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Lot'.�.��__�.__ Block� � Adclitiois or Sub-DivLston . ,�►,�
Corner Zot � I�tde Lot '� Sefback r� �� Sf
. de3'ard �
Sewer Elevatioa Foundation IIevatton
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� � ' DESCRIP'�'ION .dF BUILDtRIG �':� �, � ,
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�t � :���. : ne� � ��� `xe��t ��.� sq. �-t �+� �u. �+��.
. . ` � �� ..—� t° �. s�, rt, � cu, �t. � .
Z'yAe of Construeti� ��._. Es�. Cost:� ._._.`To be Completed
� -
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In conffideration of the issuance to ane of a germit to construct ��uiiding r�escribed above, I ag� to do
tbe proposed work 3n accardance �vith fhe descripttoa above� sei %�rFh aud in compliance wtih all pri�vistons �
a,�inaac� of the dty of Fridley.
' �
In consideration of the �3►ment of a fee of $�� Pe'rmfi is herebY geanted to ,
to construct the building or addition as described above. T1�is permit 3s granted upon
the expreas conditton that the to whom tt is gi�anted and bis a�ents, empioyees sn� worlQnen, in alI work
nen,
done 3n, around and t�Pon sai building, or any�p� thereo� shall conform in all respects to the oMlinances of
�'ridleY. Minaesota locat[on, canstruci[on, alter�tion, nnaintenan r�pafr and moving of buiid�
wl� dty ]im�tts��a� permit may be revaked at"�ny time upon��� of eay � the gravisioas of �d
��� �
E:;�;i1: ti'Ti �, .�T'''W �
.
NOTIC& - - ,� ----- _
tMs pe�! does nef eever tlro consleadfon, t�tapaNen [o� vririnS. P�o�& 8� b�S. �r� or rratar. Be sm� fo sos
Nro Boildieg 1� �er �liarate Pe�hs f� thase Bsna. _-
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. . o�ur� a�d � ssoeiates .
�.J� C �� � , 9��e
LAND SURVEYORS.
. � . " Anoka, Minnesota
C#RT�ftCATE OF SURV�f:
Ralph N. Lund .
� DENOTEb I-S"F �
IR4N5 STONC
� 7581
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Lot 6 Block 1 �
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. ELWELL�S RIVERSIDE HEIGHTS PLAT 2 ���' ��
Anaka County, Minneaote o � ��w
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• . � ` ��w�
1 FIEREdY CERi1FY THAT TIflS IS A TRUE AND CORRECT REPRESBiTATiON OF A SURVEY OF TNE bOtJNDA1bE5 O!' TI# AWVE
DESCRI6ED LAND, MID 'iliE LOCATION W' 11l! SUILDWGS. THEREON, AND ALC VIS�LE BiCROACHMB�ITS, iF ANY, FitOM OH ON SAiD. �`�
LAND. �.
/1S SURVEYED !Y ME TlMS .....�;.9EYIDAY OP ............... A.P.i�l ................................/►.D. 19....�.�.2. . _� ��' �
. � � � �
N. G HOIUM AND AS�SOCI�S, ING.%�I�'�� _... �.�
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a��.ac�io� �oe suu�zrrc ��T
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. Oumer' �. Nam� - Builde� ,
Addrese ... � : . ; �
- - --r�.�.r�.._ k _....^-�-+*
- - 'LOGATION OF BUILDII�' �
No. .' Street � Part of �t'
Lot Block_ Addition �r'Subdivision
' Cozcter Lot � " �Trtside L•ot ` Set6�►ck - Side.-Yard �
_ ,._ . ._,_..� _ .
�EWP,R Si��ATION � FOUI�ATIO�T � ELBVATIOAT -
Applicant attach to thia form Z'wo Certificatea of'3urvey of Lo� and propoaed
buildfng location drawn on these Certificates.
�'o be used ae: �� '
DBSCRIPTION 4F . BLTILDT.I�G _, . , .
� . . . .. y- ,
�ront Depth $ei::�ht �
Sq. Ft. Cu. Ft.
