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PRE 2010 DOCSVillage of FAffleyq Minn. BUHMING PERM" 668 Office of INSPECTOR OF BUIMEWS lig Owner, Architect Fridley, Minn., J Builder LOCATION OF BUILDING No. Street, Part Of Lot Lot Block Addition or Sub -Division DESCRIPTION OF BUILDING Front --! Dept% Height -'Y— Stories—'Manner of Construction_ To be used as To be completed Estimated Cost Ili ILII Permit is hereby granted to to. the building described in the above statement. This permit to granted upon the express condition that the person to whom It is granted, and his agents, employees and workmen, In all the work done in, around and upon said building, or any part thereof, shall conform In all respects to the ordi- nances of Fridley, Njun., regarding the construction, alteration, maintenance, repair and moving of buildings within the city limits, �: and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ti Inspector of Buildings. AGREEMENT AND SWORN STATENMNT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby state and say that the facts stated by me And contained in the above permit are true as therein stated. Subscribed and sworn to before me at Fridley, Minnesota, this A day of -L" C SUBJECT P. City of Fridley 12708 AT THE TOP OF THE TWINS BUILDING PERMIT i , • ------� COMMUNITY DEVELOPMENT DIV. •L r � PROTECTIVE INSPECTION SEC. /f � /�-'S CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY `-_J• 612-560-3450 910-F15 9/10/74 JOB ADDRESS Craig Heierem 1631 66th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. S X 2 Moore Lake Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Craig Heierem 1631 66th Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. American Builders 1201 West Broadway 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING recidential 7 CLASS OF WORK ❑ NEW ❑ ADDITION X91 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK new cabinets & misc. 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQ.UIkED FOR WIRING HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. wood 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 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 $2,000 1.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS ANY OTHERS TE OR LOCAL LAW REGULATING CON- $12.00 STRUCTION THE PE E O CONSTRUCTION. PLAN CHECK FEE TOTAL FEE C' 13.00 SIfNX'TUTIEOFCONTRACTORORAUTHORIZEDAGENT (DATE) LIDATED THS IS Y R ERMIT �WHENRLY 04 DATE SIGNATURE OF OWNER(IF OWNER BUILDER) (DATE) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME • ,'"t -U BUILDER: ADDRESS: �— "% /� %��` ADDRESS: �, e✓t" �'� `'P` NO:. 3 STREET. LOT: = BLOCK:— CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: tiff A Front: s Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stxict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: SIGNATURE: (See Reverse Side For Additional Information.) 40. • • 53-8h-9915051 , a�li4r i�� cr PIurr�I:10 Cnc� Gr L.1 -cMM ;g • � .�..�...�. -- .•- Dopt. of Bldgs. Phone fic"B•34W DE5Cyti ION O: V1011r. Lo,-stloa ' 1631 66th Ayo,North Num!>*r. Kid mhd Lrcr_3oa of rixtares , V x570: t Nav Fire-arv. Old 0—e inc, Cc:.;pwl City of Fridley:. The undersigned hereby makes application for a permit for the work herei specified, aCr eeing to do all work in strict accorda :ce with the Ci$ OrdL"nce • and Qing of the Department of Buila...1mv, and hereby declares that a:I L`te face and representations stated in ttiis zpplicatiofl are true and correct' Fridley, Minn Owner Graig Kind of Building Used as re To be completed about x-22-76 -- PARTIAL RATE SCHEDULE Estirr.ated Cost. $ in -nn Parait:?o. Old am Building Permit Ilio• -- Lv'�SSIlia F1:CTJ2?E RATES: s TOTAL w�t[a Mrx. z � Signed � �7ppslz�a x $2.60. 