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AF - 35549� n City of Fridley, Mi�nn. : � �� Date: ...�..�..°�.....'� .��.......... Own� ........................................ Addre� ...................................... N° 3705 �/ Builder ..��:��P1.••.�� ...... ................. Address ............................................. LCaC�►TIQN OF BUILDINC l] . No. . . /. . !. �. . 5treet . . . . . . . . �� . Part of Lo . . . . . . . . . . . . .. . . . . Lot . . .�� . . . . Btock . . . . . ! . . . . . . . . . . . Addition or Sub-Division . . . . . . . . . . . . . . Coraer Lot ............ Inside Lot ............ Setback ............ 5ideyard ......... DESCRIPTION O� BUILDING TO U88d : a � : . .. .. . .. . �t �� :�� ne�tn ��f� � x��t /.. .�i.=.��. 7ssq. Ft. ,��(o..(� �. Ft. � ��°� .................... Front ......... Depth ........ Height ........ 5q. F't. ........ Gtti. Ft. ........ Type of Construction ... .. .. .. .. ........ I�it. Cost. /. 311 � .� .... To be Completed ..... .............. In consideration of Yhe issa�ance to me of a permft to construct the building desribed above, I agre� to do the proposed work in accordanc� with the descript[on above set forth and in campliance with all provisions of ordinances of the dty of Fridley. �..� .......!��.. ............. ...... � In consideration of the payment of a fee oP $. �� .. .. ., permit is hereby granted to . .. .. .. .. . . .. . . .. .. . .. .. .. . . .. .. .. . . . . . .. . .. to construct the building or addition as descrlbed above. This permit fs granted upon the express condition tha.t the person to whom 3t is �ranted and hia agents, employe� and worl�en, in all work done fn, around and upon said building, or any part thereof, shall eonform in all respects to the ordinanc�s of Fridley, Minnesota. regarding location, con�truction, alteral3on, maintenance, repafr and moving of buildiags with- in the dty limits and ihis permit ma.y be revoked at any time upon violation of any of the pmvisions of said ordinances. �� NOTICE: . .�:�i.��f.: r..��:°'. J... . B�lding Inspector Thls permlt does not cover tha constructlon, Inataltation or atte�ation for wlrtng, sewer o� water. Be eure to see tha Bu11dIn8 Inspeotor fo� separate permii� fo� thes r �, �� gaa heating, v �. Phonea GR�n`arQOd 3-8352 ARLEI�H. C. SIVIITH Registered Prof�sioaal Engin�r and Land �usveqor 18215 Wagzala Soulevard y{�$�y�, � �� V��EY OF PROPERTY OF �'�� e�� . � "�� ',�,�' , � descriibed as folTov¢s• �,� '� �a•'� —„=� �� s�: Z �Il .r�'1 � fee�. p � �� % . �.s�t.� �. �'� �� . �+� - -- �..r, w � � �� .`�`�`" ,�,� � � CERTIE`ICATE OF LOCA� ION O� SUILDII�G CERTIkiCATE OF SURYEY I here�y cerEify that o 1 I hereby certi#y that ��+ �� ,�' 1 L made a survey of the �ocation of the I survey�d the property described above and that -:_ buileiing on the above described property and xhat the above plat is a correct representatipn of said the i�cation pf said; building is correctly show� on aurvey. the above pla� ,:� �c, � �'`� ~ h�. � ,- � �� ,��?� � ��.� � .�rs.e..�,, ;�'�_... .�„ �. � as . �, s � � � � 1 � �1 � �9�� City of Fridley, Minn.. N° 8298 BUILDING PERMIT ��: t�ugust Z, 19b5 �; Mr. Ce11 Mickelsoa B�der •4ndrew F� Gawel Const. Co Ad� 773 Bennett �x�-3.ve AT.E. A� 2i�.07 Washington St. �1.E. _ Fridlep, P�Linnesota Mizuaeapoli.ss Minnesota� LOCATION OF BUILDING No 7?