PRE 2010 DOCSCITY OF FRIDLEY
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
TELEPHONE ( 612)571-3450
April 29, 1977
�:BM Investment Company
3005 Ottawa Avenue South
Minneapolis, MN 55416
Shallow Sewer Service
Dear Sirs:
9A CW [�0
During the process of final design for the above referenced utility
project, minimum depth of sanitary sewer was unavoidable due to
existing elevations of existing sewers in the area, therefore, please
be advised that prior to any full basement type construction of
residential buildings, it would be advisable that contact be made
with the Engineering Department to determine the elevation of the
sewer available for your particular future lot.
The design of the sewer will be approximately 8' below the proposed
street elevation.
If you have any specific questions as they pertain to your lot, please
feel free to contact me.
Sincerely,
CITY OF FRIDLEY
?homas A. Colbert, P.E.
Assistant City Engineer
TAC/yrs
cc:Darrel Clark /
�C_ommupity Development Administrator/
City of Fridley
SUBJECT
� 14805
AT THE TOP OF THE TWINS
PERMIT
`
BUILDING
RECEIPT
COMMUNITY DEVELOPMENT DIV.
1 PROTECTIVE INSPECTION SEC.
1
dZ3
i CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF APPROVED BY
612-560-3450
910-F15
7/17/78
JOB ADDRESS 1601 - 731i Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
W. 96 O
S. 2/3 of
Lot 4 A. S. No. 108
SHEET
2 PROPERTYOWNER MAILADDRESS
ZIP PHONE
Korman Construction 707 Columbia Blvd.
788-7362
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.
6 USE OF BUILDINGPERMITS
ED FOR WIRING
v(� WIRING.
Residential HEATt
w
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 40' x 26' Dwellincr and a 22' x 20'
Garage
9 CHANGE OF USE FROM TO
STIPULATIONS Providea hard surface driveway. Provide a verifying survey before
framing. Provide sod in the front and side yards. Provide combustion air
to the furnace.
SEWER LOCATION: (Approx. 10' Deep in Street) 55' E. of Manhole
(Inv. 890.74) Wye Elev: 890.96
TOP OF FOOTING: 893.96 Minimm
WATER LOCATION: 75' E. of N. Catch Basin
DRIVEWAY DEPRESSION:` N/A
WALING
BAN a1W9 cell -lout utilltl"
W CO OF MOAN► Dogs Noy
• ELECTRIC - GAS. EtCi
WARIW7Ee TW!'TELEPHONE
ACCURAty OF UMM t4rAr4NS AND UWAnoNS.REQUIRED
THIS
BY LAW
pATA IS Von WoWr4N pUePC OS
ONLYA14D
PERSONS U R to VERIFY TH! IWO"AtION
ON THE SITE,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
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
1172+440
26,144
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
R-1
Total
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
$ 38, OlO
$19.00
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
PROVISION OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$104.58
$400.00
STRUCTIO THE PERFORMANCE OF NSTRUCTION.
PLAN CHECK FEE
TOTALFEE
.14
$549.72
IGNATURE OF CON R CTOR R A.VtH I DAGENT (DATE)
EEN�PROPE LY VALIDATE THIS IS YOUR PERMIT
/
On
INSP
DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
• CITY OF FRIDLEY
' APPLICATION FOR RESIDENTIAL BUILDING PEMITS
MEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: - BUILDER:
r
Address: Address:
Tel. Ng�o .
�•�'�� f
No.: [(�-Street: fT��
G%/ %G �
LOT: BLOCK: ADDITION:
CORNER LOT: INSIDE LOT: 1/ SETBACK: �3 S SIDEYARDS:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Used As:
Front: Depth: 01 ip Height: C')0
Square Feet: �.� Cubic Feet:
Front: Depth: U• Height: / ()
vt qL-
Square Feet: 'y 40 Cubic Feet: '<10o
Type of Construction: L-onn& 11(122t,Q Estimated Cost: $ _
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 wort: 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 fo additional information.
DATE: 1 �� � SIGNATURE: %rIR
Stipulations:
0A ®9,®0
I
1
, ,
i
7yy�
Z ✓
alar zo ��d z
X /o ' _
y -lad
J
o?Ol)1dw d'
C2 a, i
9Go
x ��z _r is, z
�--
,7;e/9. �.Z
1�
r.
rNorth 1.;ne.of Soijib 0/3 of Loi 4
96.00 - IRON
Ito
10.
4, 96.00 IRON
7.3, A.,A VC -r- Al Uf N. E.
k. 50ufh J;ne oP North kz of Lot 4
IDLV DOES 1401
ATiOh
pie OVY Of PR 0�* AND
ACC of UpUV LOCAII OSFS ONLY AND
,kccl t 200ot4 PURP PWAXION
181S DAIA IS fol 11 SHOUID \,Er4py JrHf. 0*0
yid\egnRSO�* USING
'st4 IWE
wo *
SURVEY FOR:
Bar - Ett Investment Cotopa ny
Scale: 1" = 30'
DESCRIPTION: The West 96 feet of that part of the South 213 of Lot 4,
Auditor's Subdivision No. 108, Anoka County, Minnesota,
which lies North of the South line of the North Half of
said Lot 4. Subject to road easement for 73 112 Avenue -
Northeast.