� � � �ont ,� � `Depth IieighC
Eq. FC � ' ._ Cu. Ft �
Tqpe o€ Co�tst�ructi�n Eetfm�ted Coet
To �tse Completad , . . .
The uridersigned hereby �akes` gpplic'ation �or'�'permit �or the work '�etein
specifi�d, a�reeistg to dc a7.1 wtork in strict accordance witb the Citq of
Fridleq Ord3nances and �uli'ngs�of'�the D�part�ueat oi Buildings, aad hereby
declares that all the facta and representationas atated�in,�his application
are true- �a�d: �c�orrect . . ` _. . � .
; , . . �
DATE SzG1�tA7�'C1RB . c � �
(Schedule of Fee Costa can be found on the�x�verse Side): '
� �� � n
.► =�d"
BOiI.D?1QG 1'ERMaT FI� S(�EDULE
�,
Section 2. The Inepector of guildingsfshall, betore iesuing say permit for
tlae erectfon of anq building or �tructure, or`€ot any addition �o anq euist-
iag building or sCructure, or for any alteraCione ur repa3ra to any existing
building or �sicructure,� upo�i appli�ation'�herefot, require the gaymea� by ehe
applicant for such perm�i.t of fees to the amount�he�ein below set fo�th �d
in the m�naer herein provided to-wit: '
2.1. For aay such permit fo�the erect�Lon of any fire-p�oof building, other
than a gara�e� warehouae, factory or grain eleva�or, or for the erection of
aay fire-,proof addit�on, for eimilar occupancp� to anq en3sting bui��in�
ahal� be �t the ra�e �f ��,:�0 for each 6ne thaueand cubic feet, or�fraction
thereof, ia such cubical contenta,
2.2. For aay such permit for �he erection of any f�ra-proof,�arage� warehouse,
fac�ory or grain elevator, or for the ere�tion of an�r fire-proof additioa,
for similar occupaacq, to any existing building shall be at the rate of $1.25
£or each- one thousand cubic feet, cl.asaified as °tfireproof1° bq° Sectioa 502 of
''. the: Miuneapolie Buildfa�g ��t.e. � ?
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r. � ��VY�7i'IS � . f ,. ., . . .1.. . ' � .
2.3. For anq such permit for the erectioa of any non-£ireproof building other
than a garage, warehouse, factory or grain elevator, or any non-fireproof
addition, for�similar occupancy, to aay esistiag building - permit $1.00 for
each one thousand cubia feet. .
GARAGES
2.4. For..any such permi,t �or the erectioa of aaq noa-fireproof gara�e,
wairelrouse, factory or grein elevetar, or for tbe erection of anq non-fireproof
add3,tio�t, for similar occupancy, to any esi�ting building or for each such
buildiag or �dditiaa - aiztety cents ($0.90) for each one thousand cubic feet
or fsacCion therepf, ia the cubical coateuts thereof w3th a minimum of $4.00.
For the purpose of eempu�ing fees.for building permits, the cubical coatents
of any bu3lding or addition to a uniform height throughout by multiplyin� the
grouad are�a covered f�� a�oi�� �i,x.(�) 3.AChes below the �lour line of the
base�neat ar cellar to the avarage height o� the upger surface or to the
:avera$e height of the roof suxface of the main gat�le of a pf�ched roof.
2.5. P'or regairs or.alterations to an existing struc.ture, the fee ehall be
at t�he rate of $3.00 per �ach Five Suadred Dollars (�500.00) or fraction
Chereof ia the cost of al1'proposed work.
2.6. In na +case shall the fee charged f�r any permit as set forth in
Sectian 2 be lees tiiea �4.00. :
,� � � /^1 r� �e - ` .a
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,
CITYOF
FRIDLEY
����i� �'--,�
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
�� -
April 10, 1966 -
irl�'�. Dennis Yood `
757 � Alden Way N. E.