� Stseet �E111�TT 1?RT�VE N. E. Part oP Lot � 10 _ gl� 1 Adciition or Sub-Divisian �3stie .A,ddition Coraer Lot — Inside Lot Setback Sideyard Sewer IIevation Founda.tion IIevation DESCRIPTION OF BUILDING To be Used as: F�ont Depth Height Sq. Ft Cu. FL Front Depth I�eight Sq. F't C�. F't. Type of Construction F�t, Cost �� 5� • 00 To be Completed Repa3ss - �torm Dam�.ge Iu cbnslderation of the fsauance to me of a perinit to construct the building described above I agree to do � P�P�� work in accrordance wlth the d�scription above se orth and 9n complian th af 1 provls�tona of ordinancea of the dty of FrYdley. Ea consideratton of the Pa3►ment of a fee of $ 10.00 ,�t ia hereby granted to ��?t2EW P. ��' to �et the building or addit3on as desccibed above. Thisp�� t ia granted upon the exPreas condition that theperaon to whom it is graated and his agents, employees anc� workmen, fn sII ar�k. done 9n, around and upon said building, or any part thereo� shall conform in all respecta to the orrlinancea of FridleY, Minnesota regarding la:ation� construct�fon, alteration� maintenance, sepeir and �oving of bufldinge wlthin the dty ]imits and this permit maq be revoked at an,q time upoa viola.tion oY aay � the provfs�tona of said ordinant�es. �T;r�:N G. JENSEN 8��' � ,P-1 NOTIC& '�ds p�redt doa aot eewr t6s eemteoeNon, MutaO�fiee ie� �r6in0, P��+��. 6p b�8. snr�e � water. B� sues to sN 11a e�ldio8 I�tor tor aparat� ps�mh� tor thw t�. � _ _ .� APPLICATIOft FOR BUTI,DIl�TG PERMIT CITY ,0�`' FRIDLEY, MINNESOTA � � ANDREW P. GAWEL CQNTRACTdRS, INC. ' 2407 WASHINGTON ST. N. E. OWNER'S .NAl+� �'• Cell Mickel�on gUH,DER MINNEAPOLIS l8� MINNESOTA �R�1P� ADDRESS 773 Bennett �'E. IV.E. ADDRESS LOCATION'OF BUILDING � N0. STREET PART OF ?�OT _ � 9 � � LOT C� BLOCK % ADDITION OR SIIBDIVISION CORNER L0� INSiDE LOT SETBACK � SIDE-YARD .�..�_ . SEWfiR ELEVATION FOUNDATION EbEVA�I01� Applicant attach to this form Tcao Certificates of Su�veq a� Lot aad propoaed building location drawn on these Certificates. DESCRIP3'ION OF BUILDING To be used as; , Front Depth Height Sq. Ft. Cu. Ft,. Front Dept ,_; Aeight Sq. Ft. Cu. Ft. Tqpe of Construction Estimated Cost_�� ' To be completed The undersigned hereby makes apglication fox a permit for the work herein speci�ied, agreeing to do ali. work in strict accordance with the City of Fridley Ordinances and rulings o�.the Depaxtment of Buildinga, and hereby declares that a11 the facts and repreaentations stated in this applicatioa are true and correct., � DATE SIGNATURE {Schedule of Fee Costs can be found on the Reverse Side}. �% 3 � �i ^ - _ , � � / ,` ••, �i a � • / � $IIII.DII�TG PERMIT FEE SCHEDULS y SECTION 2. The Inspector of Buildings shall, before isauiag any permit for the e�ect�Lon of any building or structure, or for anq addition to anq esiating building or str�cture, or for any alterations or repaira to any exisein$ building or.et�ructure,`upon application therefore, require the payment by the applican�,f.or $uab pe�3�'of fees to th� amoun,t�h��ein below set Eorth and 3n the mauner here3n provided to-wit; 2.1, For anq such permit for the etection of any fire-proof building, othe= than a garage, warehouae, factory or grain elevator, or for the ereceion of any fire-proof addition, far simiZar occupancy, to any esiatin� building, shall be at the.rate of $1.40 for each.oae thoueand cubic ieet, or fraction thereof, in auch cubical contents. 2,� 2 For anq such permit for the ereceion of any fire-proof gara�e, warehouse, factory or'�rain elevator, or for the erection of any fize-gr-oof addition, for eimilar ocrupancy, Co any existing building shall be at the rate�of $1.25 for each one thousand cubic feet, classified as "fireproof11 � by Section 502 of the Minneapolis Building Code. HOIISES 2.3. For any such permit�fos the erecti,oa of any non•fireproof building other than a garage, wareliouse, factory or grain elevator, or any non-fireproof addition, for �imilar occupaacy, to aay e$isting building -. permit $1.00 for each one thousand cubic feet. � GARAGES 2.4. For any such permit for the erection of anq non-fireproof garage, warehouse, factorq or grain elevator, or for the erectian of any noa-fire-proof addition, for aim3lar occupancy, to ariy existing build3;�g or for each such buildiag or additioa - ninety cents ($0.90) for each one thous.and cubic feet or fraction thereet, in the cubical cont�en�s thefeof wieh Che minimum of $4.Q0. For the