3 r R --- � zoe 0 x $1.50 $ - By MINRIEGASCO V7 1� S :. ;�..Gi Businu s Phone No Q iy •L Hifi V a t9 . Catch Basin .................... _._._. x $3.25 $ _ • ° Water Beater 'L'p to 0.3.000 BTU). • • • x $3.00 $ ROUGH New Ground Faun 01d Bldg....:..:. ---- x 43.25 S _----- - s :2.00 S B3sr FINF+L i1S nTTING FEES: I1 O. R�+TE TOTAL Ist 3 Fixtures • • • ..............-----.-- x $2.00 Additicnal Fixtures ............... '------- x $ .75 S Gas Rs: je to 193.060 BTU ........... ----- x $5.00 �---- 5.G0 . .50 State SurCY:2: qe ALTERATIONS—PWar fo Coda • Ik:cription...............:.................« ..... I:: : ' TOTALF*: S— ;-��3--�.1ass `.A.` surcharge .SGS. r s 2 rd 3rd V x570: t Nav Fire-arv. Old 0—e inc, Cc:.;pwl City of Fridley:. The undersigned hereby makes application for a permit for the work herei specified, aCr eeing to do all work in strict accorda :ce with the Ci$ OrdL"nce • and Qing of the Department of Buila...1mv, and hereby declares that a:I L`te face and representations stated in ttiis zpplicatiofl are true and correct' Fridley, Minn Owner Graig Kind of Building Used as re To be completed about x-22-76 -- PARTIAL RATE SCHEDULE Estirr.ated Cost. $ in -nn Parait:?o. Old am Building Permit Ilio• -- Lv'�SSIlia F1:CTJ2?E RATES: No. RATE TOTAL Signed Number Fixtures ................ _______—.- x $2.60. 3 - --- Future Fixture Opening ......... • • .— x $1.50 $ - By MINRIEGASCO Businu s Phone No few Fixture Old pyering• .. • • ••• • • • ---- x $1.50 3 _.. _ . Catch Basin .................... _._._. x $3.25 $ — • ° Water Beater 'L'p to 0.3.000 BTU). • • • x $3.00 $ ROUGH New Ground Faun 01d Bldg....:..:. ---- x 43.25 S _----- - s :2.00 S il•ctric Maar Y..atar.....:........ FINF+L i1S nTTING FEES: I1 O. R�+TE TOTAL Ist 3 Fixtures • • • ..............-----.-- x $2.00 Additicnal Fixtures ............... '------- x $ .75 S Gas Rs: je to 193.060 BTU ........... ----- x $5.00 �---- 5.G0 . .50 State SurCY:2: qe ALTERATIONS—PWar fo Coda • Ik:cription...............:.................« ..... : ' TOTALF*: S— ;-��3--�.1ass `.A.` surcharge .SGS. City of Fridley _ SUBJECT PER45 AT THE TOP OF THE TWINS BUILDING PERM RECEIPT O. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC.77 1 1 i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L J" 812-580-3450 910-F15 12/6/77 JOB ADDRESS 1631 - 66th. Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 2 Moore Lake Park 1st SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Craig Heieren 1631 - 66th Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION 1 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a chimney for Franklin wood burning stove 9 CHANGE OF USE FROM TO STIPULATIONS Provide minimum 2" clearance to combustibles. Owner agrees to install all chimney appliances to comply with Minnesota State Codes-* SEPERATE PERMITS REQUIRED FOR WIRNG, HEATING, PLUMBING AND SIGNS, WARMING Before' digging call local utilities TELEPHONE - ELECTRIC - GAS Etc. REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 1 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. $800 $.50 WITH WHETHER SPECIFIEDHEREINOR 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- $7.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $8.00 SIGNATU OF CONTRACTOR OR AU RIZEDAGENT (DATE) �y HEN VALIDATED THIS IS YOUR PERMIT F� WLY J BLDG INSP DATE SIGN URE OF OWNER (IF OWN EPFBUILDEHI (DATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTE=RATIONS, ADDITIONS, OR REPAIRS) OWNER: )/7/e/ Y'G42 Address: / /o %- (o� tit l / LJG A) F BUILDER: Address: Tel. No.. No.: ) 13 l Street: L+k 4\je- N m LOT: BLOCK: ADDITION: 1^11 co s CORNER LOT: ,/ INSIDE LOT: SETBACK: SIDEYARDS: 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: D/,�jJJ-�/JJe/d wom e j �✓ "' Qd) w,V. Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: Estimated Cost: $ 1� 0 0 To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side for additional information. DATE: dal -7 7 SIGNATURE: t��Zllel . � � / ✓cam Stipulations: 7a 8, o Q eta zz- r SUBJECT PER N City of Fridley 150'70 AT THE TOP OF THE TWINS PERMIT BUILDING 1. � • Ly ------- COMMUNITY DEVELOPMENT DIV. � 9�Si r � � PROTECTIVE INSPECTION SEC. �/ 7 ��02 1 i 1 /'-'1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 JOB ADDRESS 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 2 Moore Lake Park 1st Add, SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Craig Hlievers - 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sussel Com an - 1850 Coma AvpnuLa 645-0331 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 Q ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE S DESCRIBE WORK Room addition 9 CHANGE OF USE FROM, TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. 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 252 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 $6,500.00 $3.25 DES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE ROVISIONS OF ANY OTHER TATE OR L AL LAW REGULATING CON- TRUCTION OR THE PERFOR NCE OFC RUC ON. p /• 00 wAQA6-1 • TOTAL FEE SIGNATURE OF CON CT ROR AUT IZED AGENT IDATEI A GCHECK A THIS IS YOUR PERMIT DATE SIGNATURE OF OWNER I IF OWNER SUILDERI IDATEI CITY OF FRIDLEY • APPLICATION FOR IZL:SIDENTIAL BUILDING PEM41TS (NEW, ALTERATI OIJS, ADDITIONS, OR REPAIRS) WILDER: OR'11ER. Address : / i,�, �� Address : Tcl. Ido. N0.: Street: �,•06 • TOOT: BLOCK: �ADDITIOPI� COMER LOT: INSIDE LOT: SETBACK: SIDL•'YARDS: Applicaht attach to this form T<•io Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING 13c Used As: - Front: Depth: Height: Square Feet: Cubic Feet: 'Front: Depth: - Height: Square Feet: Cubic feet: _ Type of Construction: Estimated Cost: $ 6 �V WD Be Completed: /�o Alt. A Alt. B ]Proposed Driveway Width If New Opening Is Desired $ � (SEr•. REVERSE SIDE OF SHEET) 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 rep are true and correct. See reverse DATE• • * • 7 1 SIGNATURE: Stipulations: P�Qwc it �o.a, t god r.,4' ,i I EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER _._.._ iL M RS _ GRAIL•_ _ A n ER C-14 IF SITE ADDRESS _� (r, 3 I�SI,l.� Ave, E_ .�Q1 t&u M 1 N N. CONTRACTOR V G S t L DATE PHONE LIQ, it - a xii DETERMINE WORKING SQUARE FOOTAHE OF EACH _ 1. Total exposed wall area 4 &!J, 3a, 'Sq. Ft. x .185 2. Total. roof / ceiling area a.4; 1% Sq. Ft. x .04 = I Q.lb:% TOTAL EXPOSED WALL AREA ABOVE FLOOR a a kS DETERMINE "U" VALUE OF EACH WALL SEGMENT ., a. Total wall window area •••••.•........ ,4 S "U" 9 X r S 6 a14, JIS b. Total door area _ ._ X.,........ �....�.. c. Total sliding glass door area ........ X'. d. Total fireplace wall area X, e. Total wall framing area ( average 10%) 3 (Q,g X, f. Total net wall area above floor ...... -.�$ 7:3 X .b �� '_,: g. Total rim joist area ........0....... _ 10.fe . X' ' ' :o t9 "' ' ' TOTAL EXPOSED FOUNDATION AREA J2# Cw(w h. Total foundation window area X i. Total net foundation area above grade .3A L6 X' I? ' �' ' • : a f 3 ................................................. ...... .•... ......... .