Fridley, !�1 55432 ���T����_____ ,
Re: Surface Treatment (ground cover) at 757 ea--�►ay N. E. _
Dear Mr. Mood:
The purpose of thi8 letter, toget6er vitb the enclosed plot plan, is to
confirm iqy visit xith you of April 9, 19� and to clarify wbat ground aover
the City Code permits.�
As stated duriag my visit and to again re-emphasize, it would be a aice
gesture of friendship if you and your aeighbors� Mr. � Mrs. Anderson� could
agree on What improvements you feel you need that would not make tbeir
environment less desireable to them.
The enclosed certificate of survey shatirs ia color what ground cover you are
planning to make and does represent compliaace with the City Code. The
notations along your oommon lot line� beween you and the Anderson�s, indieate
measurements and maximum fence beigbts that the City Code a11oW s. The area
in yello�r is your concrete drivevay. Ti�e area in pink aan aot be concrete
but could be patio bloek aad can not be used for storage of motor vehicles.
Tl�e area in blue must be sodded and laadscaped.
You may also provide for a sidexalk along the nortb aide of your house and
garage, bouiever you must maintaia seven feet betWeen iL and your north line.
It is the City�s hope Lhat you and your neighbor can live in harmony With
' each other and that vhea the projeat is complete, it Will be something you
both can enjoy.
If you have aqy questions� please feel free to oall me at 571-3450.
ely,
DAR G. Q.ARR
Chief Building OfPieisl
DG C/mh
ENC: 1
CC: !!r. Joha Flora, Publie Yorks Direetor
Mr. Jock Robertson, Community Develop�meat Director
lrlr. Leaoy Andersoa
. • -- �. _.
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�ururyure (�crtifiratc
,-
TELEPHOtVE 927-8953
STATE SURVEYING
COMPANY I
5710 NEWTON AVENUE SO. MINNEAPOLIS, MINNESOTA 55419 I
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� I hereby certity that this i� � true e�d correct reprasentation of e
eurvey of the boundariea ofs Lot 6, Block 1, Elwell'a Rfverside Heighte
Plet 2� subject to reetrictions, reservetione end eaeements of record�
if eny,
' As surveyed by me thie 6th dey of September, 1967.
. � �
Min�esota Registration Number 852
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CIIYOF
FRIDLE.Y
CIV[C CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MINNFSOTA 55432 • PHONE {612) 571-3450
1Kay 13, 1�86
Minneapolis Post O��ice Department
Superintendent of Del3very
ls t & Marquette Avernte
Minneapolis, I�AT 55402
Re: Change of Address in the City of Fridley - Effective Tmmediately
Dear Sirs:
We are listing the �ollowing change of address in the City of Fridley:
NAME: Dennis A. Wood & Sandra L. JoYinson
FROM: 7571 Alden Way N.E., Fridley, NIlV 55432
�0: 171 Ri�ckard Road N. E. , Fridley, N�i 55432
LEGAL: Lot 6, Block 1, Elwell's Riverside Heights Plat 2
We have notified the occupant of this change and we would appreciat�
You changi� your re�sords accordingly and notifying the Fridley Post
Q�fice b�anch.
Sincerely,
�
D G. CLARK
Chief Building Official
DGC/mh
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CITYOF
FIZIDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHOIVE (612) 571-3450
May 13, 1986
Mr. Dennis A. Wood & Ms. 5anc]ra L. Johnson
7571 Alden Way N.E.
Fridley, NAT 55432
Re: Change of Address - Effective Immediately
Dear Mr. Wood & Ms. Johnson:
Per your xequest we are making the following address change in the City of
Fridley;
NAME.: Dennis A. Wood & Sandra L. Johnson
F1�M: 7571 Alden Way N.E., Fridley, A�T 55432
TO: 171 Rickard Road N.E., Fridley, A�T 55432
LE.GAL: Lot 6, Black 1, Elwel7.'s Riverside Heights
]?l.a,t 2
We have notified the following campanies of this change and also various
departments in the Civic Center. If you have any questions on this change,
please contact me at 571-3450.
,
, ' cere �,
�
--- �
DARRE 6. CLARK '
Chief Building Official
DGC/mh
CC: Nlinnesota Gas Company
Northern States Power Co.
Northwestern Bell �elephone Cb.
Minneapolis Post Office
Fridley Water Billing Dept.
