PRE 2010 DOCS0
Village of Fridley, Minn.
BUILDING PERMIT
Date: ....................................
Address /'o.� ..,1....... .
_A4
Builder ...
Address ...���. / ...........
O ATION OF BUILDING
No. �. �. .. Street ... ........ ................... Part of Lot ................ .z.
r
Lot ..... Block .................. Addition or Sub -Division
Corner Lot .. Inside Lot ........... Setback. ... Sideyard`S , �� •... .
DESCRIPTION OF BUILDING
To be Used as: / ry
..... Front . ��� .. Depth R.4 :. �i (ight,1001 Sq. Ft.1®!. ® Cu. Ft. ........
�ont.... Depth .. Height . . Sq. Ft. ........ Cu. Ft. ........
Type of Construction...... Est. Cost . /. Y ./. ®®....... To be Completed ..................
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the village of Fridley.
�... e ............ .
In consideration of the payment of a fee of $a/permit is hereby granted t .. .:.. .
......................... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, plo4lng, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these items.
17A
City of Fridley, Minn.
BUILDING PERMIT N® 3447
Date:..............................
owner .... Builder .............................................
Address ...................................... Address .........
....................................
LOCATION OF BUILDING
No. . . ... Street ... .............. ................... Part of t ............07 ... .
...
Lot ... ...... Block .................. Addition or Sub -Division .. ..
Corner Lot X......... Inside Lot ............ Setback ............ Sideyard .........................
DESCRIPTION OF BUILDING
To be Used- e _
� .. m pth �.'. ®Height ®Sq. Ft. fdf.0 Cu. Ft. .47.0
.................... Front ........ Depth .......f. Height ........ Sq. Ft. ........ Cu. Ft. .....
Tpe of Construction ................... ]list. Cost.. ........ To be Completed ...................
,oma �r/►7 �L¢�F/f744A
QQ
2 y In amdderation of the issuance to me of a permit to construct the building desribed above, I agree to do
y used work in accordance with the description above set forth and in compliance with all provisions of
ces of .the city of Fridley. ,
f.................. ..............
In consideration of the payment of a fee , permit is hereby granted to ...................
.. to construct the buildin or addition as described above. This permit is granted upon
e express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. l`
...' eW... ? 7Z. ',,..�"S�lding Inspector
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring,
sewer or water. Be sure to see the Building Inspector for separate permits for these
SUBJECT
City of Fridley
o �_ 17791,
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
ELIP T .
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 i
= HALL FRIDLEY 55432
NUMBERREV.
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910-F15
111/8/84
10B ADDRESS 1483 - 75th. Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
1
Gideo's 1st Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Vernon Thomsen 1483 - 75th. Avenue N.E.
786-5000
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
8 DESCRIBE WORK
Construct a 141.x 201 3 -Season Porcl-L and a
26t x 241 Garage 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.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$�
$5.95
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
1900
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-
$9.2.50
None
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$23,13
$121.58
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY LI DATED THIS IS YOUR PERMIT
BLDG iNSP
TE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
NEW [ ] City of Fridley Effective 4/1/84
ADDN. [ l �R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: /' 'Ar 3 17 S''r Ay A -10 -
Legal
-10 -
Legal Description:
Owner Name & Address: (Je ?WO A.) 7n O M -SCS) Tel. #
Contractor: Tel. #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
3-
LU
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Length
Length
Length
Width
Height
Sq.
Ft.
Width
Height
Sq.
Ft.
Width
Hgt/Ground
Sq.
Ft.
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: .r -A94 _ � '� �� �A Estimated Cost: $
Approx. Completion Date:
G A40C z OAISLOq iO_ ' Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: APPLICANT: �/ "� Tel. # ?,Y6'50D Z)
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ Z, Fee Schedule on Reverse Side
$ .� 2% of Building Permit Fee
$ .� $.50/$1,000 Valuation
$ $425 per SAC Unit
$ Fee Determined by Engineering
$o Z `� Agreement Necessary [ ] Not Necessary [ ]
HARVEY A. CARTWFUGHT CARTWRIGHT & OLSON
ANOKA COUNTY SURVEYS
HENNEPIN COUNTY SUR 1 EYS
LANDMINNEAPOLIS SLIRVET$ C 1 D G [OR L
8410 SHADY OAK LANE N E. REGISTERED UNDER LAWS OF STATE OF MINNESOTA
SUNSET 8.0079 LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIS
OWNER
345 PLYMOUTH BUILDING LINCOLN 8721
INDUSTRIAL - JUDICIAL
SoSINESS - TOPOGRAPHICAL
CITY LOTS - PLATTING
6urbrvor's Errtifl[dtt II
1
COMB NTNG THE RECORDS OF
J. E. HILL. CIVIL ENGINEER
ESTABLISHED 1896
C. F. SANDHOF'F
CIVIL ENGINEER
F-7AULISHED 190E
JAMES NELSON
SURVEYOR
ESTABLISHED 1922
METROPOLITANLAND
SURVEYORS. Lbl-b LIb HID 19'5'
Inv-icc 19 31
c, "_7�
"t
b
1 Yi.ere:'� c� rtify tr:9t t..i: i. true ar:_ c .'rrct . 1-A. f . :.:ry f t t t
1. lila':, 1'... ts, :eFcr, F i'�11o'.:r: ......�'C:rt: L ',:.F utn,-r♦
raid rt...c-Ft 4 -'f . rt:. ?rt '/4: 11:. f: GCC ..r rt 1 •Ci' t..E ut} 1i!t..1
dist-r.ce ^f '1, fru t; t:. -e '.-rt:. rc,,ral:F: »:th `.r.E -2rt line ti.- -.p^f ? .. _ r:ce
of 'c• feet; t:.-ncP -set ' -rn:1E _ ec`.' n .:st•+nee cf is `co, t;
Vence 'cuti. Qi .. rt l:r.et...ce _ ° _ `E Ft ; ir.t r.ir,i .