•....TOTAL If item #3 is the same as, or less than item #1, you have met the intent of SBC 6006 (C) 2. TOTAL EXPOSED ROOF / CEILING AREA = DETERMINE "U" VALUE FOR EACH ROOF / CEILING SEGMENT. "Un j. Total skylight area .......................... X k. Total roof/ceiling framing area (average 10%) X ,1j7 1.. Total net insulated roof/ceiling area X-&31 _ 7.0 4..........................................................................TOTAL .�2 If total of #4 is the same as, or less than #2, you have met the intent of SBC 6006 (C) 1. ALTERNATE BUILDING ENVELOPE DESING To utilize the total envelope system method, the values established by the sum of items. #3 and #4 shall not be greater than the sum of items #1 and #2. 1• 79.4 a + 2. /d.0,9! W 2Z Ka 3. 51. 241 + 4. Z. 21Z = 4122 _._.. _.�....._. v SUBJECT MIT N City of Fridley 17476 AT THE TOP OF THE TWINS BUILDING P E R M I T r � RECE ' ___ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. ' /'--1 CITY HALL FRIDLEY 55432 1"' NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/26/84 / JOB ADDRESS 1631 - 66th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 5 12 Moore Lake Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Craig I%ieren 1631 - 66th Avenue N.E. 571-4732 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 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑% ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Q. 8 DESCRIBE WORK Construct a 124 x 12' Deck 9 CHANGE OF USE FROM TO SfiPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING m HEAITFNG, PLUMBING AND SIGNS. Before digging Call local [Itilitie . TELEPHONE - ELEC1 RIC - GAS Etc. REQUIRED BY LAS, 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 $85.50 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $155.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $19.25 $3,75 SIGNATURE OF CONTRACTOR OR AU HORIZEDAGENT (DATE)/ WHEN PROPERLY LI DATED THIS IS YOU PERMIT a y �d�BT G �d G% LOG INSP DATE SIG TURE OWNER OF OWNER BUILDERI (DATE) v NEW [ ` ] City of Fridley Effective 4/1/84 ADDN. FR -1 AND R-2 ALTER. ['] Building Permit Application Construction Address: i �D - L (0 �-ti Q "42 a E, Legal Description: -�"�' S 1 2 'y)0 I.,1� Pcir K, Property Abh er/Addres4: a m e- Contractor: Tel. Contractor: C':` ala m P `I e v 2v'- l o w� A r Tel .# ,PS'11- 4 7Ba. Address 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 I "oZ Width I �____ Hgt/Ground �� Sq. Ft. 1'1'(r Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: U-) c' �r`rame— Estimated Cost: $ 6Z Approx. Completion Date: �u�Lr� y Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation DATE: y a3 APPLICANT: Tel. S??-E473� C Y USE ONLY r Permit Fee $ �•� Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ �S� $.50/$1,000 Valuation SAC Charge $ -� $425 per SAC Unit Park Fee $ �- Fee Determined by Engineering Sewer Main Charge $ • n , Agreement Necessary [ ] Not Necessary [ ] TOTAL $ �i STIPULATIONS: WL i 1 V I t tT -.. 4 f -'r It i i t� -yt• � � � r � I �_ •r ' )1 � ; - t � -1+ � -1 4- r + j - --� �•� �C I i ?- gyp' ' - � . - ' F I P✓ j 1 4 J: ALA + _� _ is _ I L_ } I _.} f. t ON 71 TL lip 777 41 I I . I l ► 1 t a► Yw tip r� .t. s , l 7' t . 3 ; # M. � p i• j ff J }. _ � Pi.{ - l as ♦, i_ } .:.� �.q �., '. : , f .. J� ; 1 . I j , _}rr y -._t.. }}, :� •� �^ r. I ' { + � fir, � I . . 1 .1_i_r-.1.-� j -I '�.. t I; .� 4.�. I ,�• 1 1 � _} .'�" i i i ; �, . , `, � .y. 'a+c•+w�l—r--.awl.._-aws�e.—��...-..�.. — - I I _ f_ . } } i _ j 1 { wa• "{a : a+r. �.ee - Nr +wee r �w •av �' 41 aaw•.^me• ....,,,�_ .,,,ro; is „� _ ....� ar --- -- - �--- - -- - • - y--- « 1. {_ . l — --},� .a,• t••M .e,r sa.mw a.4�e... �—ow. .r mw .•ww or +�+ w. / I —r t ' - = - —� r.--aa.,--mss..•..-..�v � .a.__ nn,__,.,a., 1 ... ... +a .+... �u .�.� -- - ---, ... jo IN 44 _ / ., 1 .- . � - 1Iy� , ,�rz wr. ,rue , awlr u.w. .wn. ..