purpose of computing fees for b�ilding permits, the cub3cal contents of any buildiag or addition to a uniform height throughout by multiplying the ground area covered fr�n a po3nt six (6) inches below the�floor line of the basement or cellar to the average he�ght of the upper aurface or to the average height of the roof surface of the main gable of a pi,tched roaf. : 2.5. For repaira ox,alterations Co an existing etructure, the fee shall� be at the rate of $3.00 per "ea�h Five Hundred Dollars ($500.00) or fract.ion thereof in the cost of a11 proposed work. 2.6. Ia no case ahall the fee charged for any permit as set forth in Saction 2 be lesa than $4.00. STORM REPAIR DAMAGE FFsES: � , Residential; E�timated Cost of work up to $500.00 •$5.00 Estimated Coat of work over $500.00 -$lO.OQ ,._ �.. s ,� Commercial; Estimat� Coat of wogk up to $500.40 +$j,,,,A.00 �a ' " � =" Estimat Cost of work over $500.00 � �.00 s �. � S � � � � � � � O � � �y �e � 9� � e � � � � � • � � � � ;� � � � � a �t" � �i � � � � � � � � °�' �3 g � �.�. �i � � � � � � : � � �� . � � , g � ,e o �. � � � . i� O o • � a • o � • • � e C o � � • • • � �p • L. Fal o .. � � . . . 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W N � � t�p � n � � m � � C � � �m Q� � � � i m � � .,, � � -a � � � � � c° v �� v ?� �, o � o � w N �► � ? D c ? o � > G� � c�o � m y m �� m� A "' m 1 v � � n n�n�� w� C Q � Z � � �� v N < -� m Z Z mN � n -� O . Z v < \ �� s r � * � D � n � o N Q y � N � o �, � o � �� Q o o m � 'd � � � �a a 0 �� N � � v� ;, fl. � � 0 c � �� O �_ � z� �� z "� ao �� m � n � < m � � n _-1 0 z 0 Z � m Z � � m n � z � m m � w 0 c 0 n a -o °< � �. W � � 0 c cQ � i 5 � � m � v m � � � � � a m z 0 �y� ;� � W _ � z � n O � � n Z -< � � � \ � � � � � O D r � m m � � 0 � � � � C � m lQ m 0 �W c� m �l � ma o m � Z � � � � _ � � � N m z 0 m' v � j � � � °, c�n < <j � � c � � � C D v�, v � � � m 0 1 � � j � �p 0 o � W � � m � 'a O � a�' -a Q° �, a �m � � o ' � � �- � � Z n n � � � � W '� O m C �. ' _ � °. �� oo. m � � � � -� � � c� o � w � � �m � � m ,-. �. � o. �n � � m � � apo,� �� . �� 4 � � m � �� n • D n 0 � O � � co i A � m � v � c� � � Z O � � C � Z n m Z � � m c � Z m � � � v m � Cii � � � � m W �i�i � -a 7 � z � � � a � � � � � � � D c y 0 3 a � �' � a�� o � t) 3 m � � � ? a c ° m � `� o x � c 3 � i � � � � � N O O O O O �7 � °o o °o °o o � t� � ts� tn tfl �' � O O v � � ° � � � 0 m � � � m v n 0 � � � � � -o m � � -=1 Z O � � W C v z � c � m v n � � � Q � �� \ � m n S � m 1 � � N � � � � � � � � � �• � n, .+ � u� a ��N�� co � a = � m .°�"' � c � c. > >� � n�m� � o � a -a .+ � �c � � W o � � � o yo � a � � �'n �Q o �°- ��i�-� � m o ' � fl. � �, �, � � � o tn �' p � � � m o � -c � Q. � n � � � � Q � � � � g � �, � � �A'� N � � 1 ' � v��n N p, t1 � � o�� Z W � � � �� v N � "'� ZZ mN v � � z v m '�o � � � � � � � � � � �a m ,� D Z Zp A � Z -p vp v_m �� c� .o 0 z vz �� on zZ �v _ �Z �� zp v r vz � < nm Nz � � Z � m � � O � � � c � j � co j « CBIMNEY AND STACR 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 BTiT � s connected Yes () No () 6. Has total heating BTIT's of All other BTU's TOTAL BTU's Re�ks �e�J ec,,�d�eE I� �., �!� �,� o�/A� ��.'.c� ��i�+FT"ELJ List Alterations Eeinq Done: . HEATING COMPANY �le �'��1.�1 C��ir/f� ��I�� . ��, 4� f r/, ` { Signed By �,I.�-�:,Z��L��p , �; �/-�z��-, . ---, e�" Date o� =��-9� ,k - – --��— sue�ecT PER City of Fridley o 19577 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T i � ' � RECEIPT NO. COMMUNITY DEVELOPMENT OIV. � ; .: ------. � �/� � r � � PROTECTIVE INSPECTION SEC. -� � _ � `•-_.