AF - 35360City of Fridley, Minn. ���=2 52 9.y�
� BUILDING PERNIIT N� . 71s7
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Addr�s _—.------ ..__.�.._.._._._.._._ Addrnee ----�r....._..._..._.._.._.._.....__._..._....—._..__._....—_.._
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�� ����7` ,�ATION BU� NG
Na � . . 3heet .. '].t�..�Cfel.� � ._.. ,!_. P of Lot .
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/ . �. ._.-------.�.. �...._�'--�-
Lot __.. ...._._..-- Block -.--._...1_.._...__._....._. Addition or Sub-Division �1�.,��+r�ks�rsi3L.f7tA �',�t/ys_
.— / • f
Corner.Lot __._.._._..._ Inatde I.ot _..__�`..._.._ Setbsck ��..-.-.---._ Sideyard ...�� ..._. .��j —...._.__.._..
Sewer Elevation ��.1'_a �_..._...._.._`._.......--.- F�wi�ht°n El�vation ��-� 4.—___._._..._._
DESCRIPTION OF
T v.�a ' I/ �����
... sront _.�1.� neash ....� y�.�_ xetehs .,�� . sa. Fc%Q�-� cu. Fti��,F-'�'
.._.__._._____..�.._ ._ Fron _._�_�.._ DePth _..._._ F Fi ight _.._.. _ $q Ft. _..__..._..._.. C�. Ft.
Type of Constructton _,. ._. Ftt „! _�... � o be CamPleted --..._._._
011TSiDE APPEARANCE OF THIS BUILDING MUST BE Of
APPROVED VARIANCE WITH OTHER BUIlDINGS IN THIS
eLOCK
In coosideraHon of ffie issuance W me of a permit to c�st
thP propoaed work in accordance with the descrlption above set
ordinancea of the dty oP Fridley. �,
In camsfderatiaai of the paymeat of a fce of S.L �—`�- -.--, Pernut is hereby grented
! above, I agree to do
�wiffi all �aviaions of
to o�struct the building or addition se described above. This permit is granted upon
the express condition that the pereon to whom it is granted and his agents, employees end workmen, in all work
�done in, around and upon said buildinB. m' aru' Part thereof, shall conform in all rnspecte to the ordinances of
FYidley, Minnesota regarding locatlon, constructi�, alteration, mazntenance, rnpair and moving of bulldinga
within the dty ]imits and tUis permit may be revoked at az�y Uma upon violation of any oE the P���s of esid
ordiosncea. �
Building Inspector
NOTICE
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}�AT��ASS CALCUCATIONS DEPARTMENT OF BUILDINGS
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i �eatheqtriq Construction No.
Guide
w� • n Reference Out. Wall Int. Wall Ceiling Roof Floor Kind
; e No I9_
fl. t► � Room � Length %� Width �' .Height �, I' FL� : t� .' Roo I
Wwdow� snd n—Crackage and Area ,� ' il, Windows and Doora—Cn
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Date: � APRIL
City of Fridley, Minn.
