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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N© Date: SM A -A Owner: .dF ..al �.J a1�. Builder - ,/, ..rLri�.w�.✓.JI �� 1 - Address Address CA 1N WILDING No. Street � A� Part o t Lot "00'- Block AM on or Sub -Division ktCorner Lot �� Inside Lot � Setback itdeyard Sewer Elevation _ _ Foundation Elevation DESCRIPTION OF BUILDING To be Used as. :- Front ' Depth Height Sq. Ft, Cu. Ft Depth freight A+F.� '. Ft. Cu. Ft. Type of Construction Est. 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 ail provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ , permit is hereby granted to to construct the building or addition as described above. This permit is grantedupon 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 o Fridley, Minnesota regarding location, mayconstrue ti�aIteration, t a time upon maintenance, n off any of the provisions of olof d owithin �ome city limits and this permit Building Inspector NOTICE: Thb permit does not cam the construction, hutaiiation for wMh& phnnhieo, on hoatin& twter or wabr. Be sun to me the BWMIng hope tar for sopern% pormhs for than abet. r APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA l OWNER'S NAME ADDRESS ADDRESS LOCATION OF BUILDING No. � StreetZ�zr art of Lot 49 Lott e%. -_Block Addition or Subdivision Corner Lot r" Inside Lot Setback Si e -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used IS. Front 09 6Depth Height ZL Sq. Ft. Cu. Ft. Front Depth Height, Sq. Ft. Cu. Ft. / Type of Construction Estimated Cost ®!� To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and_bereby declares that all the facts and representations stated in this application are true and correct. (Schedule of Fee Costs can be found on the Reverse Side). CONNERCIAL OR INDUSTRIAL BUILDING CHECK LIST 1. Zoning /�� &—/ 2. Area Requirements 3. Parking Requireme 5. 6. .front Yard Requirements_���� a Side Yard Requirements Rear Yard Requirements- 7. equirements_ 7. Dwelling Unit Requir 8. General Construction MA 0 ALLEN G. JENSEN Building Inspector rO �6 City of Fridley Applicckion for Plumbing and Comas Ruing Permit DESCRIPTION OF WORK Number. Kind and Location of Fixtures G7 fF— Z 8o = w ? • • N WATER HTR. GAS ELEG cc S3 c�°d o c>O Base L % 1st 2nd 3rd 4th • Future Connection Openings Connected with e New Fixture, Old Openings I sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $1.50 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ / x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ e 0 v New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ..........................---I/— x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $�/ly G REPAIRS & ALTERATIONS—Refer to Code Dept. of Bldgs. Phone SII 4-7470 City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Kind of Build, 0 4- ZUsed as� To be completed about Estimated Cost, $ 4P'ev­vp_ Old Ne . Building Permit No_ ROUH 3 - 1 S G _(13 FINAL 3©O Description................................................$ -- 1 TOTAL az 2M 6,3 1 Phone l4 No. '—_R'7d N° 4832 Original Permit for PIUMBING AND GAS FITTING N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for Permit I inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit., Fee l�S• �a DESCRIPTION OF WORK Number, Sind and Location of Fixtures City of Fridley �,�-e-� i % ,19 9 W W 4 .:-_...�. � G Y F w K G _0 Stories F 0 �i U Z F m e m t- tZp Q m Y W N Q K 3 F Z O 0 O LL O S N O Q J cc 1, O FU m Q Q U M Z K Q O K J Oq X F LL W -3 Q 0. b Q W N 2 Q Q G C WATER HTR. GAS ELEC. Basement / int 2nd � � Z/ 3rd 4th Connected with Sewer -Cesspool Gas Piping for t Openings Permission is hereby granted k2 A—,ae— to do the plumbing and gas fitting in the building described in the statement hereto attached, u the express condition that the person to whom this permit is granted, and his agents, employees workmen, in the plumbing or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of the provisions of said ordinances. By Order Of The Inspector Of Buildings Roughing in Inspection Date Inspector. Final Inspection Inspector. <Z Jfj__ as -v Owner Location Kind of Building f*A--� Used as �G To be Completed �"ff - / , 19-L7 Estimated Cost $_ 100-0-0 • V-� Old -New. Building Permit No. Date Inspector of Buildings. Original 0 PERMIT for Powerllants and H atin ool- e g. C ing. Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of - Heating Plants to b installe altered—repaired Make A44,&��= � , Size " a -5V , Oil fired ; Coal fired—, Gas fired ; Gas Authorization No. Remarks mt421D .� °L (� Approved Final Inspection Date , 19_ Inspector Permit N° 4512 Fee $ r. ® • o --e _ Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. , 19-61 Owner Location Kind of Buildin How Occupied ° Work to be Commenced ,19 To be Completed /D/31 ,19 Estimated Cost, $ off` ob-76 Old -New, Building Permit No. / B. ® /,6 Permission is hereby granted to >— k-� . to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition diat the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set orth in the approved application for this permit on file in the office of the Inspector of Buildings. _ �,/ Inspector of Buildings az 2M11 -67N tunn Ceti+ testing corporation OA 662 CROMWELL AVENUE ST. PAUL, MN 55114 REPORT OF: BACTERIOLOGICAL EXAMINATION OF WATER PHONE 612/645-3601 PROJECT: Drinking Water Date: July 24, 1990 TO: Auren Kerntop 201 Mercury Dr. Fridley, MN 55423 LABORATORY No. 4410 90-6014 INTRODUCTION: SAMPLE No. 205813 BENCH No. 9112 This report presents the results of our examination of drinking water sampled by Auren Kerntop at 6:30 p.m. on July 12, 1990. The scope of our services was limited to examination for coliforms and nitrate/nitrite. SAMPLE LOCATION: 321-79 Way, Fridley, MN METHODOLOGY: Standard Methods for the Examination of Water and Wastewater, 16th Edition, June, 1985. RESULTS: Date Method -# Allowed Coliform Bacteria (MPN/100mL) <2 7-13-90 908A NONE Nitrate + Nitrite (as N) mg/L <0.25 7-24-90 429 10 < = Not detected at indicated lower detection limit CONCLUSION: The water from this source was found to be bacteriologically safe for drinking at the time of sampling according to the EPA/ FHA/ VA drinking water regulations for coliforms and nitrate. REMARKS: ` Each sample was consumed in testing. TWIN CITY TESTING CORPORATION r r Todd Mitchell /Ro�4&�y - Brei and Microbiologist Supervisor, Microscopy AS A MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURSELVES, ALL TWIN CITY TESTING CORPORATION REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS, AND AUTHORIZATION FOR PUBLICATION OF STATEMENTS, CONCLUSIONS OR EXTRACTIONS FROM OR REGARDING OUR REPORTS IS RESERVED PENDING OUR PRIOR WRITTEN APPROVAL. I -I CITYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55432 • (612) 571-3450 . FAX (612) 571-1287 August 9, 1990 Nr. Auren 10-- ap 201 Mercury Drive N.E. Fridley, MN 55432 Re: Changing of Illegal Plumbing Installed at 321 - 79th Way N.E. Dear Mr. Kemtap: I in pected said plumbing an June 25, 1990 and contacted you the next day to bane this problem corrected. On July 3, 1990 I met with you and your plumber and explained what mist be done to bring said plumbing into Code complianoe. On July 17, 1990 you called and stated that the tank bad been tested by 'Train City 'Testing and that your plumber would now make the corrections. Since then, I have tried to call you several times but was unable to reach you but now I believe that this maast be done. Please contact me as to a schedule to bring the plumbing into Code am pliance or if you have any questions on this matter. Sincerely, ,=/T Bldg/Mech Inspector ;2 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE e PLUMBING FIXTURE RATES: NO. RATE c New Fixtures 4 $ 5.00 a Future Fixtures p, S Water 41 $ 1.50 $ Beer Dispenser $ 4.00 NNa Fci a, m a $ 5.00 m w .. 4 .xi W $ Rain Water Leader Heater S 5.00 S b $ 5.00 S Sump or Receiving Tank S 5.00 ~ Water Treating Appliance fi� 4 $ Hot Water Heater $ 5.00 M Gas Range $ 10.00 v1 CYyt L.' c $ Back Flow Preventer Required. . . U .[i O G U N $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 0 U a 1s of Value of Fixture or Appliance y $ O w �_O N S u 4 3 o TOTAL lec usi p1 01 i dl t� as let 2nd 3rd 4th (R) - Future Connection Opening Connected with Sewer (') - Now Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ 3.50 S Old Opening, New Fixture $ 1.50 $ Beer Dispenser $ 4.00 $ Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader S 5.00 S Hydraulic Valve $ 5.00 S Sump or Receiving Tank S 5.00 S Water Treating Appliance $ 7.00 $ Hot Water Heater $ 5.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ Back Flow Preventer Required. . . Yes ( ) No ( ) Type S 5.