� ��,'� CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BV i 612-571-3450 910-F15 7/1/88 � � JOB ADDRESS ��3 Bennett IJrive N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ].Q 1 Christie �,ddition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Vincente Gonzalez 773 Bennett Drive N.E. 571-3816 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residenti,al 7 CLASS OF WORK O NEW ❑ ADDITION � ALTERATION �7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK - Reroof Dwelli.ng & Gara,ge and 5af �it Woxk 9 CHANGE OF USE FROM TO STI PU LATION S 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 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 CORHECT. ALL PROVISIONS OF LAWS VA�UATION SURTAX AND,ORDINANCES GOVEHNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $9OO $. �JO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $23.00 PLAN CHECK FEE TOTAL FEE \ $23.50 SIGNATURE OF CON i RACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY VALI TED THIS IS YOUR PER IT `— _ f —t- � �9 / SiGNA URE OF OWNER �IF O ER BUI RI IDATEI BLDG �NSP aTE I�%v I ] A�DN [ ] AL�R [ ] City of FYidley R-1 Ai�ID R-2 Building Penuit Appl ication EEfective 5/L88 �11D�.L LL�i1.1Mi �ii i-.oiD i—��,i� ! 1 f 1(�' /\'a � Legal Descriptian: Owner Nane & Address:�llc�e�°�e� �o n��s (PZ ?�3 �P� v��-(-4 C1Y°� A�� Tel. /- mntractor: ��°�' Tp1. � Address: Attae�n to this appl ication, a Certif 3cate a� Stuvey of the lot, with the prop�soed oonstructiaci drae�m on it to scale. �' �• �• • •;• i� � • :r �� LIVil� ARFA: Length Wic�h Heic�t �. Ft. ° . yength wicit,�; �. Beic,�t s�. Ft. • D�c�t 1�R�: Length , width Hgt/Gro�a St� . Pt. , .�r@� � i ►n �Ot�__a�hcQ-�� i� r � ar� �(� , Gbrner Lot [] Inside Lot [� Ft. Yd Setback Side Yard Setbacks �ip�e of Gbnstruction: F�timated Cost: 8- �� C� Approx. (bmpletion Date: �r, � . Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: S S Wic�h + 6' See Back Page n�: ,-/ -�� icat�rrr: G��c��,�1�� - s CLTY DSE Qd,Y Pe�i.t Fpe State Surc�iarge SAC Qiarge Driveway Escrw P�ark Ftee Sewet lsain matge � 31'IF�)I.A�I�iS: S .� �' . L5 � S �� S � S S �� $ �� . T�. � ,s�i-3�'/ � F�ee Sched��le on R�verse Side 5.50/51,000 Valuation 5550 per SAC Unit Alt. 'A' OZ Alt. •B" AbOVE Plee Determired by E�gir�eering A�eenent Neoessary [ ] Nat Neaessary [ ] =:�1 � ,. ' �+;�� 4 �I� �«:i��. 1 �e Qiief Building Official shall, before issuing permits for the erection of any building or structure, or for any adciitia�n to any existing building or structure, ar 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 belaw set forth and in the ma�vrer herein pra�vided to-wit: �TAL VALUE S1 to $500 5501 to 52,000 $2, 001 to 525, 000 525,001 to 550,000 '. � �+ S15 Q�iinimua �ee is S15 plus surcharge � S15 for first 5500 plus S2 for each additiona]. 5100 or f raction therea�, to ar� including 52,000 $45 for f irst �2, 000 plus �9 for each additional $l, 000 or fractiari thereo�, to and including 525,000 5252 for first S25,000 plus $6.50 for each additia�al. �1,000 or fraction thereof, to and ir�cltuling 550,000 550,001 to 5100,000 $414.50 for first 550,000 plus 54.50 for each additional �1,000 - or fraction thereof, to anc7 including 5100, 000 5100,001 to 5500,000 5639.50 for first 5100,000 plus 53.50 for each additional. 51,000 or fraction thereof, to anc7 including 5500,000 a:,�0,001 to �1,000,000 52039.50 for the first 5500,000 plus �3 for each additional 51,000 or fraction thereof, to and including 51,000,000 51,000,001 a�d up 53539.50 for the first 51,000,000 plus �2 for each additional �1, 000 or f raction thereof DIZT Y DEP F��ON cY _R�w (Concrete Curb Streets Only) Alternate "A": Renwal and replaoement a� curb and gutter a�nly - Driv�ay width plus 6 feet times 513.50. Alternate "B°: Renaval ancl replaoement c� curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet ti�s 515.75. 1�+: � �+• M �� " ��.