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PRE 2010 DOCSWELL DRILLING FOR FOUR GENERATIONS ■ ■ SOBS 15688 JARVIS STREET NX/ELK RIVER, MN 55330/(612)427-6100 INCORPORATED MwM� Date: July 31st, 1987 MINNESOTA DEPARTMENT OF HEALTH l �/ 717 SE DELAWARE STREET t DIVISION OF ENVIRONMENTAL HEALTH �I MINNEAPOLIS, MINNESOTA 55440 I ATTN: Mr Jim Nye % (612) 623-5339 --� SUBJECT: WELL ABANDONMENT ® RE: NOTIFICATION Dear Mr Nye, This letter is to notify you of a water well in your district that should be sealed according to the Water Well Construction Code MCAR §4725.2500-2900. E.H. RENNER & SONS, INC has been notified by the owner of this property or an interested party and have subsequently submitted to them an estimate for the sealing of this well under our LICENSE #71015. We have also included a copy of the current code with our estimate. In submitting our estimate, the owner may also receive additional estimates and hire any number of Minnesota licensed water well contractors in the area to seal this well. However, there is a possibility that this well may not be properly sealed and thus jeopardize the ground water and Public Health. E.H. RENNER A SONS, INC. wishes to provide you this information for future reference with the abandonment report when submitted. PROPERTY OWNER: Mr. Doug Peterson PHONE # 537-2551 ADDRESS: 5637 Brooklyn Blvd. Brooklyn Center, MN 554XTE July 31st, 1987 LOCATION: 'ncerely Submitted, 10 1%00g 141 aymond T. Renner, V- resident :Cfi: RE S, INCORPORATED STATE LICENSE #71015 cc: i City of Fridley 6431 Univer—sity Ave. NE. FriaTey,. 55432 ATTN: Darrel Clark & Don Larrigan--571-3450 WELL DIA. 3,, DEPTH: UK 1 + STATE OF MINNESOTA Department of Administration 408 Metro Square 7th and Robert Sts. Saint Paul, Minnesota 55101 Phone: (612) 296-4639 FAX: (612) 297-1973 BUILDING CODES AND STANDARDS May 9, 1991 Darrel G. Clark Chief Building Official Fridley Municipal Center 6431 University Avenue North East Fridley, Minnesota 55432 Subject: Interpretation of Uniform Building Code Section 2516(f) 2. Fire stops, where required Dear Mr. Clark: The following is in response to your letter of inquiry regarding the above referenced subject. The 1990 Minnesota State Building Code, Administrative Rule Chapter 1305 adopts by reference the 1988 Uniform Building Code (UBC). We concur with your (safest) interpretation of current code..." to install a fire stop at each floor/ceiling or ceiling that the chase passes by or line the inside of the chase with gypsum board." Other fire stop materials per UBC Section 2516(f) 3 may also be utilized to line the chase under current code. Standard practice of 10 years ago (approximate date of construction) for chases for factory built chimneys located on the exterior of Type V buildings was to rely upon the structural wall sheathing and a single non-combustible (metal) fire stop within the chase. 1988 UBC Section 104, application to existing buildings, is applicable to these buildings. The alterations being performed affect only the replacement siding on the chases. The alterations being performed do not include replacement of chimneys or chase framing. The chase is an existing building element per UBC Section 104(c). This section states that the "existing" can remain unless the continued use can be determined to be dangerous to life. •r Darrel G. Clark Page 2 May 9, 1991 In order to enforce the current provisions of UBC Section 2516(f) 2, the administrative authority must prove that the existing situation constitutes a demonstrable danger to life. If a "danger to life" cannot be proven the building owner or contractor(s) should be encouraged to voluntarily comply with current code provisions when the chases are open and the work can be easily accomplished. Sincerely, Building