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1s of Value of Fixture or Appliance $ State Surcharge S .50 Retnspection Fee $ ($15.00) TOTAL FEE S J.S 5-3 Effective May 1, 1990. Job Address ( �� Department of Buildings City of Fridley Tel. 1571-1450 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. OWNER eor- qq KIND OF BUILDING ^^ /f et l� USED AS la -L � 1 TO BE COMPLETED ABOUT - 3 ES TED COST .4 Do 0 OLD - NEW BUILDING PERMIT NO. PERMIT 140. Company &4.', C Signed By �-^ Tel. No. 7 �( (0 17 '5- J ROUGH INSP. Date FINAL INSP. g 3 �— ?i/)— Date APPROVAL FOR PERMIT ►1INIHUM FETE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE SuB.,ECT RMIT NO. City of Fridley 29525 AT THE TOP OF THE TWINS BUILDING PERMIT � RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. �O✓ r PROTECTIVE 1 . , CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 5/21/99 10B ADDRESS 321 79th Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 17 18 1 2 SDrina Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Auron Kerntop 1140 Rockstone Ln New Brighton 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO M J Moser Const 847 19t691-499-9P.RR 266A 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 V REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof 8 -Unit Apartment (44 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. C 0 UPANCY GROUP OCCUPANCYLOAD 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 $3770.80 $1.88 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- $n7O25 Fire SC $3.77 STRUCT ON PERFORMANCE OF CONSTRUCTION 7 X �' Io�r— X PLAN CHECK FEE Licen C $5.// T L FEE 107.90 S-GNA a OF CON TRACTOR OR AUTHORIZE() AGENT iDATEi HE PR Y A I T THIS IS OUR PERMIT S-GNATURE OF OWNER,.F OWNER SUiLOERI -DATEi " SAM -NSP F,ArE NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMELY AND DUPLEXES R-1 AND R-2 BUELDING PERMIT APPLICATION 4L u Construction Address: ��, 7 9 " IMK Y Legal Description: Owner Name & Address: /,CG A ti T o P /f -11G 51on e)- A) Tel. # W 13 (I TC VL Contractor: f j/) J jig L A ra w5 f MN LICENSE # 2 k Address: Li l 9 4 UL k U S c s � fO*y( 1211 .5 S O F5 Tel. # � � S -S-� 0 .0 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EWROVEMENT LIVING AREA: Length Width Height' Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: o� Construction Type: y S x Gyc10 A 00/ = Estimated Cost: $ Y� q 5 �,� -70. Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge $ TOTAL $ d STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 [ ] E ering WATER AND SEWER Hermit No.: U 763-572-3551 PERMIT APPLICATION Received By: 763-571-1287 fax CITY OF FRIDLEY DA&VO 6.4 EFFECTIVE 4/8/09 APPLICTATION DATE: YOUR E-MAIL ADDRESS: THIS APPLICANT IS: 6WNE I�ONTRACTOR JOB ADDRESS: ( T NEW CONSTRUCTION PERMIT# .(IF APPLICABLE): PROPERTY NAME: ADDRESS: CITY STATE ZIP OWNER/ T PHONE: S CONTRACTOR NAME: ADDRESS ATE SUBMITA COPY OF YOUR STATE LICENSE WITH HO - CELL PHONE: Z 3 3 PHONE - APPLICATION STATE LIC # STATE BOND: EXP DATE: 1. Narrative/ rMen description: L� 2. Please attach sketch showing curb line, utility line, building, etc. with distances. PERMIT TYPE ❑ SEWER CONNECTION PERMIT $50 ❑ WATER CONNECTION PERMIT $50 REPAIR $40 ❑WATERLINE of SEWER LINE REPAIR $40 ❑ ADD STATE SURCHARGE $.50 ❑ SAC CHARGE @ $2000 = 1 y0 OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING NEW WATER METER COST — SEE UTILITY BILLING SPECIAL ASSESSMENTS — SEE FINANCE WATER TAP — SEE ENGINEERING NOTE: WATER METER REPAIR, INSP OR SHUT-OFF / WEEKENDS & HOLIDAYS $125/HOUR-BILLED THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a water or sewer (new connection or repair) permit and I acknowledge that the information above is complete and accurate; that the work will be m con rm ce with the ordinances and codes of the City of Fridley. I understand this is not a permit but only an application for it pe or s no to rt without a permit. // / % / / k)l er DATE: el 14� �/O� SIGNATURE OF APPLIC PRINT NAME�O' "VW APPROVED BY: �` DATE: zo COPY GIVEN TO: UTILIT BIDING (only if new meter) ❑ PUBLIC WORKS ❑ ENGINE ;(RING' City of Fridley Engineering Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3551 FAX: 763-571-1287 1 VO �e- k,4 7�?4,4t)Ky A� � � \\,\ , � \� � � , � �\� \ ���� \ �• \ }� » . \' \. � ; . �'\ /� d � � »,f < 2 §: 2 \2: ^-t a _ .� y . �� � � 2= � � `� /2 %�� � \ J �. � � a Ak. & '- �; . �w �,