�1� � : � �� Permits for construction will be issued a minimum of 24 hours f rom the time of applicatian to alla�w for proper review a� the prapo�ed structure and of the aonstruction site. A Certif icate of Sluvey of the lot, showing the loc�tion of the fauidation once it has been oonstructed will be required before prooeeding with the franing. y- .a .. ' � � SU8J8CT � , � - c�ty of Fridley 30638 � AT THE TOP OF THE TWINS g � � � p 1 N� P E R M I T i� � COMMUNITY DEVELOPMENT OIV. R� � LV �� , � r � � PROTECTIVE INSPECTION SEC. � � _ � � �"'1 � CITY HAIL FRIDLE� SS13Z NUMBER REV OATE PAGE OF AVPROVED BY �""'�� '� 612-571-3450 9t0-F15 1/25/00 / / 108 ADORESS 773 Bennett Drive NE 1 LEGAL L07 NO. BIOCK TRACT ON AODITION SEE ATTACMED oescA. 10 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL AOORES$ ZIP PHONE Vince Gonzalez 773 Bennett Drive NE 571-3816 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Sela Roofing & Remodeling Inc 4100 Excelsior Blvd, St Louis Park, MN 55416 4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO. 823-8046 1050 5 ENGINEER MAII ADORESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (22 Sq) Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS � Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITSARE REOUIREO FOF ELECTRICAL, PLUMBING. HEATING, VENTILATING OR Alp CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WOiiK OR CONSTRUCTION ZONING SO. FT CU FT. AUTMORIZED IS NOT COMMENCED V�!ITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERI00 OF 120 DAYS AT ANY TIME AFTEq WORK IS COMMENCED. NO. DWIG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TNIS APPLICATION 1 STALLS GAFAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAW$ A�UATION SURTAX ANO ORDINANCES GOVERNING THIS TYPE OF WQRK WILL QE COMP41E0 WITH WHETMER SPECIFIED HEREIN Oii NOT. THE GRANTING OF A PERMIT � 1, 923 $.9C) DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL TME pEqMIT FEE SAC CMARGE ROVISIONS OF ANY OTHER STATE OR LOCAL lAW R L'ATING CON- R CTION R T E PER�NCE OF CONSTR N $69.25 Fire �'i �1.92 � P�AN CHECK FEE TOTAL EE License $5. $77.13 tUAEOFCON'AACTOAOp uT aiZEDnGENi iDATE� W N P OP ALIDAT D HIS IS Y UR PERMIT � s��_ S�GNATUAE OF pyyNEQ��F OWNEA BUROEAi �DATE� g�pp i p�iE t t �w [ l ADDN ALTER Il Il Effective 5/10/99 CITY OF FRIDLEY SINGLE FANIILY AND DUPLEXES R-1 AND R-2 �" BUILDING PERMIT APPLICATION Construction Address: �% ,j ��i � e � � /z . Legal Description: �� 1�:�' � Owner Name & Address: �) �I C � � �h Z a �S Tel. # (��- � �� Contractor: _��F.,� -��p�y�� REhtiODF�I,I�TG, %�1�a NIlV LICENSE # 10 �� 4100 EXCELSIOR BLV�. Address: r,� T g�� ARK, �T 56416 Tel�# ��-� �� Attacl��o��iplication, a�ertificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTI�R: Length Length Length DESCRIPTION OF IMPROVEMENT m Width Width Width Height Height Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. _ _ . Construction Type: �-� � � � Estimated Cost: $ �'� ! � Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �—�'`f`Up APPLICANT: Tel. #� �� 3 ��° Permit Fee Fire Surcharge State Surcharge SAC Charge License S�rcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: � C� . �s� $ , 02 $ � (o $ $ - �� $ $ $ $ $ %% /� CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuaxion (1/lOth%) $.50/$1,0� 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 [ ] < < BUII.DING PERNIIT FEE SCHEDULE The Chief Building Official shall, before issuing permits 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 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 $1 to $500 $501 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,Q00,000 $1,000,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.� for each additional$1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,�0 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,Q00 $993.75 for first $1(30,�0 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,(�0 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 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 $15.50. 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 tunes $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper 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 be required before proceeding with the framing. �