We hereby certify that this is a true and correct representation of a
survey of the boundaries of the land above described and of the location
of all buildings, if any, thereon, and all visible encroachments, if any,
from or on said land.
Dated this 14th day of October, 1977.
EGAN, FIELD. & NOWAK, INC.
S urveyors
Minnesota Registration No. 9053
6///v 1 s o� �,ois��/�3p �j��
I - A,
,, 'SOP-t/.��1//
4,
C-4 9-AdQ�� 'L -r
Surveyor's Certificate
COMSTOCK & DAVIS, INC. Consulting Engineers and Land Surveyors
1446 County Road J, Mpis., Minn. 55432, 784-9346
Survey of: Survey for:
Part of Lot 4 Henry P. Korman
Aud. Subd. No. 108 707 Columbia Boulevard
Anoka Co., MN I Minneapolis, MN 55418
ki s,0/iftv
Levr�
' /.d6 Ortyfan
9
Deed 76.00
�. 9s y
ti
73 i
96.00
M
I
6,0
'7
d q4 9
DESCRIPTION: The West 96 feet of that part of the South 2/3
of Lot 4, Auditor's Subdivision No. 108, Anoka
County, Minnesota, which lies North of the South
line of the North Half of said Lot 4. Subject to
road easement for 73 1/2 Avenue Northeast.
l � 1 ��� Ciue x
SCALE: /'= 30
I hereby certify that this survey, plan or report was prepared by me or under my direct
supervision and that I am a duly Registered Land Surveyor under the laws of the State
of Minnesota.
—Ag—, /0i0J Z 4/� s; 197e y/o
k JV Reg. No. Date Job No.
CITY OF FRID
APPLICATION FOR POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
.AIR
CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE
TOTAL
Job Address Z
Furnace Shell & Duct Work
$12.00
$
Replacement of Furnace
7.00
$
Repairs & Alterations -up to $500.00
7.00
$
Department of Buildings
Repairs & Alterations each add. $500.00
4.00
$
City of Fridley
Tel. #571-3450
MECHANICAL WARM AIR:
The undersigned hereby makes application for a permit for the work herein
Furnace Shell & Duct Work to 100,000 BTU
$12.00
$ /
specified agreeing to do all work in strict accordance with the City Codes
each add. 50,000 BTU
4.00
$ 7—
and rulings of the Department of Buildings, and hereby declares that all the
Replacement of Furnace
7.00
$
facts and representations stated in this application are true and correct.
Repairs & Alterations -up to $500.00
7.00
$
Repairs & Alterations each add. $500.00
4.00
$
Fridley, Minn. 2-9
STEAM OR HOT WATER SYSTEM:
OW14ER l t/ %a moi' r 13 1 ?I q
Boiler & Lines up to 100,000 BTU
$12.00
$
KIND OF BUILDING
each addn. 50,000 BTU
4.00
$
Boiler only up to 100,000 BTU
7.00
$
USED AS ajl'c eq
each addn. 50,000 BTU
6.00
$
TO BE COMPLETED ABOUT
OIL BURNER- to 3 gal. per hour
$10.00
$
each add. 3 gal. per hour
10.00
$
ESTIMATED COST
GAS BURNER- from 100,000 BTU to 199.999 BTU
$10.00
$
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
(over 199,999 BTU see Fee Schedule)
$
GAS FITTING FEES:
3.00
1
1st 3 Fixtures x
$
$
DESCRIPTION OF FURNACE/BURNER
Additional Fixtures x
$ 1.00
$
Gas Range to 199,000 BTU x
$10.00•
$
�r
SEATING or POWER PLANTS, Steam, Hot Water, harm Air- No. co
AIR CONDITIONING
$4
Trade Name Size No. Gl/0 �
FAN HEATING SYSTEMS See Fee Schedule
JState
$
VENTILATING SYSTEMS
$
Capacity Sq. Ft. EDR BTU HP
ALTERATIONS & REPAIRS
$
Surcharge
$ .50
Total Connected Load,< �f;r Kind of Fuel ��/�/��Ot:
TOTAL FEE
$
,
BURNER - Trade Name Size No.
ROUGH INSP. REINSPECTION FEE
Date
CapacityA�� q. Ft. EDR BTU HP
HEATIN tj
($10.00)WELTER
'
R%►Y M.
Company Av®•
FINAL INSP.9-/-.
Date
Mi""Ota
Signed ByMjnneaP0Vs1
-
APPROVAL FOR PERMIT /
�65�5
Tel. No.
MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PER41T
PARTIAL RATE SCHEDULE
•
RATE
TOTAL
Number Fixtures
a r o
$911,60
Future Fixture Opening
x $2.00
$ b
New Fixture, Old Opening
x $2.00
a,
Catch Basin
Water
$
Water Heater - to 99,000 BTU
x $5.00
.�
100,000 BTU to 199,000 BTO
x $10.00
t�
.xoi h
}0eC4.