BUILDING PERMIT
1966
.��/6 �
N° 8757
p�r; RICHARD W, KIMBLER g�a�, SAME
_.____. ..__..._._.._._._........._._._._..---.-..-.—
�,�e _,__7638 ARTHTTR ST. N.E,
..._..— Addneae ...-----�------�--��--�---
FRIDLEY, NIINNESOTA 55432
Na 7638
� 6
Comer Lot ---
3ewer IIevatlon
LOCATION OF BUILDING
ARTHUR STRSET ft,E,
3treet —._._ — . --_ Part o! Lot --------._...—.__ _
B1ock --- 1 Additton or Sub-Divldon .__MEADOWMOOR TERRACH_...V_
___ Indde Lot __._?� 3etbuk �__.._...._._ Sideyard ---.----.._.---
Foundatlaat Elevatlon
DESCRIPTION OF BUILDING
To n� uma �.:
DETACH&D GARAGE 22 22 10 484 4 840
_.._ �__ F1aat __.. DeP� --- Heig6t -- SQ. Ft —._ _ Cu. FG - '--
------- FYa°t -- D°Pth —.-- Height _...._.._._ Sq. Fk. —_� Cu. Pk _._.__�
Type of Canskruetion -._ _F�� � Fit. Coet _._ $1,600.00 ._ .. To be Camplefsd �.�._..�--
m cm�aaennon o� me �..uence w n,e or 8�c co c�ti„�c me �,uas� ae.�atea 8� i� w ao
ttt� vmvo.ea worlC m acoora.n�e wiw the ae.crlption above r� raxw aaa in rnmplian wlw a�l provisiana ot
aamaenoes aR the a;v cr Frlale�•. C7 ld�s�.��ii ��.�
In cmddmallm of the psymffit of a fee � i- 5'�� ---_..� Das'mit L 6ereM' �anted to RICHARD W_.�
KII�LBB to caastiuet the bu�ldin8 or addition as dercrlbed above. T9ilspe t is grented up�
the e�cprea oonditlon thet the�p�eon to whom it b S+'anted aad his agenq, employcee and w�orkmen� in all work
dme ln. around and upon seid bulldlnS� �' eRY therea�, ahall oontorm in all reapecFa To the ordfnaaces oR
PMdley� Minaawta re��� locaUm4 co�tru�alteratlm, maintmsnce. reDah' and moving of buildin[s
wt� dty ]imita and thL Ded'+n1t msy bs iavokad at aqy time upon vlolatiam ot any o� the P�vLiwis ot ra�d
ALLEN G. JENSEN B� �
NOTIClt
1MM MrwY dw uM awa IY arM�Alee, Y�YOYMn /w rrYY�, �NM. W�Nr aw�r a wN�r. N wn ro a�
�M M�I�IV WMMw� M r�rM� � he Mw Y� . .
APPLICATION FOR BUILDING PERMIT
CI'PY OF FRIIYI.EY, MII!1NNSSOTA
� ,.ICI�T�iR�
aunxES s_7L3 �.9 RrH u a s r, •�/. ���oc��r annt�s s 7��,� ARtu u n sT, �+, e. r�a,at,�X
LOCATION OF BUILDING
N0. 7G �B STREET AR7Fi42 PART OF LOT
LOT�_BLOCK�_ADDIITON OR SUBDIVISION JYI � no r.: n,.,,o e 71z RR s c�
CORNER LOT INSIDE LOT�_SETBACK SIDE-YARD
SEWER ELEVATION FOUNDATION ELSVATIOH
Applicant attach to this form Two Certificates of Survey of Lot and propoaed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be ua as �
/1
.�� � Front oZ �---�epth °'z °Z-Height � �'
� � 4
Sq. Ft. � _ Cu. Ft.-��
Front Depth Height
Sq. Ft. Cu. Pt.
Type of Conetruct�i2m�� Eatimated Coat l�,n0_°••
To be completed
The undersigned hereby makea application for a permit far 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 repreaentationa stated in this application
are true and correct,
DATB 3` // (o � SIGNAT[JRE �,' /) •�uJ� (i'/,��2ti����
che8u
(S le of Fee Costs can be found on the Reverse Side).
