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AF - 43499sue�ecr PERMIT City of Fridley 17 0 9 2 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � � � , � RE . � i y_ COMMUNITY DEVELOPMENT DIV. Q,�Q U r � • � PROTECTIVE INSPECTION SEC. �/ 0�' �� i � � �l A� /'�'1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BV i.•��'J\: �.J 612-571-3450 910-F15 8/15/83 � � �oe A��s �rigadoon Place 1 IEGAL �OT NO. BLOCK TRACT OR ADOITION SEE ATTACHED DESCR. 6 2 Blomber Estates SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Garjac Inc. 3 CONTRACTOR MAIL ADDRESS ZIP pHONE LICENSE NO. Gar'ac Inc. 481 2 A - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING residential 7 CLASS OF WORK Ox NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construction 44 x 27 ft house and 24 x 30 garage 9 CHANGE QF USE FROM TO STIPULATIONS 1. Provide a verifying survery before capping. 2. PRovide sode in front and side yards 3. Provide a hard surface driveway TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED fOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. OOCI �FY�a 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 �OH3 '�' 64Z OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT ANV 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 67,850 31.43 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- 'z9,00 425.00 STRUCTI OR THE PERFpAMAN OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE � $ — <5-�� 57. 25 762. 68 SIGNATUFlE ON'RACTORO AUTHORIZEDAGENT IDATEI � EN PRO FLY�D THIS IS PERMIT i / fi � � __ [ v SiGNATURE OF OWNER 11F OWNER BU�LDERI �DATEI �'- BLDG iNSP DATE A CITY �� FItIDLCY A('PLICATIO'� FOft RCSIDLi'�TI/tL I3UILDIi�G PE(L'�ITS (Ne►•r, Alterations, Additivns, or Repairs) Ot�NER: ADDRESS: %✓�%v � � P� �� TEL �0: Effective Auq. 1, 1981 . �[3UILDER: �,i'i'� �� C l � C IIDDRESS: �l� � � OG ��-P y�- TEL f20: �%3 �� "1 ��D 7 � ConsLruction Location STTtI��' AIO: . �S �U STItEF.T: �. � -�^� �� L07': � BLOQC : � _ ADAZTZON : �� d0 !'�/ h P -Q y_ �-S�' �� J Corner Lot: Insicie Lot: �_ SetbacY.: 3� Sideyards: �� Ap�licant attach to tl�is form two Certificates of SUrvey of lot and pzoposed building location drawn on certificates to scale. DESCRIPT10�d OF CO��ISTF�JCTIO�J � �� / _�eS� Tront: � `'� Depth: �'"� � Height: � Squane Feet: /U� (�bic Feet: , V f}1Q,/-;C•�� Front: �.� � Depth: �' Height: �Q � Squar.e Fe�t: (p o�' Gubic I'eet: _ �d10 � v� iype of Cor�truction: ��/9�/�'I F' Zb Be Obr.�pleted: � CT /r . 6?,8 Estimated Cost: $ , G� B Alt. A Alt. B Proposed Drive�•ray Width If New Opening Is Desired: _ , S�E F.EV£R�L' SIDE OF SFIEET , 15ie undersianed hereby mal;e� applic�ticn for a permit fcr the �:ork herein specified, agreeing to do .all work iri strict accordance ��ith the City of Fridley Ordii�ances aiid ruling� of tlte De�kzrtment of Builc3ings, and hereby declares that all tl�e facis and representatiens stated :n ttiis applic�ti� are true and cpjrrect. s� n.�T�: �-� y' r�� SIGNATUF•c : Stii�ulations : , ;. a � ` • r , . , � � . ' � .. « w � 6��""� 22�' � j P.e S"? ,Z � . . '� 3 I . �t 3 �e. u'��A. a► � � .�. � �� i 1 f � � � f � /"Yd - lC� v � ' � i.