� •...7 '� "s'� �"" o. ` •w . -•—t-1— - r_ _ r y_ �_,__ - .i� 1i f. ef^• Y ' I . I City of Fridley SUBJECT PE 17549 AT THE TOP OF THE TWINS BUILDING PERMIT r ', RECiy___--COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432- NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/13/84 JOB ADDRESS 1631 - 66th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 2 Moore Lake Park lst Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Graig Heieren 1631 - 66th Avenue N.E. 571-4732 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Hogar Construction 2098 Silver Lake Road 636-8822 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 X 8 DESCRIBE WORK Construct a 30' x 24' Detached Garage 8 CHANGE OF USE FROM TO STIPULATIONS Provide a•hard surface driveway. Wrecking permit should be taken out for existing garage. MVI A9 aminogN '313 SVD - 01810313 - 3NON0131 PERATE Sali!I!lo Iejol llea Bulgalp aj0j08 HFAPER E AT1NG• P�r�Me�I�S REpvi�E OIVINtld11A N(; q ND FaR .S/rIV iR�ryG S. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 720 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 SPECIFI8964iEF,ElN OR NOT. THE GRANTING OF A PERMIT $8,050 $4.03 DOES PRESUME TO GIVE AUTR`OFHTY,�TO_,VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PR ISION OF ANY OTHER STATE O LOCAL LAW REGULATING: CON- ST U OR THE P R O CONST,@UCT40N. PLAN CHECK FEE TOTAL FEE �j l lv 0 " $78.53 SIGNATURE OF CO NTRACTOR OR AUTHORIZED AGENT (DA '�g�OXEN PROPERLY YALIDATED THIS IS YOUR PERMIT BLDG WSP TE SIGNATURE OF OWNER dF OWNER BUILDERI (DATE) NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ 7 �R-1 AND R-2 ALTER. [ l Building Permit Application Construction Address: Legal Description: Owner Name & Addr ss : C �l Tel. # ^ � �' Contractor: Ci_- CTel. # 0 3b°` Address: 44 a/ er,_ 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. -7 .� GARAGE AREA: Length Width Height Sq. Ft. V DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: 4417 �� Estimated Cost: $ -- ��So. av Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: `s' / I He/ APPLICANT: A�Tel, Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: ,/ CITY USE ONLY A f)`-50 Fee Schedule on Reverse Side $ —� 25% of Building Permit Fee $ $.50/$1,000 Valuation $ $425 per SAC Unit $ Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] INC. Permit by Legal Description—_ Lot Blk Type Const. l KB: By HOGAR O y Owner Approx. ❑ In 2 -STARTING POI T NLY S.P.L. / N✓ S.S.P.L. R.P.L. AI ley House F. Street Other WSquare Withj V-4940 d Rem. - By B.U. _6 Grade Point ❑Wtr.proof: OBy Own. ❑By HOG ❑Backfill: []By Own. ❑ByHOGAF ❑ Maintain 8' Total Wall Height Including Blocks OR ElMaintain 8' Wall Height on Top of Blocks Block Size (Top course) � ❑ 8" ❑ 6" ❑ 4"_ ❑ Frame with full wall height sold OR ❑ Cut studs as required for HD clearance O.H. Dr Offset �i PkWin Location, �.Window4 �y ❑ Att Gar Roof Tie-in t Drawn on attached pictures Existing garage: No Detached ❑ Attached Yes Size of existing: Existing garage will b"eau ❑ Left as is ❑ Converted to L.S. - By owner ❑ Removed By: Owner ❑ HOGAR ❑ Junk Must Be Removed By Owner ❑ Specify removals by HOGAR or Owner - trees, bushes, etc. ❑ Show approx. dist. garage to house and all prop. lines Stakes visible - ❑ Yes ❑ No Survey available - ❑ Yes ❑ No ❑ Special instructions from owner: WORK ORDER HOME PHONE: L5 / —q73 Z NAME ' L4 LI `e- BUS. PHONE: JOB ADDRESS/ 03 8 0(lh &-L' � - BLDG CODE AREA_�� SALESMAN t) A)9 CONTRACT DATE SIZE 30 FOR OFFICE USE ONLY PURCHASER'S INITIALS: JOB # DIRE4TION RIDGE CABLE TRIM �INB TR1Y+� �kbrt Ix2. NORMAL STUD LENGTH 7 FT - .PLUS PLATES ,UNLESS OTHERWISE SPECIFIED CORNER BRACE 6' . 