�)
$
m
rgo f+
po',
w
x $5.00
$
GAS FITTING FEES:
1st 3 fixtures
x • $3.00
$ 3 • ��
Additional Fixtures
x $1.00
$
Gas Range to 199,000 BTO
u
UHeater
i7
4g
U
El
�as
�lec
'
g
vel
.c.'
o
W
u
a
o
of
r
to
3
w°
vii
u a�
R
i3
c�
1st
2nd
3rd
4th
(R) a Future Connection Opening
Connected with Sewer
(*) - New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x $3.00
$911,60
Future Fixture Opening
x $2.00
$ b
New Fixture, Old Opening
x $2.00
$
Catch Basin
x $5.00
$
Water Heater - to 99,000 BTU
x $5.00
$®
100,000 BTU to 199,000 BTO
x $10.00
$
Water Softener
x $7.00
$
New Ground Run Old Building
x $5.00
$
Electric Water Heater
x $5.00
$
GAS FITTING FEES:
1st 3 fixtures
x • $3.00
$ 3 • ��
Additional Fixtures
x $1.00
$
Gas Range to 199,000 BTO
x $10.00
$
REPAIRS $ ALTERATIONS
First $100.00 $5.00 $
each add. $100.00 or fraction $2.00 S
State Surcharge $ .50
TOTAL FEE $ (�
REINSPECTION FEE
(510.00)
Job Address ./Z '73 /� CJ�
Department of Buildings
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn. , 19
OWNER r I�
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NE ILDING PERMIT NO. L146 PERMIT NO.
Company v
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT !°=�.L,
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLUS $.50 STATE SURCHARGE
:WIT OF 1-K1llLtT i � .
• 97-8�-l�16051 APPLICATION FOR PLUMBING AND GAS PITTING PERMIT
Job Address 1601 73'j Ave. NE . • .
,Department of Buildings
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correc
Fridley, Mn. 4-19-79 , 19
OWNER KORMAN
KIND OF BUILDING frame
USED AS res.
IWI-M ,
TO BE COMPLETED ABOUT
PARTIAL RATE SCHEDULE
�,
a
ESTIMATED COST 3Q nn '
'LUbMINC FIXTURE RATES: NO. '
u
RATE
TOTAL
a
NtAmber Fixtures
water
$3.00
.�
a
Future Fixture Opening
h
'•
N
C h
y" .
A
H
rot+
a
w
Heater
Signed By
m
a
$5.00
Nater Heater - to 99,000 BTV
'� �
6Y
u•
r
w
R
.
^_�
S
11
Water Softener
x
lec
S
v
p
S
x
•-ci
N
�
re
N
C
7
c
x
o
8
+� N
u to
N
v
o
,o
ai
h•
1st 3 fixtures'$3,00'
�°..vq,
w
u e"a
.ot
x
$1.00
$
o
as
x
$10.00
$
APPROVAL FOR PERMIT
?ZPAIRS 6 ALTERATIONS
,
First $100.00
$5.00
$
'
each add. $100.00 or traction
$2.00
S
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS 9.50 STATE! BCZCQD=
State Surcharge
$
TOTAL FEE
$ 10.50
'
•
a
ffEINSPEC4•Tnnr Pvs
d
ti
Future Connection Opening
Connected with Sewer
•) - Nev Fixture, Old Opening
Water
Job Address 1601 73'j Ave. NE . • .
,Department of Buildings
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correc
Fridley, Mn. 4-19-79 , 19
OWNER KORMAN
KIND OF BUILDING frame
USED AS res.
IWI-M ,
TO BE COMPLETED ABOUT
PARTIAL RATE SCHEDULE
ESTIMATED COST 3Q nn '
'LUbMINC FIXTURE RATES: NO. '
RATE
TOTAL
OLD - NEW BUILDING PERMIT. N0. _ PERMIT N0. -
NtAmber Fixtures
X
$3.00
$,_,_,_
�l
Future Fixture Opening
x
$2.00
$
Company
flew Fixture, Old Opening
x
$2.00
S
Signed By
Catch Basin
x
$5.00
Nater Heater - to 99,000 BTV
x
45.00
$
Tel. No.
100,000 BTU to 199,000 BTU
x
$10.00
^_�
S
Water Softener
x
$7.00
S
flew Ground Run Old Building
x
$5.00
$ �
ROUGH INSP.
Electric Water.Heater
x
$5.00
.•
Date
,AS FITTING FEES:
FINAL INSP. � -7-
1st 3 fixtures'$3,00'
x'
$
��
Date
Additional Fixtures
x
$1.00
$
'
Gas Asnge to 199,000 STV
x
$10.00
$
APPROVAL FOR PERMIT
?ZPAIRS 6 ALTERATIONS
,
First $100.00
$5.00
$
'
each add. $100.00 or traction
$2.00
S
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS 9.50 STATE! BCZCQD=
State Surcharge
$
TOTAL FEE
$ 10.50
'
•
a
ffEINSPEC4•Tnnr Pvs
9
SUBJECT
City of Fridley
jr
_ �933
AT THE TOP OF THE TWINS
BUILDING
PER
i
r
NO.
COMMUNITY DEVELOPMENT DIV.