� �SC1�OGC� :1_ � i • - y�� - � - � - 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 repairs to any existing building or structure, upon application therefore, require the payment by the applicant for sueh permit of Pees to the amount herein below set forth and in the manner herein provided to-wit: . - �- _, .� �1.00 to $500.00 �501 to $2,000.00 $2,001 to $25,000 �25,001 to #50,000 f� $10.00 (Minimum $15.00) �10.00 for the first $500 plus $1.50 for eaeh additional $100 or fraction thereof, to and ineluding $2,000 �32•50 for the first $2,000 plus �6.00 for eaeh additional $1,000 or fraction thereof, to and including �25,000 $170.50 for the Pirst �25,000 plus �4.50 for each additional �1,000 or fraetion thereof, to and ineluding $50,000 $50,001 to $100,000 �283.00 for the first $50, 000 plus �3•00 for each additional $1,000 or fraction thereof, to and including $100,000 ..$100,001 and up �433.00 for the first �100,000 plus �2•50 for each additional $1,000 or fraetion thereof Plan Cheek: 25 pereent of building permit fee. DriveWaq Depression LseroW: Concrete curb streets only. Alternate "A": Removal and replacement of eurb and gutter only - Driveway width plus 6 feet times $13.50 Alternate "B": Removal aad replacement of curb and gutter and install a 3 foot wide approach With 6 inch depth - Driveway width plus 6 feet times �15.75 ' - . � I - '. �.. . � Permits for construetion Will be issued a minimum of 24 hours from the ' time of application to allow for proper review of the proposed structure � and oP the construetion site. � W Or A CertiPicate of Survey oP the lot, sho�ring the location of the foundation ('j+ once it has been eonstrueted.�rill be•reQuired before nroceedina With the �j framing. � � ` ... � . � �.w �, �° � � � � � (�11! .?6) +�22 �r 2� � 10'��{ x39l� � . .. 4� � .` . V.P. � - � ,.� ��l3tc ��+ `l't�Z,�r't� � = IO�� x 3`�: Y`,,` + ' -' � G'p�� .Z�,�,!(`�x h� _ � Y'�1� �a��r `��''� � — c�ty of Fridley AT THE TOP OF TME TWINS f � � � t . COMMUNITY DEVELOPM�NT DIV. ' ; V �� , . r � � PROTECTIVE INSPECTION SEC. � � � � �"'1 � CITY NALL FRIOLE� SS132 �""'�� ,'� 612-571-3450 �os Aooaess 7570 Bri adoon Pl aC NE t IEGAL �OT NO. BIOCK TRAC' oescR. g 2 Blo 2 PROPERTV OWNER MAIL AOOR�S$ Dan & Anqela Richev 3 CONTRACTOR MAII ADORESS Daco Inc. 14510 45th St NE R� � ARCHITECT OR OESIGNER MAIL AOOqESS 5 ENGINEER MAIL ADDRESS SUBJECT .. � � � �U ILDING PERMIT 910-F15 REV OATE 6/18/99 ZtP ZIP PAGE Oi � � PHONE PNONE PMONE NO. 29716 �� annOVEO B� SEE ATTACNEO SHEET LICENSE NO �.i Rn IICENSE NO. LICENSE NO Residential 7 CLASS OF WORK ` O NEW ❑ ADOITION �� ALTERATION � REPAIR O MOVE O REMOVE B DESCRIBE WORK Rebuild roof - Fire Damaqe, all trusses & ioist realaced 9 CHANGE OF USE FROM STIPULATIONS TO See stipulations on plan. Underlayment must comp1y with the State��'T Building Code. ... -- -- - SEPARATE PERMITS ARE FEOUIRED FOR EIECTRiCAL. PLUMBING, NEATING. VENTI�ATING OR AIR CONDITIONING THIS PERMIT BECOMES NUIL ANO VOIO IF WORK OR CONSTRUCTION ZONING AUTMORIZEO IS NOT COMMENCEO VyITHIN 60 OAYS. OA IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT ANV TIME AfTER WORK IS COMMENCED. NO DWIG. UNIT; I MEREBY CERTIFV THAT I HAVE READ ANO EXAMIN�D THIS APP�ICATION AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VALUATION ANO OROINANCES GOVERNING 7HIS TYPE OF WORK