Codes and Standards EbroY Berdahl Building Code Representative Supervisor EB:me V V SUBJECT PER City of Fridley T 2 0 8 3 4 AT THE TOP OF THE TWINS P E R M I I BUILDING RECEIPT NO. a COMMUNITY DEVELOPMENT DIV. I v PROTECTIVE INSPECTION SEC.. r 1 � 1 � � CITY HALL FRIDLEY 55432 NUMBER REV PAGE OF APPROVED BY 612-571-3450 910-F15 [DATE 5/21/91 JOB ADDRESS 141 - 76th Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 Oak River Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bev/Jeff Buchli 141 - 76th. Way NE 786-7656 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Mailing Address: 502 78th.Ave NE, Spring Lake Park 55432 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 CR NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 55' x 36' Dwelling and a 221-x 22t Garage 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Provide a hard surface driveway. Provide sod in the front and side yards. Provide. City with copy of verifying survey before cappin City will check excavation for possible well location. Paid $1500 Park Fee SEWER LOCATION: Approx. 10" Deep in Street; 50' E of MH (Inv. 851.59) WYE ELEVATION: 851.79 TOP OF FOOTING: 855.29 Minimum WATER LOCATION: Approx. 10' E of Sewer Service DRIVEWAY DEPRESSION COST: 16' + 6'' = 22' x $13.50 = $297.00 [/� % �h•J dY�V 1111 fL Li � Sa4( 0cg- Is 7 l fL � �YG �' ��,�.�C✓�'S1� a, tj r.C1. �'7 C010c, CQsoj 7 Cfii - TYPE OF CONST. erCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $111 5OO $55.75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE SC $650.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $681.SO Fire SC $111.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $1,498.75 + PF & D SIGNATURE OF CONTRACTOR OR AUTH IZED AGENT® IDATE, T IS YOUR PERMIT iGNAT E F OWN OF OWNER BUILDERI IDATEI DATE V V NAW •[� ADEN [ ] ALTER [ ] Construction Address: 14 legal Description: R-1 AND R-2 Building Permit Applicaticn r) Co" . Effective 1/1/91 Miner Name It Address: c °3 > o C, 14- 1 J.1C# Contractor: s1 j13' Address. Attach to this application, a Certificate of Survey of the lat, with the proposed construction drawn cn it to scale. VESCRIP M Co' narOIVEMM LTVM AREA: length �� / Width t�' Height Sq. Ft. I f to GARAM AREA: Iength oZ Width 4�' Height Sq. Ft. DECK AREA: Ie cjth Width Hgt/Ground Sq. Ft. OEM: Corner Lot [ ] Inside lot [ Ft. Yd Setback Ljq fA'Side Yard Setbacks Type of Cozwtructicn: Estimated Cost: Apprcx. C oopletion Date: 2'Z Proposed Driveway Width If New opening Is Desired: ��� Ft. Width + 6' See Back Page DA'L'E: !S—'l �-cj I APPLSC M: W. # Permit Fee $&A Jw So Fire Surcharge $ State Surcharge 4 e. -Tr SAC Charge $ [80,& Driveway Escrow $ ?-Cn.Qo Park Fee $ [ S 00 . p U Sewer Main Charge $ TOR'AL $ Z�000,S v tt CITY USE Oia,Y Fee Schedule cn Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] (�, LL too1� % -i4,fcCWArlaN 14), r?cr4- au, iri l. )c 1.4 I. 19 GIC I I. oQ' z OU440 34 13K 30 Ot Rb .�• C,. �C 1 L = �Z. 1�0� 52•�OS = g�Sw3;S0,�0 111 ��lvq, m� 11110wo 1oocoo. 61CLSo 11 -A%114 11 0UiLvriIvi a REGISTERED UNDER LAWS OF STATE OF MINNESOTA 7601 -73rd Ave. No. 560-3093 INVOICE NO. AOS¢3 INDUSTRIAL—JUDICIAL 30 Minneapolis, Minnesota 55428 F. B. NO. COMMERCIAL—TOPOGRAPHICAL SCALE 1" _ ' CITY LOTS — PLATTING urije>�rArs CnEr#iftctt#e O — DENOTES IRON DOUG PETERSON '15.10 + F FR4 L Y DOES NOT GUARANTEE THIS THC CITY 0 ACCUPACY OF TI I 1 FORM A LOCATo0N PURPOSESNS AND TONLY, N \ THIS DATA hie USI THIS INFORMATION SWOULD AND PERSO VERIFY IT +0N THE S E 8efote digging call 'Of all Utility locations � ` T 454.0002 t I ;-f t:�tuly.�E'� REQUIRED �Y LA F.��MF� DEQ ` � 6,.o X30 DAY 'fit fTC MMOVAI AND REPI AT DRIVEWAY � 1111 o � S fzq IJF�- ,,- 1. 