SEC.
['R'CEIPT
�®
r PROTECTIVE INSPECTION
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
9/17/80
JOB ADDRESS 1601 - 73' Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Pt 4
Alld. Sub. #k108
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
David Helman 1601 - 7311 Avenue N.E. 784-1385
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.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
f NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 10' x 16' Storage Shed
9 CHANGE QF USE FROM TO
STIPULATIONS
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 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
$600
$.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
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$7.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
J
$8.00
SIGNAEOFCO T Ra (DATE)
UR PERMIT�
WHEN PROPEALIDATED THIS IS YOUR
�
BLDG INSP
aAjj
E
SIGNATUREOF WNE IFO R UIL R) IDATEI
9
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
• (New, Alterations, Additions, or Repairs)
OWNER:
ADDRESS:
TEL NO:
BUILDER:
ADDRESS:
TEL NO:
Construction Location
STitMT NO: I �Q� 1 STREET:
LOT: BLOCK: ADDITION:
Corner Lot: Inside Lot: Setback.: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION.
Front: t
Square. Feet:
Depth : ! i b A ti,:t
Cubic Feet:
Height:
Front: Depth: Height:
Square - Feet: Cubic Feet:
t� Gi D
Type of Construction: `' Estimated Cost: $
TO $e Oompletgd:
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.
Ci
DATE: p �S IGNATU RE : �ce
Stipulations: ® v
7
SUBJECT
PERMIT
City of Fridley
e°
171.7 5
AT THE TOP OF THE TWINS
BUILDING PERMIT
ECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
,', CITY HALL FRIDLEY 55432
NUMBER
REV.
D�r�31/83
PAGE OF
APPROVED BY
L J` 612-571-3450
910-F15
JOB ADDRESS 1601 - 73'Ig Ave. N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
Part Of 4
Aud. Sub. #108 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
David Helman 1601-73]i Ave. N.E. Fridley 55432 784-1385
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Owner
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residenial
7 CLASS OF WORK
X❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Increase existing deck to 19' B 151,
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.
Wood Frame
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
R-1
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
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.
nn
PLAN CHECK EE
EE
TOqn
SIGPlIATUREOF RO UTHORIZEDAGENT (DATEI r
+' WHEN PR PERLY LI E TYOUR PERMIT
BLDG )NSP QATE
SIGNATURE &F OWNER IIF OWNER BUILDER) ID )
7
fc� 1;�
— 1,r,,, 1�-►�
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S0000,
Effective Aug. 1, 1981
CITY OF FRIDLEY
APPLICATIM FOR RESIDENTIAL BUILDING PER141TS
(New, Alterations, Additions, or Repairs)
OWNER:
ADDRESS:
TEL N0:
BUILDER: �
ADDRESS:
TEL NO:
Construction Location
STREET NO: l ®� STREET: -7 3 �/2 - rl 7 - � " F
LOT:
BLOCK: ADDITION:
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location draian on certificates to scale.
DESCRIPTION OF CONSTMI CTION
Front: Depth: Height:
Square Feet_ Cubic Feet:
Front:
Depth: Height:
45Square Feet: Cubic Feet: _
�a '" U
Type of Construction: 2-
7b
Be Cbmpleted: J � �—
s7m vv
Estimated Cost: $
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE FEVERS E SIDE OF SHEET
Mie 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 Depzirtment of Buildings, and hereby declares that all the facts and
representati ns stated in this application are true and coir ct.
7
DATE: SIGNATUF•:
7
Stimulations:
SUBJECT
PER
City of Fridley
O 17 4 9
AT THE TOP OF THE TWINS
BUILDING PERMIT
t
REC
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
/,277/(
1 �
! CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
5/21/84
�
JOB ADDRESS 1601 - 731t Avenue N. E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4
Aud. Sub. #108 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
David Heiman 1601 -- 732i Avenue N.E. 784-1385
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
Cj NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct a 161 x 24' Above Ground Swimming Pool
9 CHANGEOFUSEFROM TO
STIPULATIONS
See stipulations on letter dated May 21, 1984 from Environmental
Officer. The pool and any related structure must be kept 3 feet or more
from any lot line.
WAR111AF, SEPERATE PERMITS REQUIRED FOR WOW
Before d� HEATING, ,PLUMBING AND SIGNS,TELEPIiO
E.ng calf local utrfit>je,
ELECTRIC
_ GAS Etc.
REQUIRED
g LA W
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
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
$2,600
$1'30
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-
$38.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$39.80
SIGNA�}URE OF CONiRACTO p�TH�ORIZED AGENT
WHEN PROPERLY LDATED THIS IS YOUR P RMIT
7(DATEjI�/
- - BLDG )NSP DATE.
I SIGNATUREOF OWNER IIF OWNER BUILDER) IDATEI•
NEW V\j
City of Fridley Effective 4/1/84
ADDN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: ��vol `73
Legal Description: t' T- Lo r 4 c S t o g -
Property Owner/Address: 160/- 73 21 A4A Tel. 4
•
S z k -- ,/�+D 1vv�A� Tel. # - S
Contractor.