WILL QE COMPUED WITM WMETHER SPECIfIEO HEREIN OR NOT. TME GRANTING OF A PERMIT X�� 55 DOES NOT PRESUME TO GtVE AUTMORITY TO VIOLATE OR CANCEL THE pERM1T fEE PROVISION$ OF ANY OTHEfi STATE OR LOCAL LAW REGULATING CON• ��X�� G TR CTION OR THE PERfORMANCE OF CONSTRUCTION �� PLAN CNECK FEE ti�� /�� 7' L 1 C C S�GN11iURE0 CON"FAC10AOpAUTMOQ�ZEO�GENT iD�TE�� HE PF S�GaaTUAE O� OwwEA�� OWNEABU4DEiii iD�TE� � - B c. �N5 Permit Inspection Cards Wili Be Mailed To Homeowner To Post OCCUPANCVGROUP OCCUPANCVLOAO SQ.FT CU FT OfFSTREET PARKING STALLS GAf;AGES SURTAX 000 ` �CgX�� $27.50 SAC CHARGE �8.75 F' e SC ��x�� $55.00 a� FEE $5. 0 ��x�� $766.25 �Y VAU D TMIS IS UFLP�R�yyj/j jf/� �'� C r�c T t � . NEW [ ) ADDN ALTER Effective 5/10/99 [ ] CITY OF FRIDLEY [ l SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUII,DING PERMIT APPLICATION Construction Address: Legal Description: ��W � b� �� Owner Name & Address: L"�Q„ � A n�,��4_ 1? dc�,e� Tel. # Contractor: �� a c o .� h ! MN LICENSE # 3/ ftC� , Address: � y3!!� �/_ �'y S �' n/G • �o�p�� ,� 3 ?�Tel. # �/z �/p�'-3p�v Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIP'rION OF IMPROVEMENT LIVING AREA: I.ength C� Width Height� `� Sq. Ft. / GARAGE AREA: Length .: Width Height ' � Sq. Ft. DECK AREA: _ _ Sq. Ft. OT'HER: -- ' �_� ( = C _ — ( �Z � t4 �� L-L. �i�-�SS�'S �� .JU� S � (� C=� �o �onstruction Type: � ' Estimated ost: $ S,S'G�. �' Driveway C�rb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �/�� APPLICANT: �,� ,, CITY USE ONLY Te1. # y9%-35'00. _. __ �(�� Permit Fee $ ��J�-�. Fee �chedule on Reverse Side (�v�8- �S� Fire Surcharge $ � • �� .001 of Permit Valuation (1/lOth%) �S. • �a State Surcharge $ �, �S ^$.50/$1,000 Valuation v� �, s L% SAC Charge $ $1050 per SAC Unit � D 0 License Surcharge $ s, � Q(� $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above l%lo�o.�s Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ $ $ � d- s?� $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ J Not Necessary [] �-��_S � O� �9Sv � � �s� � � � (�?. �� c� _._______ � (� 0 � �� w � \' - �--�"-._._...___, � �. � �-�------��--- - � c � ��`--..'`�-�----....._ u,l � � � � �` � . 3� � � � � � � , �� , � �, °c� �"7� � vi � y �� _�---- _� � � d �� !� ~ � �� '� ? � � �� ' � ' �s � � (�' � � �\ s . • �� w � � r ` � � � �� m �. 3 ` v a\ � �, � � c� � � , T d� � N�� T _ � � � ti � � � � _ ____.__. �� __ . _ n_�_�..___�______ �J � E� � �� ` " V � � w � �. � � � �t�,�� "i � . .�"�'�� . .,,..__.,__ � � � �/.. � .�,�. ,�....�,,,,,, � �..._. . ... W � � \ \� � � � i� �, % � . � __ ....,. ..... ,........._,,,�l�'r'-;�!r d� ` ` ` �� '. � � v ' � � �. e � �— s--�-_� °n - , J -- __ _ _ � , � � -� - _ ____. __ _____. , _ . __ _ . � �-�, � v; �� ti � �� ` 1 � 1 � t ^ � � �! 1 v �.i i �1 � � ^� i� � � � Q s 1 r` C � � J� � � ♦ � � � � � � � t � � � � � � r U � � � � a� �o c� � � ,....._. _ ...�.... --� �'J f t � \ � � �� , � � �� 3 v � � � � � � `� � � � � .� �� `�- � � � : \ � � � � `� � �:.� y �� } �^-�- � �r✓°^ �� CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON FACH FI c�(�R Effective On May 10, 1999 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�" N0. RATE TOTAL � Gas Range** Gas Dryer** Back Flow Preventer Required ()Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or App(iance State Surcharge TOTAL FEE Z.