Fridley Assessing �pt.
Fridley Police Dept.
Fridley Fire Dept.
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%j .(j t>� �q�/
` �(J� � l
��1ay 9 , 1986
City of Fridley
6431 Uni versi ty �,ve. PdE
Fridley, P9�d. 55A�32
RE: P,equest for change of street address
Gentlemen:
l�Je woul d 1 i ke to request that our address of 7571 A1 den t�lay �JE, Fri dley,
P•1P�. 55432 be changed to 171 Rickard Road, Fridley, P�1P��. 55432.
If you have any questions, please feel free to contact me.
Si ncerely,
�a��.� �.° � D��-n./
Sandra L. Johnson
71-1808
�.�3' k.sh�... �
� �
Dennis A. Wood
571-1575
��
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♦
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3�50
August 27, 1986
Mr. Dennis Wood
171 Rickard imad N.E.
F'ridley, MN 55432
Re: Final Inspection on Garage at 171 Rickard Road N.E.
Dear Mr. Wood:
A final inspection was conducted on August 26, 1986 of the garage construction
at your address and the followirig item was noted which must be corrected
.before the garage can be finaled;
The door between the new garage and house must be a fire door,
therefore no standard glazing is allowed.
You can correct the door you have by changing the glass to wire glass or you
can install a different door without qlass. Y7e will expect this bo be completed
by Sept�nber 15, 1986 and a reinspection called for t�o final out the garaqe.
If you have any questions on this matter, please feel free to contact me at
571-3450.
Sincerely,
� I
.�� � ♦ _ _� �►
--�- - -
. • •, «
- . •
DGC/mh
Sue�¢cT .
City of Fridley - 2 5� � 5
AT THE TOP OF TME TWINS g U I L D I N G P E R M I T �
! � ECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
� �v ��"•�, �
r � � PROTECTIVE INSPECTION SEC.
1 � �
� � /��i � CITY NALL FRIDLE� �5432 NUMBEN REV. DATE PA6E Oi APPROVEO BY
�----�• •,, 612-571-3a50 9�aF�s 3/27/98 / /
JOB ADDRESS 171 Rickard Road NE
1 LEGAL �OT NO. BLOCK TRACT OR AOOITION 8EE ATTACHEO
. oesca. 6 1 Elwell's Riverside Heights Plat 2 SHEET
2 PROPERTY OWNER MAIL ADDRES� ZIP PHONE
Dave Larson 171 Rickard Road NE 571-5058
3 CONTRACTOR MAIL ADDRE83 • �P PNONE LICENSE NO.
Midwest Siding & Roofing 18979 Gladstone Blvd, Maple Grove, MN 55311
4 ARCMITECTORDESIONER MAILADDRESS IIP PMONE LICEN3EN0.
416-4804 20010277
5 ENdINEER MAtI ADDRE88 ZIP PMONE LICENSE NO.
8 USE OF BUILDINO
Residential
7 CLASS OF WORK '
O NEW 0 ADDITION O ALTERATION {�] REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (19 Sq) Tear-off
9 CHANQE OF USE FROM TO
STIPULATIONS Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBINti, HEATINO, TMPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY IOAD
VENTILATING OR AIR CONDITIONINO.
THIS PERMIT BECOMES NULL ANO VOID IF WORK Oii CONSTRUCTION 20NINO SQ. fT. CU. FT.
AUTNORI2E0 IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. 01NLG. UNITS OFFSTfiEET PARKING
I HEREBY CERTIFY TMAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX
AND ORDINANCES GOVERNING TNIS TYPE OF WORK WILL 8E COMPLIED @
WITH WHETHER SPECIFIEO HEREIN OR NOT. TFIE QRANTING Of A PERMIT W1,584 �.79
OOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEFiMIT fEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REOULATIN(i CON-
ST OR THE PERFORMANCE Of CONSTRUCTION. �S I.. ZS F� e SC $ I...SH
PLAN CNECK FEE TO FEE
�h� Licen $5.0 $58.62
NATUREOFC NTRACTOROiiAUTMORIZEDAOENT IOATEI N O VALID- T /// THIS IS YOUR PERMIT
� � ���� �
SiGNATUREOFOWNER��iOWNENBUILDER� �DATE� -- "+� BL �h5p �iatE
NEW
ADDN
ALTER
Il
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con�au��o�aa�s:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
« � �,�i ,��.