11,x4ol BRACING 2 REAR CORNERS ON 22 s OVER GARAGE WIDTH BOSTON RIDGE NSPHALT SHINGLES 5f FELT PAPER BOXED EAVES �SXDINO_ 35001 TEST . L REAR � f CONCRETE A WITH METAL CORNER . DOUBLE HEADER s 2-2"x12" w/PLYWORQ ,!, v X1/2" INSULATED SHEATHING ON 16 FT. GARAGE DOORS �� I1 21lx4" DOUBLED FOR FASCIA 6" /TREATED HEADERS WITH STANDARD BOTTOM PLATE RANCH WINDOW, 2'4t6" SOFFIT 4" v ALUMINUM THRESHOLD HEADERS FOR OVER 46" INSTALLED WITH'CONCRETE WINDOWS ` ANCHOR SCREWS NCHOR BOLT 2'-0" APRON 4" CONCRETE SLAB SILL 2" x 5" TRIPLE CORNER STUDS SILL SEALER NORMAL "W" TRUSS 6" BLOCK i + • I ♦' WIRE MESH i A . 1/2 RAFTER B - 1/3 SPAN NOTEi USE SILL SEALER TRUSS ABOVE OVERHEAD DOOR ° TREATED OR CEDAR STUD 2"x4" -ANCHOR' SILL � , _.�.- ;•. � �. _ ._tom" � 4U ♦, ? ,; P. SPAN IS EQUAL TO NORMAL--' b't " ' WIRE MESH SPAN LESS FOUR FEET _ I- NOTEf NO SILL SEALER CUT TO RECEIVE FASIA r HEADER AT CORNER CUT TO TECEIVE SOFFIT LING BASE TRIM 1"x2" FASCIA 6" SOFFIT 12" -% • 16'y • 3 NAILS 16" BOTH SIDES, 1 IE2" x 4" FILLER RIDGE GABLE TRIM �NETRIv+'� 1 NORMAL STUD LENGTH 7 FT. .PLUS PLATES .UNLESS OTHERWISE SPECIFIED CORNER BRACE 6' - 2"X4" BMC I NG 2 REAR CORNERS ON 22 6 OVER GARAGE WIDTH BOSTON RIDGE -2401 ASPHALT SHINGLES .1Sf FELT PAPER �'� BOXED EAVES 2' X O 1 X r I RAFTERS 16" 0. C. 2"x4". DIAGONAL BRACING FRONT r �(`• ' / 34001 TEST . 6 REAR CONCRETE Ilk SIDING CORNER WITH METAL .'� . DOUBLE HEADER � r 2-2"x12" W/PLYWOO ON 16 FT. _ ��V )/I" INSULATED SHEATHING GARAGE DOORS 2"x4" DOUBLED FOR FASCIA 6" n i ;, TREATED HEADERS WITH STANDARD SOFFIT 4" �" i BOTTOM PLATE RANCH WINDOW. 2"x6" y ALUMINUM THRESHOLD HEADERS FOR OVER 481, INSTALLED WITH CONCRETE WINDOWS ANCHOR SCREWS CHOR BOLT 2'-0" APRON �� '4" CONCRETE SLAB SILL 2" x 6" NORMAL "W" TRUSS TRIPLE CORNER STUDS -_. SILL SEALER jr 6" BLOCK + a • + + + WIRE MESH M A • 1/2 RAFTER '1 B • 1/3 SPAN NOTE: USE SILL SEALER TRUSS ABOVE OVERHEAD DOOR, ' TREATED OR CEDAR STUD 2"x4" r ANCHOR BOLT SILL SPAN IS EQUAL TO NORMAL--' + ' SPAN LESS FOUR FEET -WIRE MESH NOTE: NO SILL SEALER v CUT TO RECEIVE FASIA HEADER AT CORNER /2 CUT TO TECEIVE SOFFIT 16'y I L/ NAILING BASE TRIM 1'x2" 3 NAILS 16" BOTH SIDES, 1 Z" x 4" FILLER FASCIA 6" SOFFIT 12" STATE OF MINNESOTA DEPARTMENT OF HEALTH ABANDONED WELL RECORD afIR 1. LOCATION OF WELL• MINNESOTA nkNIQUEf not WELL oLwn)N0. H County Name Township Name Township N Range Number Section No. Fraction 4. WELL DEPTH (completed) Date sealed FRIDLEY `�'� E h k of h 30 r 24 W 13 NESENE 65 ft. MAY 5 , 2992 S Numerical Street Address and City of Well Location or Distance from Road S. DRILLING METHOD (1f known) Intersection Cable tool 40 Reverse 70 Driven 100 Dug 1631 66TH AVENUE N.E. 2L]Hol IowRod SQ Air 80 Bored 110 Shur exact Location of well 313 Rotary 60 Jetted C Power Auger (in section grid with 'X') N Sketch amp of well location 6. OBSTRUCTIONS N W NONE Well obstructed U Yes No Obstructions removed 0 Yes 0 No If obstructions cannot be 9®_ j E �ra U. MEN& HARDNESS OF 3. FORMATION LOG COLOR FORMATION FROM TO If not known, indicate formation log from new well or nearby well. removed, contact MOM before sealing. T I 1 a ii31] o 0 g. SCREEN Screened well from 60 ft. to 6 5 ft. (If known) 0 Open Hole from _ ft. to _ ft. 7. USE 1�Domestic 40 Monitoring MONO �T/ 1 v7 20 Irrigation Test Well 50 Public 6M Municipal I Well obstructed U Yes No Obstructions removed 0 Yes 0 No If obstructions cannot be 9®_ j E �ra U. 8. CASINGS) (Black 9Threaded 70 20 Galv. Sp welded 30 Plastic Go Stainless Steel 3 in. to 60 ft. in. to ft. HARDNESS OF 3. FORMATION LOG COLOR FORMATION FROM TO If not known, indicate formation