to respond to this letter, the City of Fridley will proceed with the demolition per State Statue 463.151. If you have any questions concerning this matter, please feel free to contact me at 763-572-3603. cc: Scott Hickock, Community Development Director Ron Julkowski, Building Official �1�9 Ldp �� Tyl. 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