�7U h/Z.�� $ .50 $ '� �� JOB ADDRESS �%S�7f� ��; � � �I oo.+�, 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. , 1999 Owner Building Used �f � Estimated Cost`�� t7 v PERMIT NO. /��" l�' PLUMBING COMPANY �o�i� P�6c, � d�ld� Fnc SIGNED BY `�.,,,,,,_ �,,,.,,.,,, TEL N0. �`�l' 9- 2c' 3� Approved By Rough-In Date Final Date �^�'� � *"COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES. __�. CITY OF FRIDLEY INSPECTION 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE DIViSION Effective On May 10, 1999 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent • Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes Rate TOTAL $ 30.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 25.00 $ All Others/Repairs & Alterations (LIST ON BACK) 1� of Value of ppli nce or Work / �,C�-2., + �7 G( �'�c., �J � Com ercial/In tr'al ��,�� 1.25% of Value of Appl' n e or Work State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. . �, $ $ .50 $ �-�S� �`O JOB ADDRESS_ 7�70 �� t� �c%a.�n OWNE BUILDING USED AS�e ��-- ESTIMATED COST � �f�o PERMIT NO.�� DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR 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 an rulings of the Building Division, and hereby declares that all the facts'and representations stated in this application are true and correct. HEATING CO /�"�n Plbs � '�!"�`/ Signed .�.. n � � CITY OF FRIDLEY INSPECTION DIViSION 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 (Side Vent • Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Ft'��' Gas Range -��"QP�� Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1 jo of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $ $ 10.00 $ $ 10.00 $ /� � $ 10.00 $ $ 25.00 State Surcharge TOTALFEE MINIMUIVI FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written perrrlission from adjoining property owner. � �/�i o2`%�'Ps ��`� '?/D � ' ` '�S� � $ $ JOB ADDRESS S � � OWNER �C�C( �/ � BUILDING USED AS_____�2� ESTIMATED COST Effective On May 10, 1999 �/ � PERMIT N0. I � � �1 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name Size No. STU HP EDR $ 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 an $ .50 rulings of the Building Division, and hereby declares that all the facts and ��5� representations stated in this application are true and correct. , HEATING CO ��1�%.�2/L Signed Approved ByU�_ Rough-In Date E /` Final Date �/ � sue�etr P O. c�ty of Fr�a�ey 30239 AT THE TOP OF THE TWINS g � I L D i N G P E R M I T r � . , � R �.°3 � • COMMUNITY OEVEIOPMENT OIV. � � �P - r � � PROTECTIVE INSPECTION SEC. � � . � � �""1 � CITY NALL FRIOIE� SSIJ2 NUMBER pEV O�TE P�GE OF •PPROvEO Br �----�•• •,, 612-571-3450 9�0-Pt5 9/�20/99 / / JOB ADDRESS %5 B l t LEGAL �OT NO. BLOCK TRACT OR A�DITION SEE ATTACHED DESCR. 6 2 SHEET 2 PROPERTY OWNER MAIL AOORESS 2�P PMONE D Ri he - 3 CON7RACTOR MAIL ADORESS ZIP PHONE LICENSE NO Owner � ARCHITECT Oii DESIGNER MAIL AODRESS 2�P PMONE LICENSE NO. 5 ENGINEER MAII AODRESS 21P PHONE IICENSE NO 6 USE Of BUI�DING Residential 7 CLASS OF WORK O NEW �� ADDITION O ALTERA710N �Q REPAIR O MOYE D REMOVE 8 DESCRIBE WORK Construction of a 19' x 13'6" Deck 9 CHANGE Of USE FROM TO STIPUTATIONS See stipulations on plan �� Befa�C di�gi�g Ca!