Address:
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.
DECK AREA: Length idth Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
�o
Type of Construction: /111 %^,,7 Z Estimated Cost: $ ^U -
Approx. Completion Date: vtr
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation
DATE: 12-91
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
r L/G�u
APPLICANT:
CITY USE ONLY
STIPULATIONS: 14
Y.
(:v , ""F -
Tel.
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 [ ]
-� � /-/"�>3&eH�4a4'�A'
G7YOf'
FRIDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E., FRIDLEY. MINNESOTA 55432 • PHONE (612) 571-3450
May 21, 1984
Mr. David Helman
1601 - 73 1/2 Avenue N.E.
Fridley, MN 55432
Re: Swimming Pool Construction at 1601 - 73 1/2 Avenue N.E., Fridley
Dear Mr. Helman:
This letter is to make clear this department's requirements for the swimming pool
construction at the above address.
1. As indicated, one (1) skimmer approved by the National Sanitation Foundation
will be provided.
2. As indicated, one (1) inlet of approved design for fresh and/or repurified
water will be provided.
3. The filter and pump shall be approved by the N.S.F. and be of sufficient
capacity to provide a minimum turnover of at least two (2) times in 24 hours.
This department recommends a turnover rate of 6 - 8 hours.
4. A deck of at least three (3) feet wide, measured from the pool waters edge,
shall be provided which extends completely around all private residential pools.
Above ground private residential pools may be provided with decking of a minimum
size of 4 feet by 4 feet at pool entry points and provided that such decking has
the approval of the City.
5. Fencing or other effective means including but not limited to walls or
buildings, acceptable to the City, shall be provided to positively control all
access to public and private residential swimming pools. Fencing shall meet the
following criteria:
(a) The fencing shall prevent the entrance of children and be without hand or
foot holds that would enable a person to climb over it.
(b) The fencing shall be at least 6 feet high and entrances shall be equipped
with self-closing and self -latching gates capable of being locked.
(c) Self-closing and self -latching devices shall be placed at the top of the
gate or otherwise inaccessible to small children.
(d) The opening between the bottom of the fence and the ground or other
surface shall be not more than four inches.
Mr. David Helman
May 21, 1984
Re: 1601 - 73 1/2 Avenue N.E. Page 2
6. An automatic chlorinator should be provided with a suitable test kit.
T. All electrical and plumbing installations shall be inspected and approved by
the City Inspection Department.
8. All overhead electrical lines must be a minimum of 10 feet horizontally from
the pool surface, and 18 feet straight line distance from the Waters edge. An
alternative is to bury said lines.
9. The pool fill spout must be protected by a vacuum breaker or air -gapped.
10. Suitable safety equipment to include but not limited to a ring buoy and rope
that is 1-1/2 times the pool diameter and shepherds crook pole must be provided
and maintained With the pool at all times.
Furthermore, these and any other requirements must meet the provisions of the
Fridley City Code, Section 115, Swimming Pools. The building permit is approved
contingent on final inspections and approval of the City.
If any questions or problems arise from this letter, please feel free to contact
me at 571-3450.
Sincerely,
STEVEN J. OLSON, R.S.
Environmental Officer
SJO/mh
,purveyors Certificate
COMSTOCK & DAVIS, INC. Consulting Engineers and Land Surveyors
1446 County Road J, Mpls., Minn. 55432, 784-9346
Survey of:
Part of Lot 4
Aud. Subd. No. 108
Anoka Co., MN
'S1
Survey for:
Henry P. Korman
707 Columbia Boulevard
Minneapolis, MN 55418
DESCRIPTION. The West 96 feet of that part of the South 2/3
of Lot 4, Auditor's Subdivision No. 108, Anoka
County, Minnesota, which lies North of the. South
line of the North Half of said Lot 4. Subject to
road easement for 73 1/2 Avenue Northeast.
® �1� Armor
off Rwesxwr /fire
SCALE:
d�/7o¢e.5 %mar! /�7Di7�//ri�✓7� � ri/ll�
I hereby certify that this survey, plan or report was prepared by me or under my direct
supervision and that I am a duly Registered Land Surveyor under the laws of the State
of Minnesota.
Reg. No. Date Job No.
SurveybA 6itificate
COMSTOCK & DAVIS, INC. Consulting Engineers and Land Surveyors
1446 County Road J, Mpls., Minn. 55432, 784-9346
Survey of: Survey for:
Part of Lot 4 Henry P. Korman
Aud. Subd. No. 108 707 Columbia Boulevard
Anoka Co., MN I Minneapolis, MN 55418
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UCK
4(6.50
AP/11/ ,bevel
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Deed %,.00
96.00
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40.1
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DESCRIPTION: The 1 -lest 96 feet of that part of the South 2/3
of Lot 4, Auditor's Subdivision No. 108, Anoka
County, Minnesota, which lies North of the South
line of the North Half of said Lot 4. Subject to
road easement for 73 1/2 Avenue Northeast.
e •� f
SCALE: 30'� f �!
O Oe/IOTGS //-O/7
I hereby certify that this survey, plan or report was prepared by me or under my direct
supervision and that I am a duly Registered Land Surveyor under the laws of the State
of Minnesota.