1 b_ 4 . I - war \ Lot 3, Block 1, OAK RIVER \ ESTATES �\ We hereby certify that this Is a true and correct representa- tion of a survey of thetoundaries of the above described land and the location of all buildings and visible encroachments. If any, from or on said land. Surveyed by us this 23rd day of "L ! 19—KL 0 00-010 0. �J CUa Ok oyl lv' cry To, Sr�e/-- 4w J nile r9��r, lD'E oFS� S�2v,c� ��GtJ ,��p2G.s5io� t�oS V 6J) P -P4 -t- >( 7 ' ENERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION PLANNING AND INSPECTION DEPARTMENT CITY OF FRIDLEY, MINNESOTA G? This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING OFFICIAL can determine that submitted plans comply with the ENERGY CONSERVATION DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). It is the APPLICANT S responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA in the plans; submit product specifications, if needed to support the "R" and "U" factors used; and to assure construction is per approved plans. JOB LOCATION: OWNER/CONTRACTOR: ADDRESS: PHONE: A. Determine the Total Exposed Wall Area as follows: 1. Total wall window area r2.© 2. Total door area 21 3. Total sliding glass door area .56 4. Total fireplace wall area !g- 5. Total wall framing area (average 10%) 11"7 6. Total net wall area above floor(average 90%) 105-4 7. Total rim joist area 17-0 Subtotal: Total exposed wall area above floor 8. Total foundation window area 9. Total net foundation area above grade X2.3 Subtotal: lbtal exposed foundation area 131 GRAND TOTAL EXPOSED WALL AREA 1673 /,- B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17 = Item I 2 %4. C. Determine the Total Exposed Roof/Ceiling Area as follows: 10.• Total skylight area to 11. Total roof/ceiling framing area (10%) 12. Total net insulated roof/ceiling area 2 O O O GRAND TOTAL EXPOSED ROOF/CEILING AREA D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X .05 = Item II 100 4 E. Determine the "u" value of each segment (1-9) and multiply by the area as follows: 1. 120 x ..U.. o•Ct9 = S�- bar 2. 21 x oluls 0-321 _ ?per q [� 3. �6 x "u" a-� I, = 2 , �6 Building Code 6006 (c) 1. CYe;�, I. 5. I 2 �} • 1 X foull, O .O 14 �� = S• 2 6 6. j_D�(� x nuts 0-0(4s- _ • 14-6 7. x flue -0- 162- = 8. x tout$ 0-41 = 9 L 9. 12 3 x nun o . 67 g t • 4 - ADD 1-9 FOR TOTAL WALL SEGMENTS = ITEM III 2,13 . 66 F. Determine the "U" value of each segment (10-12) and multiply by the area as follows: 10. d x "u" 56 = 11. — x "U" _ 12. 2000 x "u" •02.L ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS 5.6 _ 4+•o ITEM IV +'1 •6 G. If Item III is the same as, or less than Item I, you have met the intent of State Building Code 6006 (c) 2. Cy e-� H. If Item IV is the same as, or less than Item II, you have met the intent of State Building Code 6006 (c) 1. CYe;�, I. Add Item I 2 �} • 1 + Item II WO•S �4 • 91 J. Add Item III + Item IV G = 32Z • 6 K. If the sum of Items III and IV are less than Items I and II, you have met the intent of the Code for total envelope system. 0 " The undersigned, as applicant for a building permit, hereby affirms the above information has been prepared and submitted by himself or under his direction, hereby acknowledges the information to be correct and accurate; and hereby presents the information with required plans in support of the building permit application. By: DATE: ej O d r1 o vo a Q o^ J � r L5 Q-1�'�s�o -73 7 � a • m 0 d 0 ej O d r1 o vo a Q o^ J � r L5 Q-1�'�s�o -73 7 � a 0 ej O d r1 o vo a Q o^ J � r L5 Q-1�'�s�o -73 7 � a IlJ 5 b,, 7 `b X 15s e^-" -� �A 19� to 1� Y. 9 CQ � 17 Z-) 19 % J% L z —19 6 L6 \7L IlJ 5 b,, 7 `b X 15s e^-" -� �A 19� to 1� Y. 9 CQ � 17 Z-) 19 % J% L z —19 6 L6 Minnesota Department of Health 1KDivision of Environmental Health 925 Delaware Street Southeast P.O. Box 59040 Minneapolis, MN 55459-0040 May 30, 1991 � Mr. Darrell Clark, Building Inspector� j i City of Fridley 6431 University Avenue, Northeast Fridley, Minnesota 55432 Dear Mr. Clark: This letter is in response to your telephone call on May 17, 1991, concerning an unused abandoned well reportedly located in Oak River Estates, Lot 3, Block 1, Fridley, Minnesota. The information provided by your office and by Mr. Kevin Hoppe.