( f0i ail utii�ty locations 454•0002 . � REQUIRED BY LAW TVPE Of CONST. OCCUPANCV GROUP OCCUPANCV LOAD SEPARATE PERMITS AqE REOUIRED FOR EIECTRICAI, PLUMBING, MEATING, VENTILATING OF Alfi CONDITIONING THIS PERMIT BECOMES NUIL ANO VOID If WORK OR CONS7RUCTION 20NING SO. fT CU FT. AUTHORIZEO IS NOT COMMENCED WITHIN 60 DAYS. OR If CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONEO FOR A PERIOO OF 120 DAYS AT ANY TIME AFTER WORK iS COMMENCED. NO DW4G. UNITS OFFSTpEET PARKlNG I HEREBV CERTIFV THAT I HAVE REAO AND EXAMINED THI$ APP�ICATION STALIS GARAGES ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUiiTAX AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED �2444 �Z.ZZ WITH WHETHER SPECIFIEO HEREIN Ofi NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME 70 GIVE AU7MORITV TO VIOIATE OR CANCEL 7kE pEqMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCA� LAW REGULATING CON- STRUCTION OR TME PERfOiiMANCE OF CONSTRUCTION �B�J.ZrJ Fire C�2.44 PLAN CNECK F TOiA E $ .91 SiGWAi1JREO�CON��7ACiQqOQ�UTMOQ�ZEO Ear �OarE� EN ROP ALIOAT TNIS IS R P FMIT � 7 ^ � C ,G � � :1 - � � ` � 1 y, ��-�l" �- �S�GHSivaEOa EQ�i%OWHEQBWIDEQ� �O�TEi B G �ti5� �i�iE r�vv [ � � ADDN ALTER Effective 5/10/99 [ ] CITY OF FRIDLEY [] SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2 BUII,DING PERMIT APPLICATION ��°3o�a-35 Construction Address: ��7p �GC�(',�dc�cxV %�` . �'`c� C� r �,KK�{,/ S3'`f�z 36 2�1 Legal Description: ��,(j f,�G ,�ST�lI'f,s . I_�T C. t3LOLK �- Owner Name & Address: �,f,�/ ,�,��' � Tel. #1 iZ -�d'3-S�Zd�S Contractor: S �L � MN LICENSE # Ad�ress:__. �,.g�r� �go,�,�— Tel. # Attach to this application, a Certificate of Survey of the loe, with the progosed construction drawn on it to scale. LIVING AREA: Length DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length �e� Width /3'6 " Hgt/Ground� `�Sq. Ft. � OTHER: �G d. Construction Type: ��S�t aG�j ��Z,�,r Q�•yrgG� Estimated Cost: $ � �� ,�6 a�oX 9 = r Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ � DATE: �� APPLICANT: � Tel. # 6' �Z - �� Zd�.Sr Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: �3 ��"' $ ` . $ l �Y $ $ — $ $ $ $ $ �� q� CITY USE ONLY Fee Schedule on Reverse Side 001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1050 per SAC Unit $_5.00 (State Licensed Residential Cont�actors). : Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] r tj',: �i'� r'!'!� 3 � �,i� �b�� ,�,�5� � � '� �` Y �� i� � ,��' r��a � ,,L -�' �/�r/t/� C.�� ► jt°''� � ��P �'�� ?X � �. z��G, /r � ;��'� � � � , ��f;� �� ,,,�� .� r. �:�,�. � �-.-.. .y...� ; �� --- .. � -�--��._ �_ .�: - :..:� C,; �� .� �,. ��"il.s�� va /s � '�' ��% . .� ` '�-4..�.... � � _ s �� .� �v�� , .�� . .�/� -� � . _ ,. l� :��:� _� � � � � , ------� ;� � . _ ��-. ..r-�- �� -�-� - -- - � ' '' �.__ _ __. _ _ �"' . � ,� _ . -1 �'7�f�-/y`z''� � � G'��✓�C�93c� 7/b��"�1_ :� � � .LS/D�'��--: �. �rr 1 �io�a --�-t�-r%�' _ -- � � � ��'-�' ,, ; p / � ��/Q J �r%��, /~�GEg ly� - a. ��-�J-a3'''`� .� ��_� ��,�.��.,3i.� : .% -7 /b/2LGat,b" ,� �4%!i '' . � ,'� , , � i � ��J�p � �,,�� C� ��f{� � �r,�• � � , ;,. . - , .. _ . ,_ . . : � - -. r� �� . - ,� . 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