Effective 1/1/98
�
��g7`�
l ���
Legal Description:
Owner Name & Address: I��ve ,� � ucrt� 1�� S�it/ Tel. #��� ���
COIItraCtOT: %� � /��?� CId �r � MN LICENSE # a0 UT�_
Address: %��l ? `7 _ �.rc.o� t 5 '�zi� f �v� � a �T ro�1� �.�.31� Tel. # �i�� ` �.�o y _
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIP'rION OF IlVIPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: ��C �af ��SC � ��4�� l � S �• `7'�4�-G��
• „�� � �
Construction Type: ���- a �� Estimated Cost: $ ��,—��J � °E-� -
-� a
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: "� % � APPLIC ..,�. (� Tel. � �1 ��- � G r%�-
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
. STIPUI.ATIONS:
� � G{�. �' _�
$ � �.���:.
$ �
, � ,�
$
$ � �`
,���
$
$
$
$
-� � � ,_
,
$ �;�; � �°;.�s"°5
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valua�tion (1llOth%)
$.SO/$1,000 Valuation
$10� per SAC Unit
$5.� (State Licensed Residential Contractors)
Alt. "A° or Alt. "B" Above �
$450.� Conservation P1an.Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
. .. .
0
BUII.DING PERMiT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any exi�tnng building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the°�payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$i to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,0�
$50,001 to $100,000
$100,001 to $5�,000
$500,�1 to $1,�0,�0
$1,000,001 and up .
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $1� or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,�0 plus $9.� for each additional $1,�
or fraction thereof, to and including $50,000
$574.75 for first $50,� plus $6:25 for each additional
$1,� or fraction thereof, to and including $100,000
$887.25 for first $100,� plus $5.(� for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,�0 or fraction thereof, to and including $1,�,000
$5012.25 for the first $1,0�,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for pro�r
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will 1� required before proceeding with the framing.
� �
, ' SuBJFCT � ' �
c�ty of F��a�,�y
�
AT TME TOP OF THE TW�NS � � � L D 1 N:� P E R M I T
i � ' .
� i y����� � COMMUI+IITY OEVELQPAM�NT OIV.
r � � PROTECTIVE INSPECTIQN SEC.
� . ,
i--_-� ��•'• �'� CITY MALL FRIOLEY '3Sr32 NUMBBP p��
L 612-571-34Cp 910-Ft5
J08 ADDRESS 171 Rickard Road � NE •
t LEGAL �OT NO. LpCK TRACT OR ADDIt10N
oesca. 6 1 Elwell's Riverside
2 PROPERTY OWNER MAIL ADQRQS�
David Larson, 171 Rickard Rd, Fridley, MN 55432
3 CONTRACTOR MAILADDRESS
Windows America, 7928-C Univprsity Ave NE, Fridl
4 ARCMITECT OR DESIdNER MAIL ADORE85
S ENGINEER IdAILA00flE88 �
8 USE OF BUILDINt3
DW@�l�llg
7 CIASS OF WORK N� p AQDITION 0 ALTERATION
�
8 OESCRIBE WORK
Vinyl window replaceme,nt
9 CHANOE OFUSEFqOM TO
STIPULATIONS
12/�/oi 1 / /
3z3�o
RECEIPT NO�
W �
•nvnovEO er
SEE ATTACMEO
Plat 2 sNEEr
�IP PMONE
763-571-5058
�IP PMONE LICENSE NO
5432 763-786-8115
CIP PMONE LICENSE NO.
ZIP
❑ REPAIR
LICENSE
O MOVE � O REMOVE
Provide smoke detectors in a1Z sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
Caulkiag and flashing for a11 exterior openings.
SEPARATE PERMITSAiiE REGUIREO POii ELECTRICA�, PLUMBING. HEATING, �"
VENTILATING OR AIR CONDITIONING.