Reg. No. Date Job No.
LNCIod'11000
Pos Rust PhMection on
rmn tr name
��� sized
• Special Doughboy virgin vinyl
formula for optimized wear and ultraviolet
ray resistance
• Embossed for extra skid and slip protection
• Expandable Durallex liners allow for
optional deep swim area
15 Year Limited Warranty on
20 Mil Expandable liner
Above ground pools are designed for
swimming and wading. Do notJump or
dive, severe personal injury may result
"the original portable pool"
d"unOOU®
. .
t.241x161
40'x 16'
APPROX.
SIZE
SURFACE
APPROX.
EXP.
APPROX.
OVAL
MODEL
AREA
GAL.
GAL.
SHP.
(SQ.rr-)
CAP.
CAP.
WM.
24'x 16'x 48"
4646-92
325
9,150
10,230
625 lbs.
32'x 16'x 48"
4626-92
450
12,700
15,060
875 lbs.
40'x 16'x 48"
4606-92
574
16,240
19,870
1,100 lbs.
41'x 21'x 48"
4611-92
756
21,270
26,270
1,150 lbs.
. .
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40'x 16'
A
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pimple Maing system uft Vacuum pdndple Mtering system
the SMm4 Jne tLrouug sU mmm AU the SkimdlneTM tluuvan skin
Wines p
features pito:
X self searing Re~
40 sq. Ji self seating Reemay
tg element with molded -In
Jtltering element with molded
Ie :
handle
► -art dirath ua4e
i Suiltdn drain value
`+� 4 aDtnpotel hose and hardware
Complete hose and hardwarc
6 hup with special element
hook-up with special element
nbTgarzzle.
cleaning nozzle
y OWSOW Pool Power~ /
Highly eJliclent Pool Power -Pa;
�i+ty1/ze�une
with stylized enclosure
�� �S t1L ilsted
•Pool Power Pak®# is UL listed
1. 1
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Clear.
{deterntlne
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bra fid to { } 1.41-4--, + a I
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impeller for hlghestr
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uks 5i lbarbed 1 A fi se
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1 c t,t s e
"� ,A qou hno exa,�t}� ,
rlfeD_ ^4 :adapter tof �ositive ! I : , ,. _ , 1 i
ung_ump;seat Insulator:` ' +
1.-1-
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_t_, 4.1 ; 1 extreme heatif.pump I
tuns dry 4 { . ._ , 4
Single -bar hose - - .�� +-t 7 ,
4- adapter for "hive Dafen ei/;haft gleeVe degign
4 j V ,___._,. nsulates:motor shaft
hose Seat- - n►�.rn-
? + t t ? Y t + r I t i from water • - . }
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J • y �. fiherrii protested, high
11 + !
efficient cool operating
iaP�lcltY strainer_ !%' •motor for longer life . . . . . .
- -- + - -� .basket- a� _ , _ . . . . . . . . .
Protective motor cover
can,. easily be removed for
t_? : accessibility and service
1 JWlnterizing drain plug in :.Ja j,-- . \ a . . . . . . .
- +pump and strainer pot T
StrOiner pot slip fifl into -- -
pump and is secured with Y
stalnlesS Steel screWs to
......... grieve.. rptatjop. _ i . ..-...... . .
VMOed diffuser, housjng:
equalizes internal forces . r Convenient On / Off
... . . . . . . to extend motor life . . . .switch
Stainless steel pump seal '
:: : : ilow-thru.air ventilat.on , : Stainless steel hardware
for.cool running motor. .: . . '
. . . . . _ . . . . - . Motor is elevated 4 Inches . . . . . . . . .
_ .. :. ialfoVerdund in a high .. . _. . . . . . . , . . .
tl� jmpact base _ _
CO .. - —
5 Complet th
_ + , Seff priniind, double _ . . . . �S foot, auge,
. . . . ... . . . . _ r ---insulated.. thermally _ _ outd ele at cord.
_ _ protected _ In u es saffheettyyoi��u,'/�nd/
Model Rumber
Horsepower
1624.00
Ufa H.P.
162:-00
&A n.P.
1626-00
1 H.P.
24%1
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Doughboy as manufacturer reserves the right to
revise, change or modify construction of Doughboys
family products, or any part thereof, without incurring
any obligation to make like changes on products
previously manufactured.
Your authorized dealer is:
'"e original portable pool' MEMBER
w (�
hbo 0 V
NATIONAL
GPA A POOL
INSTITLITQ
DOUGHBOY RECREATIONAL 10959 Jersey Blvd., Rancho Cucamonga, CA 91730-0959
DB 184018
SUBJECT -
PERMIT N
City of Fridley
Wo 17940
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT N
• COMMUNITY DEVELOPMENT DIV.
r y ______ PROTECTIVE INSPECTION SEC.
i �i•� CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
•---
L 612-571-3450
910-F15
5/1/85
JOB ADDRESS 1601 - 73h Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR,
Pt. 4
Auditor's SMD. #108 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
David Helman 1601 - 73�i Avenue N.E. 784-1385
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 6 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct a 26' x 15' addition to Dwelling
9 CHANGE OF USE FROM TO
'3'TIPULATIONS
Variance granted on 5/7/84
'DARNING SEPARATE PERMITS REQIJIRED FOR
S.