1 Q Q
�7
. . _ • .., _ • •. - � •
BUELDING P&RMIT FEE SCHEDDLB
SECTIOR 2. The Inapector of Bul2dings shall, before isauing any permit for
the erection of any building or atructure, or for any addition to any esiating
building or atructure, or for any alterationa or repairs to any exiating
building or structure, upon application therefore, require the payment by the
applicant for such permit of feee to the amount hetein below set forth and in
the manner herein provided to-wit;
2__1. For any auch pesmit for the erection of any fire-proof building,
othe= than a garage, warehouae, factory or grain elevator, or for the erection
of sny fire-proof addition� for similar occupancy, to any existing building,
shall be at_the rate of $1.40 for esch one thousand cubic feet, or fraction
thereof, in such cubical contents,
2_2 For any such permit for the erection of any fire-proof garage,
warehouae, factory or grain eievator,.or for Ehe erection of any fire-proof
addition, for similar occupancy� to any eatisting building shall be at the
rate of $3:,25 for each one thouaand cubic feet, ciassified as "fireproaf"
by Section 502 of the Minneapolia Building Code,
AOIISSS
2.3. For any such permit for the erection of any non-fireproof
building, other than a garage, warehouae, facto�cy or grain elevator, or
any non-fireproof addition, for aimilar occupancy, to any exiating building -
permit $1.00 foz each one thousaad cubic feet.
GARAC3BS _
2_4. For any auch permit for the erection of any non-fireproof garage,
warehouae, factory or grain elevator, or for the erection of any non-fire-proof
addition, for eimilar occupancy, to any exiatiag buiiding or for eath such
building or addition - ninety cents ($0,90) for each one thoussnd cubic feet
or fract3on thereof, in the cubical cantenta thereof with the minimum of $4.00.
For the purpoae oi computing fees for building permita, the cubical contenta
of any building or addition to a uniform height throughout by multiplying the
ground area covered from a point six (6) inches belo�v the floor line of the
basement or cellar to the average hcfght of tha upper aurface or to the average
height of the roof eurface of the main gable of a pitched roaf.
2__5. For repaira or alterations to sn e.xiating atructure, the fee sha,ll
be at the rate of $3.00 per each Five Hundred Dollere ($500,00) or fracti�n
thereof in the cost of'all proposed work.
2.6. . In no case shall the fee charged for any petmit se aet forth in
Section 2 be Iess than $4.00.
STORM REPAIR DAMAGE FEES:
Residential: Eatimated CosE of work up to $500,4� - S5,!;0
Estimated Cost'of work over S5�_'^>:' --�'�D
Comm�rcial; Estimated�at of work o ^ ,';� ,''�
Batimated st of woz`. u�_r ;_r,e..u.. ,<i!.
Ju1y 29, 29f7
occu�az�t
7t�38 �iirthur st.
t�ridleyi �'inates�at�
�ear 5ir:
7'hQ Ci.f.y o£ I'ridl$y is enforcing the health Lac�� oP the
city anct tt�e Stat� flf : innesot�, Zn t'�i� connection azul tsy� ca*aplair►t
thie 3oard ar�de es �urvey r�f ytauz pre�:ises �nd the £ollowin� aonditions
were note� ���Sics: are in n��d of correcL�ans or improvamen�.
Yatfr uarbaGe and refuse cans were caithauC ls.d� . AIi
�;arbage �u^t be �rai.ned, wranped and �srop�,rly etorec3 in metai r�ntain�s
wit'� ti�;ht fitrin;; lids. Cittj !�E•r requirea that ��rbage and refuse
cuntainets %e stnrect in ihe gar�s�e �sr to the rear of the �operty
i:� a rac?c alevatixs� the cans �t leaat i8�" �bave the groun+d s�fa.ce.
��arbag� �hall be collected at least nnca �a wee'� ar�d the burnizs; c�f
,��r�;z,e ia proiib3.tect.
It is al�o requestec3 tk�.at you rea:-ove the tr�s'- cans
�silicF� qou deposited at 7��9 Racon L�r3ve.
Lnl�as� substaatial i�provenents are r,.ade by Au�ust S'
19E,7, t:�is Soarc? �ri12 'r?eve rn choics but to esuse sai.d nuisar�ce Yo
b� abated. F.ie h�he, ho�ever, tivat such action •aili he unneressary
and th�t you v�3,1�. voluzitarily cnr?�Lq with t:�e Law. 'Je ahall be �lad
to discusa any qu�wtions or difficulties you m�q have ira co*rplyin�g
wirs: th� r,>ini:^us� he�3 th larrs,
'lery trulq yowrs,
Ja�^es II. Hensleq
Citq of Fridley Bosrd of k�eslttt
cc: Cit:y :�'�sr
� •
.3'?It/r
SuBJFCi
City of Fridley
ATTHETOPOfTHETWINS gUILDING PERMIT �
�_�� LOMMUNITY DEVEIOPMENT DN.