-of.,E,�H. Renner and Sons, Inc., indicates that an unused abandoned ell is located under or near the foundation walls of the house located a 149 76th yay, Lot 2, Block 1, in Fridley, Minnesota. The Minnesota Department (MDH) will send a letter to the property owners of the property located at 149 76th Way and explain to the property owners their legal obligations concerning an unused well on their property. The MDH has been provided with no 'nf�r"maion which suggests that a, well exists on the property located a 141 76th Way, Lot 3, Block 1. If evidence indicates that an unused well doe or if a well is uncovered during excavation, the well must be put into use, a maintenance permit obtained from the MDH, or the well sealed by a Minnesota licensed well contractor. If you have additional questions or require further information., please contact Douglas Edson at 612/627-5141 or myself at 612/627-5151. RDT:DSE:sg cc: Mr. Jeffrey Buckley Sincerely yours, Ronald Thompson, Supervisor Well Management Unit Water Supply and Well Management An Equal Opportunity Employee CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace Gas Piping (Needed with new furnace) Gas Range Gas Dryer JOB ADDRESS 1 `_k k I �0W The undersigned hereby makes application for a permit for the work Rate TOTAL herein specified agreeing to do all work in strict accordance with the city codes and ruling of the Building Division, and hereby declares $ 20.00 $ 0 CG that all the facts and representations stated in this a pl, tion re true and correct. ,1991 $10.00 $ Z� - OCA OWNER_ ej: C" $ 10.00 $ $ 10.00 $ *Air Conditioning - All Sizes $ 10.00 All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work Commercial/Industrial 1 % of Value of Appliance or Work State Surcharge TOTAL FEE $ - Vic' BUILDING USED AS & k8clA� ESTIMATED COSH 1 �.I0® PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water(Warm Air) Trade Name 9J04 Size No. BTU 100 Q 1-113_77_;`a2) EDR $ Fuel A)A7DZA Total Connected Load $ .50_ Burner Trade Name Size No. BTU HP EDR HEATING COMPANY MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 Signed Approved By 0_- Rough -In Date r Final Date //` 22 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE l CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes ( ) No ( ) 2. Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes ( ) No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's Remarks List Alterations Being Done: HEATING COMPANY Signed By Date CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas Gas Range NO. RATE TOTAL $ 7.00 9,10 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 —L $10.00 Gas Dryer Back Flow Preventer Required ( )Yes () No Type $10.00 $10.00 $5.00 JOB ADDRESS "l / 7(3 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 Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. _'1991 Owner r /� •®� Building Used Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance State Surcharge TOTAL FEE Estimated Cost ®®® PERMIT N PLUMBING COMPANY SIGNED BY &Al_ N0. -716 -%" 0 Approved By - L Rough -In Date Final Date/ 2- ^17 50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 $ lb/.60 PLUS THE $.50 STATE SURCHARGE I CINOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 November 25, 1991 Jeff & Bev Buchli 141 - 76th Way NE Fridley, MN 55432 Re: Final Inspection at 141 - 76th Way N.E., Fridley Dear Jeff & Bev Buchli: A final inspection was conducted on November 22, 1991 of the above address and the following items were noted which must be completed before the structure can be finaled: 1. Post address numbers on structure. 