BBfbM digging rail local WIRING, HEATING, PLUMBING AND SIGN)
afrfff� c
TELEPHONE
- ELECTRIC - GAS' Ek.
�C
ZED BY LAW
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
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
$19,750
$9.88
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-
$140.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
FEE
TOTAL FEE
%A;NCHECK
$185.51
SIG�A"T�URE OF CO T RO TMORIZED AGENT IDATEI
WHEN PROP VALIDATED THIS IS YOUR PERMIT
{'
BLDG )NSP DATE
SIGNATURE OF OWNER 0F OWNER BUILDER) IDATEI
NEW [ J City of Fridley Effective 4/1/84
ADDN. R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: �Q (` r73 )1Z
Legal Description: °'
Owner Name &Address : J � I � � l bo i -?3 z k N �. Tel. #
Contraotor: Tel. #
Address:
Attach to this application, a Certificate of Survey of the
lot, With the proposed construction drawn on it to scale.
DESCRIPTION OF iunyEMENT II
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ ] Inside Lot����//�] Ft. Yd. Setback Side Yard Setback
W.,�
Type of Construction: °"-b L Estimated Cost: $
Approx. Completion Date:
r
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: �l' d � APPLICANT: �G'�-'� -Tel. #
CITY USE ONLY
Permit Fee $ LHP o^'S Fee Schedule on Reverse Side
Plan Check $ ?' - 1 25% of Building Permit Fee
State Surcharge 9,919 $•50/$1,000 valuation
SAC Charge $ $425 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
Agreement Necessary [ ] Not Necessary
TOTAL $ [ ]
STIPULATIONS:
(L&I
NEW [ ] City of Fridley Effective 4/1/86
ADDN. �R-1 AND R-2 �•s-e_ 5 -s -Y
ALTER. Building Permit Application
I
nstruction Address:
gal Description:_,
ner Name & Address:
®/— 73// , IJ,!
Tel. #
Contractor: Tel. #
Address: -
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.
DECK AREA:
Length
Width
Hgt/Ground
Sq.
Ft.
OTHER:
Corner Lot [ ]
Inside Lot [ ]
Ft. Yd. Setback
Side
Yard
Setback
Type of Construction:
Estimated Cost: $
Approx. Cc=p etton Pate: D I
L� � Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $$
See Back Page for Explanation
�
DATE: /� APPLICA : Tel.
CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
q
$
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$ 525 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
(4cecu�oL� �
�,o
suejECT
City of Fridley
5
eF
AT THE TOP OF THE TWINS
?-,
BUILDING P E R
M I T
r
RE Ml_ NO.
COMMUNITY DEVELOPMENT DIV.
I.' ______
r PROTECTIVE INSPECTION SEC.
NUMBERNEV
DATE
PAGE OF
APPROVED BY
l A ��"',•� CITY HALL FRIDLEY 55432
.---
L J` 612-571-3450
910-F15
3/4/99
JOB ADDRESS 1601 73 1/2 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
I Pt 4
Auditor's Sub. #108
SHEET
2 PROPERTY OWNER Juergens MAIL ADDRESS ZIP
PHONE
Mike/Mary s 1601 73 1/2 Avenue NE
785-0492
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Al-Ko Home Improvement 8090 4 Ave, Lino Lakes, MN 55014-2008 788-5850 1927
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 Ek REPAIR
❑ MOVE ❑ REMOVE
6 DESCRIBE WORK
Reroof House & Garage (21 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State 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 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
$.90
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1, 799
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHERSTATE R LOCAL LAW REGULATING CON-
STRUCTION ORT E PERFORMANC F CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
z�o
XJNATU.
License SC $5.00
$64.45
NWtC_T_0Ff0RA ORIZEDAGENT IOATEI
WHEN PROPER Y VALIDATED THIS IS YOUR PERM T
SIGNATURE OF OWNER, IF OWNER BUILDER) IDATE,
Bl .NSP
DATE
NEW [ ] Effective 1/1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress•
Legal Description:
Owner Name & Address: '� .' 74 Tel.,
MN LICENSE
Contractor:
Address: �� / d �-Tel. #
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.
DECK AREA: Length 1Width Hg(/Ground Sq. Ft.
OTHER: j I rr
-- ? v Ti
Construction Type: �i r Estimated Cost: $
'77 (Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: .2 C�l
�A(PPLICANT: l Tel. # `X
p'_�6�-
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ / C)
.001 of Permit Valuation (1/10th%)
State Surcharge
$ 90
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$ C)0
$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:
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
763-572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Effective On January 1, 2001
JOB ADDRESS ,/6!2% , ` g -
OWNER /W.'c_4&x_
Rate TOTAL
BUILDING USED AS
$ 30.00 $ L /
ESTIMATED COST �w.� PERMIT N0. i
$ 10.00 $
DESCRIPTION OF FURNACE AND OR BURNER
$ 10.00 $
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
$ 10.00 $ Trade Name &",J,- 4 Size No.