PROTECTIVE INSPECTION SEC.
�""� • CITV HALL FRIDLE� 55<J2 NUMBEP REV OniE naGE oi
,�' 612-571-3450 gt0-Fi5 6/9/97 � �
JO6ADDRESS 7638 Arthur Street NE
1 LEGAL �OT NO. BIOC�
DESCR. G ]
2 PROPERTYOWNER
Meadowmoor Terrace
Judy Meyer 7639 Arthur Street HE
J CONTqACTOR MAILADORESS
LaFrance Exteriors 12008 Ibis Cir, Coon
a AqCH1TECTORDESIGNER MAILADDRE55
5 ENGINEER
OF BUILDING
Residential
SS OF WORK
❑ NEW
❑ ADDITION ❑ ALTERATION
Reroof House S Garage (22 Sq) Tear-off
9 CHANGEOFUSEFROM
MN 55448
L� REPAIR
'�.7143
��
RECEIPT NO.
�8�3
ncPnweo ev
SEEAT7ACHED
SNEET
GHONE IICENSE NO
755-9470 20081887
PHONE LICENSE NO.
PHONE LICENSE NO
❑ MOVE O REMOVE
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, � Tr��� ��
VENTILATIN6 OR AIfl CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITH�N 60 DAYS, OR IF CONSTRUCTION
OR WpqK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 �AYS AT
ANY TIME AFiER WORK IS COMMENCED. NO. DWLG
I HEREBY CERTIFV THAT I HAVE READ AND E%AMINEO THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECi. ALL PROVISIONS OF LAWS yq�UATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILI 8E COMPLIE� @1 HLS
WITH WMETHER SPECIFIED HEHEIN OR NOT, iME GRANTING Of A PERMIT '�' �
DOES NOT PFESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMITFEE
SRRUCTONSOPfTHEy ERf ERMANCE OFRCONSTRUC ONEGULATING CON� $S9.SO
PIANCHEC
C C �'
STALIS
License SC $5.00
51 UP C NTRACiORORPUTHORIZEDAGENi IOAiE� WMEN PROPERIY�(
/J
HOUP OGGUPANCYLOAD
CU FT
OFFSTREET PARKING
IGAFAGES
SURTA%
$.91
$ACCMARGE
Fire SC $1.82
TOTALFEE
$67.23
. . .. , . . . ... ... . ., r , , ... . .. . . . _ . - .., � . . . . , o ,a; . .� _ ... . . . _ . . .. .
NEW [ ]
ADDN [ ]
ALTER [ ]
ConstructionAddress:
I.egal Description:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING I'ERMIT APPLICATION
Effective 1/1197
����
Owner Name & Address: � :I�_ Tel. #
Contractor: ��� �,.no �.a� g MN LICENSE # Z(2� g 15rT Sl �
Address: � ��$ LB !� G(L-Cl-L C.o0�1 (ZeP �IJS M� Tel. #?SS - `� �Zd
Attach to ttus application, a Certificate of Survey of Yhe
lot, with the proposed construetion drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTI�R:
LenB►h
I.ength
Length
OF IlbfPROVEMENT
Width Height Sq. Ft.
Width Height Sq. Ft.