THIS PEiiM1T BECOMES NULL ANp VOID IF WORK OR COMSjFiUCTIO�tI 201
AUTHOR12ED IS NOT COMMENCEC V�1ITH�N 80 OAYS. OR If CONStRUG�TION �
OR WORK IS SUSPENOED OR ABANQONQD FOR A PERIQO Of 12Q DAYS Ai
ANY TIME AFTEI; WORK IS COMMENCED. ' NO
I MEREBY CERTIFY TNAT t MAVE READ ANO ExAMIN�Q THI$ APP�ICATION
AND KNOW TNE SAME TO BE TqUE ANO C041RECT. ALL PqOVISiQN$ OR LA►W$ yp�
AND OROINANCES GOVERNING THIS TYPE OF WqRK WILI, Q� CpMP�lEO
WITM WMETMER SPECIFIEO HEREIN Oii NOT. TME GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CAMCEL THE pEp
PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGULATIN�i CON•
STRUCTION OR TME PERfORMANCE OF CONSTRUCTION
S�GNeTUpE OF CON'AACTOp ON pUTMOp�ZED AGENT IOAT�t
CO ST. OCCU ANCY GROUP
IING SQ. fT
01NLCa. UNITS OfFSTR
STAILS
UATION SURTAII
$5,388.00 ` $2.69
MIT FEE SAC CM�
'. $125.25: $5.39
N CME K fEE TOTAL F
$5 ice e 138.
WN :P�P F4Y VqLID 7E0 TMIS
1
Ncr �ono
CU FT.
- ,a
�16Tf
�24-� 15� 34 FR�'1 C 17Y � FRI DLEY 1'0
. +vEw [ 1 .
� [ I anro� �c�r
ALTFR ( j SU+i6LE FA�Y AI� DUPLEXE8 R t AND R�
Bl1iL�INC P�AACt' I�PPUC�1iTOPi
/
. .�, :«, . � . .� �= I�
�
'7�i81S P.02�03
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r.r_ �•::. s c:. �
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i� � I
i
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_ �_
: _.:.� � , . .
Lt1t�IG AEiEA:
t3ARAGE AREA:
DECK �►REA:
OTHER:
� c� � �c�,, s cena�e �s�y o��
lot, a� �e pro� cons� dr�nm on d to scaie.
� - • •- - - . �:;:�
L�rtgtl� VU�th H�t Sq. Ft
Length, 1�th l�t� Sq. Ft
Ler�th v1� ,_,� F�lc1rrountt sq. Ft
� � / � � �•r
. :. � �r� . ..- �. ,� .1.... ' c:. . - i
� � � !� � �
�
oriY�y c� cut w�tn N�d: Fc �s Ft= �cX s ��
DATE: A�PUCANT: TeL �
CiTY USE ONLY - Caii (T63j 6i2-3�4 %r Pen�t Fes� �f n� in ap�on
Permii Fee $���. �� �ee Schedu� cn Reverse S'�ie
__ ._ -,.P. _ _
_. _
- -- -
F`i� SurcFtarge � J j� 9 .tR?'t ofiP� Valuation �tffi�i�loj
�tate Surc�ttarge $ a t fv 9' �.5i��,�ci �� ,_
SAC Charge $ �1900 �r S�C Und
ucense surc9��rge � .�, DD �5.�0 (S�ie t.�ec�sed R�i�ntial Contrac�ors)
Drivewtey Es�xow $ A�. "�►" � Alt. "B" Above
Erosion Control $ �.OQ Cor��rvat�n Pi2�t Review
Patk Fee S Fee Detenn�i bY Engineer+n9
Se�nrer Main Charge S Agreement Ne�sa�► [ 1 Not N�ce�sarY I J
TOTA� $ `3 � �►�
s npUta�no�s: ���o YiO�" � o/1E �L`Te�:,'�a''_� c
� i�..- .S'� .
3�0. 9. 9y t�l.� ��. ,v�
�. �.� i� �,���,�.�-�--�
�'�-.S,�i.��i�" �LG-- �..7�'/��- ��vi..�S' .
.