t't Ct t: C E' re.-ent . --r r crf v, 1 tLE rt
c -i r tree :.CL'th i' feet .`.: re^?1: "'1:'VE;:r^ ^..E t. lF 1
I
r �GAFWRIGHT AND OLSON
SUBJECT
P .-
.8
City of Fridley
'27 06
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
REIC�ENO.
RECEIPT
�• ____ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
' 612-571-3450
910-F15
8/10/98
JOB ADDRESS
1483 75 Ave NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
1
1 Gideo's First Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Venn Thomsen
786-5000
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE
LICENSE NO
Bo's Construction 2218 22nd Ave S M is 55404
709-5037
20100656
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
❑ NEW ❑ ADDITION ❑ ALTERATION )M REPAIR
❑ MOVE
❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (25 S) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with 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
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
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
$2085
$1.04
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-
$75.75
Fire SC
$2.08
STRUCTION R THE PERF RMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TO FEE
Licen C $5.90J
$ 3.87
SI URE OF CONTRACTOR OR AUTHORED AGENT IDATEI
N RQ AID
BLD INSP
E HIS is
UR P'R T
gaiE
SIGNATURE OF OWNER I IF OWNER BUIL DER) IDATEI
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: o I V L
Legal Description: S-000
Owner Name & Address: V e"', �� �'K 5 &n Tel. # „
Contractor: MN LICENSE # o l o 0 G S
Address: M41", Pkv '5 S Lot( Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
DESCRIPTION OF EMPROVEMENT
Width Height
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
OTHER: SY2
FW" 7 k c� �` ��� Estimated Cost: � 5� v
Construction Type: /� $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: Tel. # 70''- 5037
CITY USE ONLY
Permit F e $ J • %5 Fee Schedule on Reverse Side
Fire Surc $ OCT
State Surcharge $
SAC Charge $
License Surcharge $ �-
Driveway Escrow
Erosion Control
Park Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ -99 • -7
STIPULATIONS:
sueJEtr
P O.
City of Fridley
28767
THE TWINS
BU ILDiNG
PERMIT
57�-5664
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC
/1I
i ��"' �•� CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
12/16/
8 PAGE OF
APPROVED By
1 ----�
612-571-3450
910415
=_
JOB ADDRESS
1483 75th Avenue
1 LEGAL
LOT NO.
-NE-,
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
Gideo1s First Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
ft Thomsen JF
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
u
-
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 xQ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside house and garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before covering.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
S0. 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
10 000
$5.00
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
$162.25
Fire SC $10.00
PLAN CHECK FEE
TOTAL FEE
Lice se SC $5.00
1$182.25
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT [DATE,
WHEN PROPERLY V
ATE THIS IS
ZYnPERMIT
5,GN4TURE OF OW NERiIF OWNER BUILDERI --DATE.
BLOC INSv
pAtE
NEW ` - [ ] Effective 1/ 1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: 143 25� 4& 4) &
Legal Description:
Owner Name & Address: / S Tel. #
Contractor: C77 A)C-1MN LICENSE
Address: 9a,;?7 &n& A �� FLAj7-5SI/ 4el. # 72 -
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
LIVING AREA: Length Width Height
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
OTHER:
Sq. Ft.
Sq. Ft.
Sq. Ft.
.06)Construction Type: Estimated Cost: $ le9j00
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: APPLICANT:
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee $
Sewer Main Charge $
TOTAL
STIPULATIONS:
Tel. #
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 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 [ ]
01
Su9jEGT
Pf
City of Fridley
28890
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
!��
____
VV -
1� PROTECTIVE INSPECTION SEC.
/i/"
1 �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
=
6 �'-'1 CITY HALL FRIDLEY 55432
IL'
---A �'' 612-571-3450
910-F15
2/2/99
JOB ADDRESS 1483 75 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DEscR.
3
1
Gideo's First Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Vern Thomsen 1483 75 Avenue NE
786-5000
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
Ck NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct a 12' x 10' Shed
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Securely anchor shed
to ground with a foundation
or tie -downs.