W' th Hgt/Gmund _ Sq. Ft.
r
r� �
Construction Type: ��4n.. d—�►C-w�, FstimaYed Cos� $ 3aOC� � ��/S�
(Fee Schedule on Back)
Driveway Curb C�t Width Needed: _Ft. + fi Ft =_Ft x$ _$
DATE: G- R- Q7 APPLICANT: �✓Mi hL� -��_ Tel. # 7�S- 9�'70
�
Pernut Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Fscrow
Erosion Control
Park Fee
Sewer Main Charge
rr•yr•��
STIPULATIONS:
CTl'i' USE ONLY
$ 5%, S Ci Fee Schedule on Reverse Side
$ /, cga .001 of Permit Valuation (1/1()th%)
$ 9 / $.50/$1,000 Valuafion
$ $950 per SAC Unit
$ S- DU $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation ljlan Review
$ Fee Determined by Faigineering
$ Agreement Necessary [ J Noi Necessary (]
$ � . �3
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing peRnits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon appiication therefore, require the payment by the applicant for such percnit of fees to the amount
herein betow set forth and in the manner herein provided to-wit:
__ _ ._ .
TOTAL VALUE .
$1 to $500
$SOi to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
__ _ .
$1,000,001 and up
FEES _
$21 (Minunum Fee is $21 plus surcharge)
$21 for fust $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for fust $2,000 plus $12.50 for each addirional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $1{)0;000
$887.25;for first $100,000 plus $5.00 fa
$1,A00 or fraction thereof,_to and inciud
$2887.25 for the first $500,000 plus $4..
$1,000 or fracfion thereof, tA and includ
$5012_25 for the fust $1,000,000 plus $
$1,000 or fraction thereof
��� ��,
�S:�W.�
i for each additional
�S $1',�,� � �
75 for each. additional
DRIVEWAY DEPRESSION ESCROW =-
(Concrete C�rb Sueets Only) _
Alternate "A": Removai 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 instali a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet tunes $15.75.
VERIFICATION OF FOUNDATION
Permits for co�strucrion will be issued a min�rr�um of 24 hows from the time of apglication to allow for proper
review of the proposed stmcture and of the construction site.
A Certificate of Survey of the lot, showing the locarion of the foundation once it has it has been constmcted
wi(1 be required before proceeding with the framing.
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UlYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERS[T'Y AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
May 6, 2002
Kent & Darlene Andrews
7638 Arthur Street NE
Fridley MN 55432
Re: Paved Driveways
Dear Mr. & Mrs. Andrews:
In 1997, the City Council adopted an ordinance declaring gravel driveways a public nuisance.
They were declared a public nuisance for a number of reasons, such as: they can cause
erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravei in the
City's storm sewers and detention ponds. When gravel driveways were declared a public
nuisance, the City Council gave property owners five years to have their gravel driveways
paved. The five-year deadiine is quickly approaching, which means all gravel driveways within
the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002.
If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at
the Anoka County Courthouse. A misdemeanor citation is a criminal offense and is punishable
by up to 90 days in jail and/or a$700 fine.
If you've already paved your driveways, Thank you! Please call me at 763-572-3595, so I can
update our files.
For your convenience, a brochure on the City's loan program has been enclosed. You can use
this loan program to acquire financing for your driveway improvement project. Please call Jim
Hesnik at 612-335-2651, 'rf you have any questions regarding this program.
Thank you for your cooperation! As you successfully complete your driveway improvement
project, please call me at 763-572-3595, so I can do an inspection of your property and update
our files. If you have any other questions, please feel free to call me at the above number.
Sincerely,
Stac St mbe���u��
Y 9
Planner
C-02-53
_
_
CIZYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
July 2, 2Q02
Kent & Darlene Andrews
7638 Arthur Street NE
Fridley MN 55432
Subject: Paved Driveway Reminder
Dear Mr. & Mrs. Andrews:
This letter is a friendly reminder that all driveways within the City of Fridley need to be paved by
December 31, 2002'.
As you are aware, the City Council adopted an ordinance declaring gravel driveways a public
nuisance. They were declared a public nuisance for a number of reasons, such as: they can
cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in
the City's storm sewers and detention ponds. When gravel driveways were declared a public
nuisance, the City Council gave property owners five years to have their gravel driveways
paved. The five-year deadline is quickly approaching, which means all gravel driveways within
the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002*.