2. Cover attic access in garage. 3. Set hinges on garage door. 4. Insulate rim joist in crawl space. 5. Raise handrail on basement stair to between 34 and 36 inches - it is now only 32 inches. 6. Complete all electrical and plumbing corrections. We will expect these items to be completed on or before December 16, 1991 and a reinspection called for. Occupancy of the structure is approved. If you have any questions on this matter, please feel free to contact me at 571-3450. Sincerely, DARREL G. CLAK Chief Building Official DGC/mh CIiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 December 17, 1991 Jeff Buchli & Bev Barker 141 - 76th Way NE Fridley, MN 55432 Re: Final Reinspection at 141 - 76th Way N.E., Fridley Dear Mr. Buchu & Ms. Barker: A final reinspection was conducted on December 17, 1991 of the above address. The construction was approved and finaled out. If you have any questions on this matter, please feel free to contact me at 571-3450. Sincerely, DARREL G. CLARK Chief Building Official DGC/mh OF SUBJECT City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT(f3L7O361 � rr COMMUNITY DEVELOPMENT DIV. SEC. r PROTECTIVE INSPECTION I "'1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 110/7/99 JOB ADDRESS 141 76th Way NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 1 10ak River Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Beverly Barker 571-9234 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Eagleview Const. Inc. 2937 174th Ln NW Andover 55304 753-5469 20067043 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 O NEW O ADDITION 0 ALTERATION XX REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage (35 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 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 $3059 $1.53 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE E SAC CHA31C PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $97.25 Fire 3.06 PLAN CHECK TOTAL E % 7 �L� L' e C • .84 S NATUA OF COW OR AUTHORIZED AGENT 1 AfEi ME P BI&G INSP Y VALIDA D IS IS YOUR P7'T QAtE SGNATUAE OF OWNER ❑F OWNEp BU4 DERi iOAfEi OF NEW [ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY �^ ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 j BUILDING PERMIT APPLICATION Construction Address: _ /y�� -7o A Legal Description: Owner Name & Address: Tel. # %� �l�•z3 Contractor: C -'v ) u-nfx a"Z . MN LICENSE # ,,,?©c) 67y9� Address: 1,0414 Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EWROVEM ENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: 1SAz4 Y- � , C� t�a�iQ Estimated Cost: $tic/ Permit Fee $ 9 /, - S `z Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ $ , S�7-3 DATE: ;D APPLICANT: Tel. # CITY USE ONLY TOTAL STIPULATIONS: r Permit Fee $ 9 /, - S Fee Schedule on Reverse Side Fire Surcharge $ ,O(o .001 of Permit Valuation (1/10th%) State Surcharge $ , S�7-3 $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ S-00 $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: r Building BUILDING Permit No.: ®® Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Recd: (0 -7-U DATE ` I YOUR E-MAIL ADDRESS SITE ADDRESS i0 Lp- THIS APPLICANT IS: ❑ OWNER NTRACTOR PROPERTY OWNER/ NAME: (., t' GL /°f`' ADDRESS: `B i / %6 k)G �J 6 CITY Pri `t STATFd�Y%�!P TENANT PHONE: CONTRACTOR NAME: ©e-rI FN&A 1S 1 C-R)n STATE LICENSE # TO -S1 Z 3 I I EXP DATE 2 t { �J c-kiY P-4 CITY ILoL e -r -. STATE IP SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 110 WITH APPLICATION PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILYNEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION❑ G VE/SHED ❑ WINDOWS ❑ BASEMENT FINISH CS°ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: rC yea V — 0 4 fie ' rZ.)v SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOVING ❑ hUV2ih ONLY NUMBER OF SQUARES 3z*USE & GARAGE BASEMENT REMODELING SUBMIT: ;ATTACHED 1. Existing Floor Plan GARAGES GARAGES GARAGE Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used 3. PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ YA30 OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks savable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work w is re ires r A and approval of plans. SIGNATURE OF APPLICANT. �/" — PRINT NAME � �� �v_� e DATE fyZI-Vy Minnesota Commerce Ott iliil'�RrCE Energy Info Center News Releases Contact Us Page 1 of 1 Commerce Home I North Star Home I Commerce Site Mai Tuesday, October 17, 201 rn in nesota nonh SII Advanced Search I Search Topics Q All NorthStar Q Commerce Site Only _. _.._.._. Consumer Industry Applications, Info and Info and Registration, Services Services Certification License Detail Unclaimed Heating Weights & Minnesota Petrofund Property Assistance Measures Relay Here are the details for the license you are currently looking for: Licensee Name: BLOCK CONSTRUCTION AND RESTORATION INCORPORATED Licensee Address: 12024 TUCKER ROAD City State Zip: ROGERS , MN 553740000 License Number: 20372311 License Type: Residential Building Contractor License Status: ACTIVE License Effective Date: Feb 14, 2003 License Expiration/Renewal Date: Mar 31, 2007 Qualifying Person: DANIEL BLOCK Number of hours of continuing education required to renew license: 7.0 Enforcement Action: No Copyright 2000 North Star, Minnesota State Government Online State Of Minnesota I About Us I Get Acrobat North Star is led by the Office of Enterprise Technology Reader l This site best viewed with 1024X768 or greater and with Netscape 4.7 or Internet Explorer 4.5 or greater. https://www.egov.state.mn.us/Commerce/license_lookup.do?LIC_NUM=20372311 &LIC... 10/17/2006 Building PLUMBING Permit No.: Inspections RESIDENTLAL APPLICATION Received By: 763-572-3604 CIT- OF( LEY DaW 763-502-4977 FAX ft' EFFECTIVE 1-1-08 DATE J2 11!909 YOUR E-MAIL ADDRESS SITEADDRESS pVit 99 THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: O Cmilyd Ymchez OWNER/ ADDRESS: I (0�% I(% CITY �e1� STATE%/ZIP ✓� 3a TENANT -12 PHONE: CONTRACTOR NAME ,Dyef/ ru,4 ejqri11 M SUBMIT A COPY OF T YOUR STATE STATE LICENSE # EXP DATE LICENSE, BOND AND STATE BOND 4 EXP DATE CERTIFICATE OF 7719 ADDRESS: Dy 60 Kdotn S�' MC q CITY STATEA6�LZIP 5532 INSURANCE PHONE ��j"�5t�� 2r9q FAX 3 ?Sq" 2008 PERK UT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: E3NEW !REPLACEMENT DETAILED DESCRIPTION OF WORK 5lflf+0 [a4VVk Ef *j: ' ftl41 W PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $ l 0.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. SINK/LAV FLOOR DRAINS WATER PIPING —BATH —SHOWER _ GAS PIPING (NEED CITY LIC) SWIMMING POOL —WATER SOFTNER ($35) —BATHTUB _ _ CLOTHES WASHER _ KITCHEN SINKWATER CLOSET _ BACKFLOW PREV. ($15) DISHWASHER LAUNDRY TRAY EWATER HEATER ($35) FOR IRRIGATION _ _ WATER METER OTHER 1.{ 4{ �tn� � i, Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ OR Number of fixtures @ $35.00 x $35.00 = $9G. 00 TOTAL DUE $ State Surcharge = $ .50 (MINIMUM $15.50) (MINIMUM $15.50) Total = $lr-kv THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will' be in accordance with the approved plan in the case of all wo which requires review and approvalof plans. SIGNATURE OF APPLICA PRINT NAME I ikJ - DATE 7 APPROVED BY DAT/ PLEASE NOTE: PARATE PERMITS ARE'REQUIRED FOR-.B.UILDINO . ELECTRICAL. AND MECHA T T WORK: l City of 'Fridley wilding _inspections Department 0431 University avenue SIE. Fridley. MN 55432 763-572-3604 FA 763-502-y9.71 N