log from new well or nearby well. removed, contact MOM before sealing. T I 1 a ii31] 0 20 g. SCREEN Screened well from 60 ft. to 6 5 ft. (If known) 0 Open Hole from _ ft. to _ ft. 7. USE 1�Domestic 40 Monitoring 80 Heat Loop �T/ 1 v7 20 Irrigation Test Well 50 Public 6M Municipal go Industry 1CQ Commercial I— : St. — 1 L 7[] Air Conditioning 110 2. PROPERTY OWNER'S NAME DUANE POEHLS Mailing Address if different than 1631ad66THicAVEbOVeNE FRI DLEY , HN. 55432 8. CASINGS) (Black 9Threaded 70 20 Galv. Sp welded 30 Plastic Go Stainless Steel 3 in. to 60 ft. in. to ft. HARDNESS OF 3. FORMATION LOG COLOR FORMATION FROM TO If not known, indicate formation log from new well or nearby well. SAND BROW 0 20 g. SCREEN Screened well from 60 ft. to 6 5 ft. (If known) 0 Open Hole from _ ft. to _ ft. CLAY BROW 20 60 FINE SAND GRAY 60 190 10. STATIC WATER LEVEL DRY —ft.? below [3 above land u ace Date Measured 5-5-92 SHAKOPEE DOLO . PINK 190 215 JORDON SANDST. GRAY 215 235 11. WELLHEAD COMPLETION 10 Pitless Adapter 40 Found Buried Basement offset 'r0 30 Well Pit 16. REMARKS, ELEVATION, SOURCE OF DATA - CASINGS REMOVED, CASINGS PERFORATED, ETC. 12. GROUTING INFORMATION 3 BAGS XHeat Cement 20 Bentonite 30 Grout material PORTLANDfrom 65Le_SURF eU. yds NEAT GROUT GEOLOGY WAS TAKEN FROM THE WELL AT: ( CENTRAL AVE.& MISSISSIPPI ST.,FRIDLEY WATER LEVEL IN THE ABOVE WELL: 45' DATE WATER LEVEL WAS TAKEN: 3-22-46 13. REAREST SOURCES OF CONTAMINAilom ___'3fet S direction CITY SEWERtype Well disinfected before sealing?XYes 14. PUMP 0 Removed XNot Present Type: 10 Submersible 30 L.S. Turbine 50 Reciprocating Jet 40 Centrifugal 60 MAY T 15. EXISTING WELLS (Please sketch locations of abandoned and active wells in remarks section or on back.) 11A17. L Other unused well(s) on property? 0 Yea MNo Abandoned: 0 Permanent 0 Temporary [] fftlealed 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 O 5 E -H156 AAens.�eAtsio�NamgST, rj,W.License No. t3 Add IV .553.3.0 427-6100 1'— �1 Signed Date 5-6-92 Date 5-5-92 Na of Driller FFICIAL ABANDONED WELL RECORD (May be used for Property Transfer) XXPCRrAN7: PILE WZ?W pmw KEVIN HOPPE W5-00'51� NEW [ ] CITY OF FRIDLEY ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: 16 31 � &WL e �*41 ' Fr , it Y, A,15 **Lel. # 74 Z 0�6 MN LICENSE # � Obi 1Y7A/SW/19Te1. # Legal Description: Owner Name & Address: ✓ ►� Contractor: 1_ /W 1e`vyr/�ew C v Address, of A,,Ja114 /- 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 f Alk f� ✓v® I / Construction Type:�4f'"a�J e r Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$ DATE' 4-20-05- APPLICANT: /"t ✓elf? 44516�(-( Tel. # Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ 0 Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 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 [ ] STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571_1287 PLUMBING NXTURE RATES: 73 Effective Apra 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT NO. RATE TOTAL JOB The undersigned hereby makes application for a permit for the workherein 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. DATE: 20 OBJ OWNER BUILDING USED ESTI MATEO COST V La PERMIT NO. PLUMBING CDhAPANY SIGNED BY m rm State Surcharge $ .50 Approved By TOTAL FEE MINIMUM FEE F06 $� OF THE IMHE ROP Vj§ COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE G -A. TELNo,-7 3-d38- L1703 Rough -in owe Final Date 3 tL 9 0 co ra 0 0 ra C!1 r m 3 m U r 0 m m LA m 0 0 HtcHE ER Is 1;R T R ON ORK L SS THAN v 0 "PROM E COM ON 'INFO OH BACK SIE 'e R) New Fixtures ff Ofd Opening,'New Fixture 510.00 �-- 610.00-^ Beer Dispenser Blow Off Basin $10-00 Catch Basin -- $10.00 �~ Rain Water Leader $10.00 � -L SumprReceiving Tank $10.00 --- HVater Treating Appliance $30.00 17 u- water Heater -Electric $ 35.00 LL Water Heater - Gas- Gas Range" 35.00 $35'00 u Gas Dryer" $10.00 Back F1OW Preventer Required ( )Yes () Na $10 .00 Type $15,04 `1 N Reinspection Fee $50.00ft A ALL OTHERS AND/0R REPAIRS AND ALTERATIONS -' 1.25% of value of Fixture or Appliance JOB The undersigned hereby makes application for a permit for the workherein 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. DATE: 20 OBJ OWNER BUILDING USED ESTI MATEO COST V La PERMIT NO. PLUMBING CDhAPANY SIGNED BY m rm State Surcharge $ .50 Approved By TOTAL FEE MINIMUM FEE F06 $� OF THE IMHE ROP Vj§ COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE G -A. TELNo,-7 3-d38- L1703 Rough -in owe Final Date 3 tL 9 0 co ra 0 0 ra C!1 r m 3 m U r 0 m m LA m 0 0 HtcHE ER Is 1;R T R ON ORK L SS THAN v 0 "PROM E COM ON 'INFO OH BACK SIE 'e R) NEW [ ] CITY OF FRIDLEY Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: ) 1 31 T U Legal Description: �(' S ( Y)[j Owner Name & Address: ICY $,1t�-C) YY Nk-tV) Tel. # -TU 9 7-T%+ -1-vw Contractor.\i$ !)MN LICENSE # 10 I LP �4 Cl' 3 Address: q q JL l r1 \L I'i P6 � 4 ] Z 1 Tel. # 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 Length Width Height Sq. Ft Hgt/Ground Sq. Ft Construction Type: i R6 Estimated Cost: $ vr� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 65APPLICANT: %\r Ck V) Q o n 6 Q m o44 Tel. #031 -q6 -o` ds - Call JCall (763) 572-3604 for Permit Fees If mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ Z d Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] STIPULATIONS: 9..0-0 Building BUILDING Permit No.: `%062`0 G Inspections RESIDENTIAL APPLICATION. Receives By: 763-572-3604 763-502-4977 FAX CITY OF FRIDLEY Date Zo EFFECTIVE 1-1-08 ,q DATE OUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: O OWNER CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: -/63/ b 4 9/) CITY sTATEf%'/ N 3 PHONE: ' CONTRACTOR NAME: SS: ADDREAX STATI� S Sa I SUBMTf A COPY OF PHONE / �- l� F ZIP YOUR STATE LICENSE SLATE LICENSE # f Z Li% g EXP DATE -3 3 / i-� / 23 PROPERTY TYPEAS-SINGLE FAMILY ON SIZE O TWO FAMILYMEW CONSTRUCTION STORMS PERMIT TYPE ❑ ADDITION ❑ GARAGFISHED WS O BASEMENT FINISH O ROOF O DRAIN TILE O DECK O SIDING O OTHER O SW504ING POOL TYPE OF WORK: 0 NEW HOME CONSTRUCTION 0 ADDITION O MAWE'4ANCFAWAIR. O REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT RO (3 HOUSE ONLY NUMBER F SQUARES O HOUSE GARAGE BASEMENT REMODELING SUBMIT: GARAGES O ATTACHED GARAGE I. . 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: PROPOSED HEIGHT: E3 DETACHED GARAGE 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, 0 Vinyl OSoffit ADDITIONS & PORCHES SIJBMIT.• O Aluminum O Trim 1. Site Plan/Survey showing the existing structures O Other O Fascia and proposed project. VVWWwS 2. Two sets of construction plans s LOCAOR IN EXISTING OPENINGS<CP%M 3. Energy Calculation FOR NEW OPENING SIZE OF OPENING CHANGES & TYPE OF. WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ONVAL ATION INCLUDING TSE COST OF LABOR AND MATERIAr c; _ WMG THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks a able to: City of Fridley Attach Stiatdations THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information ve 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 on Codes; that I d this is not a permit but only an application or a permit and work is not to start without a permit on site; that the work will m acco cc ' the approved p case of all work which nevi and o lana. / SIGNATURE OF C VT' PRINT NAME DATE IeAalb ��.-0- --- Q