If you've already paved your driveways, thank you! Please call me at 763-572-3595, so I can
update our files.
For your convenience, a brochure on the City's loan program has been enclosed. You can use
this loan program to acquire financing for your driveway improvement project. Please call Jim
Hesnik at 612-335-2651, if you have any questions regarding this program.
Thank you for your cooperation! As you successfully complete your driveway improvement
project, please call me at 763-572-3595, so I can do an inspection of your property and update
our files. If you have any other questions, please feel free to call me at the above number.
Sincerely,
Stacy Strtlmber�� g �h�
Planner
'If on December 31, 2002, your driveway hasn't been paved a cifation wili be issued and filed at the Anoka Counly Courthouse. A
misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail and/or a$700 fine.
C-02-83
Building
Inspections
763-572-3604
STTE ADDRFSS _
THIS APPLICANT IS:
From: City of Fridley To: 651-203-0554 Page: 4/5 Date: 7/261200812:02:13 PM
BUII,DING Permit No.
RESIDENTIAL APPLICATION Received E
PROPERTY OWNER/
TENANT
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PERMIT TYPE
❑ OWNER
STATE LICENSE H�
ADDRE55� �
P NE J
1NGLE FAMILY/M
❑ TWO FAMILY/NEW
❑ ADDITION
❑ BASEMENT FINISH
❑ DECK
TYPE OF WORK: u rvGw
� ❑ MAINTENA
DESCRIBE WORK BEING DONE:
SIZS OF IIviPROVBMENT
ROOFING
NUMBEROFSQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
❑ Alumiwm
❑ OIM1er
WINDOWS
IN EX[STINC OPENINOS �Yes ONa
OR FORNEW OPENINGS•DESCRIBE SI2E OF
OPENING CAANGES & � 7
TYPE OF WINDOW TO HE INSTALLED S!i
ALL
Permit Fea
Plan Review
Fire Surcharge
Surcherge
Licanse Suroherga
SAC Chazge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
�
CITY OF FRIDLEY I Date Re°'
�)t &MAIL ADDRESS
'f-
❑ ROOF
❑ SIDMa
❑ SWIMMING
� HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
OSoffit
❑ Trim
❑ Fucia
LOCATIONOFWINDOW� �
��� ��
❑ DRAIN TILE
❑ OTF�R
�RF BASED ON VALUATION, INCLUDING THE COST OF
(USING THE 1997 U.B.0 FEE SCHEDULE)
JOBVALUATIONS ��OOO OCCUPANC
HASEMENT �MODELING SUBMIT•
1. Existing Floor Plan
2. Propasedfloorplan
3. List af swc[ural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
�nniTtot�tc $ vORCHES SUBMIT� �
l. Site Plan/Sorvry showing the oxisling svucturcs
� and proposed prnject.
2, 7Wo se[s of consWClion plaas
3. Energy Calculations
$ ( e"L� �� 'S— See Back Page for Fae Schedule �
$ 65°ia of Building Permii Fee
$ , QU 001 times the total job valuation
$ ,3 � .0005 x Permit Valuation Minimum $.50
$ . � ,t1'� $5.00 (Stata Licensed Residential Contrectors)
$ $1550 per SAC Unit (Plans to IvfWCC for determination)
$ ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineenng �
Agreement neceasary ( ) Non Necessary ( )
Make ehecka pavable to: City of�Fridley
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hemby apply for a building permit and I acknowledga that fhe information above is complete and accurate; that the work will be in
conformance with the ordinancas and codes of the City of Fridley aztd with the Mituiesota ConsWction 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; fhat the work will be in accordance with the approved
plan in the casa of all work wh�' ch requires review and approval of plans. AI �! �% /
SIGNATURE OF APPLICANT /\ I�IvAp_�� PRINT NAME x k o,�. 3Y' ��� ,� _DATE� O� S �(O