BTU _3,� HP EDR
$ 25.00 $ Fuel Total Connected Load
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
$ .50
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner. ';�k"T—o
Burner Trade Name Size No.
BTU HP EDR
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 an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE
HEATING CO A-111`a1�:^eS�e
Signed �'41__�" ATEL # G��'� - f 33' --?C® i
Approved By Rough -In Date Final Date �a
Co'ner` BACK SIDE MUST 113E FILLED IN ON VENT SIZE, VENT CONNECTORS
AND COMBUSTION AIR VERIFICATION
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No ( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to Install a new combustion air, it will he sized and installed
to meet the current codes and manufacturers specifications. Yes () No ( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( ) No ( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :
"IT Y OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2000
AS: University Ave NE
'ridley, MN 55432 APPUCATION FOR POWER PLANTS AND HEATING, 0001ING, VENTILATION,
763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
j08 ADDRESS. V aIa--
I
aesidential Rate
Furnace Shelf and Duct Work, Burner -
Also Replacement Furnace $ 30.00
(Side Ment - fill Out Back)
Gas Piping (needed vh* new fUrr13CO, $ 10.00
but not replacernent)
0.00
Gas Range
Gas Dryer $ 10.00
"Air Conditioning - Ali Sizes $ 25.00
,OTAL U
BUILDING USED AS --.---.
ESTIMATE) COST _ PERMIT NOS'_!_-
bESPRIPTiIF�FURNACE AN�, DOR BUR
No. of Beating Units --I—. Circle One (Steam) (Hot Water)
Trade Name__. _ _ _ _... _______ Size
EI3R__–. _..�t� �`_i� =.
---Total Connected Load__
All Others/Repairs & alterations (LIST ON BACK) Burner Trade Marne __-� _. Size
..%a e, Value of Appliance or Work S__�_� BTU__._.__ _ ... _ HP
:omrserceaf/Industrial
1.2510 of Wue of App5artce, ar Work
Sia.e Surcharge
TOTAL FEE
u liifl l'� t° I'®R hir►Y lily;`FING�/COOIiNB�dllEd�iTic��.
fI.� 9►1T1flN/AIR CDNDIilQNIt+1G_ IT IS
��s T}ll� s.�o sTaT�St111CHARGiE
:-INSPECTION FEE &47.00/Hr
Air Cordtioners can not be placed in a side yard without
,ritten permission from adjoining property owner.
The undersigned : ereby makes application for it permit for the work here;n
specified agreeing to dei all work ir, strict accordance with the City Codes ar,
rWings of ttte Building Division, and hereby declares that all the facts and
a representations stated in this application are true and corre6c.
DATE .._.
HEATIN O
Signe
s
Approved By �,. R®ugh-tn ®ate --Final Da,e
Z9 ' d -3101
COMMON Vaf:NTiV�-i�'QQN_N-UCQR AN®CC?M1/8T10N AIR VEFtCATOo
When mlaCIng an exlstin"jrance, the undersigned hereby verifies gnat the
venting has been examined and is free from rust, deterioration, obstructions,
and Is securely supported a"d firestopped where required. Yes (,No ( )
The venting system is piastICIPVC and meets aI1 current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes (,,y No ( )
The undersigned also verifies that the roplacerment unit is a Pisted assembly
and meets the current codes and manufacturer's specifications: This does
include AGA-GAM.A Category 1 Central Furnace Venting Tables for fsn
assisted and natural draft appliances, Yes (-)"'No
The gX-191jWeoMhugWqn air is sized and installed to meet the current ;-Mer'
and manufacturefs specifications. Yes (<No ( )
When required to Ins ! a ew co bastion a _,_k will be sized and Installed
To meet the current codes and manufacture€'s specifications. Yes (.0Y"No ( )
When MM-a-Mrig a new ventingsystern, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
specifications. This does include AGA -LAMA Category i Central Furnac-e
Venting Tables for fan assisted and natural draft appliances. yes (�o ( )
Is the common vent and vent connectors sized and installed correctly aflar
an appliance has beefyremovedfrom the a :)Moron vent and vented
separately as per current codes. Yes (®` )
Appliance_ y artd Siae/CoMmon Vent _and int qc,raneat r Informatioll
Appliance 101 Type
BTU input an Assisted or Nat
Appliance #2 Type _
- BTU Input
Fan Assisted or Nat
Appliance #3 Type _.
BTU Input
Fan Assisted or Nat
Tota! Appliances _
Total Sia, Input
'
Common Vent Type - _
Vent Height
_- P Diarneter _..__ _ _ inches
Appliance #1 Vent Connector Height
Appliance #2 Vent Connector Height
„- x _ A Length
Length
ft Diameter ire Type
ft Diameter„
Appliance #3 Vent Connector Height
_._ft
fit Length d„_
in Type
ft Diameter _-.------_ in Type
ALTIi_RATIONS: tRescribe)
HEATING CO-
.�; •
r-�
Signed By- Date:
Z028 ' d S09BGSL 01 AT U I d a X AlM W0I-4 BS a is T 0002—TZ—A0N