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
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
@@
$.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$400
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-
$21.00
Fir SC $.40
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOT F E
.90
SIGNATURE OF CON TRACTOR OR AUTHORIZED AGENT iDATE-
oe4 MEN R
- ALIDA IS YOU ERM
. ByO .NSp
�IS
�lAi
S,GNATUAE OF OWNER �-�OWNERBUILOERI_ iDATE,
01
NEW [ l Effective 1/ 1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 p�O
BUILDING PERMIT APPLICATION
ConstructionAddress: /'/S-3 �5/�y .416
Legal Description:
Owner Name & Address: 1)61h,\ T/i o ims e -i Tel. # '7j- 6-SZ9 O
Contractor: '5 e /'C MN LICENSE #
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF M1PROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
/'Q" /o'
Construction Type:
t4j
C r A,
Estimated Cost: $ 410 y
(Fee Schedule on Back)
Driveway Curb Cut
Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: 2,/a /9E_
APPLICANT:
Ve 1-,4 o,^ d¢ ?� o✓ws e ti Tel. # W6 - S'D e o
CITY USE ONLY
Permit Fee
$
0166
Fee Schedule on Reverse Side
Fire Surcharge
$
, QLD
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$
$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:
HARVEY A. CARTWRIGHT CARTWRIGHT & OLSON
ANOAA COUNTY SURVEYS
HENNEPIN COUNTY SU„EYS
LANDMINNEAPOLIS SNRVEYS [ 1 U ` ElO
U
Salo SNAVY OAK LANE N E. REGISTEREO UNDER LAWS OF STATE OF MINNESOTA
SUNSLT 8.0070 LICENSED DY ORDINANCE OF CITY OF MINNEAPOLIS
' OWNER
345 PLYMOUTH BUILDING LINCOLN 8721
INDUSTRIAL — JUDICIAL
B•ISINESS — TOPOGRAPHICAL
CITY LOTS — PLATTING
6urbrvor's �rrtiticatc
t.
' Is
I t,
1 �•
IJ
iAc1
CO` O KING THE RECGROS OF
J. E. HILL. CIVIL ENGINEER
ESTARLISHEO 1096
C. F. SANDHOFF
CIVIL ENGINEER
EsTA.LIBNEO IBO.
JAMES NELSON
SURVEYOR
ESTABLISHED I928
METROPOLITAN LAND
SURVETORS, uiABLIb NFD 904-
Ir:v•,ic( 19 31
('l'. —/a
'•:i::e Gi:lc o
b
F ✓• !^' L /i:l t •.r /V 1'V
I �hereby ct rtify trgt t: -i: i. true an. c : rfc: . 1” t cf rrv, t • t
L.%l ..Crt::«£ Ft 't4 of ..., ,1 r't ... t C' : i .1 r 1 w!.::. ] I
G,!Ur:t..•, .'inn Ec't9T :eFCrlt F :'.illowr: .L�.C'C:rle .t 1—e• L'tLA. :-t `•�r f
:aid `•:I rt::we. t 'G of .:,.rt.. t ' j.:; t:.t a ::f t .:1 'r.: :.t: :utr li t:. a
tri:c ie Ir
•.irt .:cedistsrce ^f 1) fFct; trze
o_ !c`. feet; t•..-nce : nst nrs:ic : .rith _r. 1?rt t..(•7'ecf n ..et,lnce c.f i. `•ft t;
tf:erce rcuti. e1crF . -,rt 1-retr.c. :f .:t-:r.ce _f i_ «t Ant ,••f i.• , r.irl .
•3: iE'Ct to ' C f ' re.Ei.t . cr r '? , ! 1:"i c:•f . .:w I' t:: f' FL :"� 1 L t: I.rs
cvcr the, South i i feet : r." re vf ": : •J:.Vf;: e-4 :,.t
i
�•--` _ _ ynR.TWRIGHT AND OLSON
17
n "a')
_ ... t 0 �-
0
U
.n
,Q
r" l
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f
-
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1
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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
FAX (763) 571-1287
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) r=o Q Gia d1
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 January 1, 2003
JOB ADDRESS
OWNER UCGY41L'OA)
Rate TOTAL
BUILDING USED AS fro M c
$ 30.00 $
ESTIMATED COST PERMIT N0. A5✓���
$ 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 Size No.
BTU HP EDR
$ 25.00 $ Fuel Total Connected Load
Burner Trade Name Size No.
$ BTU HP EDR
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
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
$ 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
$ .50 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
Signed VRIL, e— TEL# 7,6-3- 5 00c�
FAX #
Approved By� Rough -In Date
'�A
Final Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
When raplar-Inn an nAnting figrannp, 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 (i No ( )
The venting system is plasticlPVC 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
indude AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes( ) No( )
The salla inn cnmhimatinn air is sized and installed to meet the current codes
and manufacturer's specifications. Yes( ) No( )
When required to inatall a now _nmhuebnn airy it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes( ) No( )
When Inatallinn a new ventingyyStpm, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does indude 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 #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 N
HEATING CO:
Signed By: Date