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AF - 42885� � �� r � � �L '� Certificate �.:� �� ,:. uqnu suRtrt�roRS • CML pVqNEQtS LAAID PLANNERS . LANDSCAPE ARCHITECTS of Survey for: I�ouse Address: Fdouse �Ic�del: ;� + ;�_ . , , :*_ - � • �e , s C.�I�TE.�T,�'O.�i � � _ ____ _ CO �JRT � 54. 5 V� Cc3.T� � �s c �� o� �� d � � % -� / ----- � � ��:.ci0�� SATELLI�'.� LA�TE 2422 Enterprise Orive Mendota Helghta, MN 55120 (812) 881-1914 FAX:881-9488 825 Highway 10 N.E. Biaine. MN 55434 (s�a) �a3-�8so FAx: �a3-�� P 0 � K eoo.o D�ct� Exrs4rng Ele,notron P�oPOSEn .�� vATpnl�Ts '� Denotes Proposed Elavotlon Lowest FIooP Elevotlon: 853•7 —� Dtnotes Drc/noge Flow Direction Top of �lock E�evotlon; �56.4 �'� De»otes Droinag� dc Uttllty Fa�ement Garage Slab Elevatio�: 56 (at door) ---a- Denot� Monument NOTE: Proposed buildb�g �(to qrading ta &� Qe�rdo�� s --�— Denotes Of�et Iron B�ordng� s�otar� are osst�med ��9 �l�a °�O� b=' �0 etty enyin�. NOTE: Contraotor muat varify ap olmenalona de driveray do�qn. LOT � .�LOC�' � C.�1'�IST.EIV��V C1��SI�TG RAMSEY COt1NTY, IWINNESOTA We hereby ceriii`y that this aurvey, plan or roport was prepared by me or under my direct �pervis�cn cnd that I a duly licens�d Land Surveyor under the laws of the Stofe of Minnesota. Dated this �15i day of -%�1-, A,D. 19�7, --�— Signed: PIONEER ENGIN ERING, P.A. ...m-�"_.._",� s c� l�. 1 ch =� O teet By. �"` Robert B. Sikich� LS. Reg. No. 14891 or 23 16190.09 TF2B ` Terrence E. Rothenbacher, L.S. Reg. No. 20595 �.� sue�ecr PER c�ty of Fridley " 5 � 4 5 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T i � i � • COMMUNITY DEVELOPMENT DIV. � r � v � PROTECTIVE INSPECTION SEC. ��`� � 1 ; r (---_ w �"','j CITY HALL FRIDLEv $$432 NUMBEP REV OATE PAGE OF AVPHOVED BY L �� 612-571-3460 910-F15 8/5/97 � � J08 ADDRESS 152 Christenson Court NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. �+ 1 Christenson Crossing SHEET 2 PROPERTV OWNER MAIL AODRESS 21P PHONE The Rottlund � Company Inc 2681 Long Lake Rd, Roseville, MN 55113 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 638-0500 1335 4 ARCHITECT OR DESIGNER MAIL ADDRESS LIP PHONE LICENSE NO. 5 ENGINEER MAII ADDRESS ZIP PHONE IICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK � NEW O AODITION ❑ ALTERATION p REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Construct a 42'6" x 25` Townhouse and a 22' x 20' Garage 9 CHANOE OF USE FROM TO STIPULATIONS See notations on plan. Paid Park Fee of $375.00. �� efore digQing c�il far �� Utf�l�}I �OC�tIA�IS SEPARATE PERMITS REQUIRFD FOR ��QUIRED BY 1NIR1�1G. HEATING, PLUMBING AND SIGNS� �� SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBIN(i, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. fT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, Oii IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTEH WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I MEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yq�UATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED $111�7Z7 �SS.86 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEpM�T fEE SAC CHARGE PROVISIONS Y OTHEFi STATE OR LOCAL LAW REGULATING coN- $947.25 Fire SC $111.73 STR OR THE PERF AN OF CONSTRUCTION. � PLAN CHECK FEE T07AL FEE , $� License SC $5.00 $2,069.84 + PF SIGNA FCON7RAC AUTHOAl2E�AGENT iOATEi WHEN PROPERIY IDATED TNIS iS YOUR PQERMIT /�o �� l S�GNATUFE OF OWNEAiii OWNER BUILDERi iDATE� BLOG NSD r�aTE NEW AD�N ALTER [] [l [] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress:_ �,�j� �� Legal Description: �'� � Effective 1/1/97 �� J , ,� �� Owner Name & Address: � uE �� ;� ��, ��,, yy ( NC„ Tel. # ..��pp Contractor: S� m� MN LICENSE # � 3� Address: �?�Q$1 �JC� ��{E, '�cyc�ll ��d � �.l.�E , ,�� 5ll Tel. # (� J$ -� Q �O LNING AREA: GA►RAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the . lot, with the proposed construction drawn on it to scale� � 2? �s�; DESCRIP'.CION OF IlVIPROVEMENT �N/�^', x ! �,�� ,s�'7 �3� ca. sy� �r= , �l$��l Length �-U+�� Width a`j�-�'� Height Z�-o�� S Ft. � ��y q• .� ' Length GZ'"0'� Width ZD'-p►, Height �po' Sq. Ft. �%�(�%� q�Z' � yq �n� � Width �' Hgt/Gro�d �— Sq. Ft. _—'�/� 5'' Ca � � � < , ��r Constniction Type:_�p ��Nl� � `��Jti17�1�1'`t Ip1l.Estimated Cost: $ � '/ 1, �D l ( Z7� °!`f (Fee Schedule on Back) Driveway Cbrb Ciut Width Needed: Ft. + 6 Ft = Ft x$ —$ DATE: � 02� ' APPLICANT: � r Tel. # � �� ° � Permit Fee Fire Surcharge State Surchazge SAC Charge License Surcharge Driveway Fscrow Erosion Control Park Fee �ewer Main Charge TOTAI, STIPULATIONS: � � 7�� $ , 7.3 � ��'d � � �U° o $ 'S;� —.� $ $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) � .� $.so/$1,000 valuation � ' � $950 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review $_ � �r �° �� Fee Determined by Engineering Ea $ � y��y ��l E��. Agreement Necessary [ ) Not Necessary [ ] ,� ° �I ��l �� 3'�S • I3UILDING I'EIZ�vI[T FEE SCHEDULE T'he Chief Building Official sliall, before issuing perniits for the erectio» of any buitding or structure, or fi�r an}� addition to any existing building or structu�e, or for any alteration or repair to any existing building �r scructure, upon application therefore, require the paymen[ 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 $�O1 to $2,000 �2,001 to $25,000 $25,001 to $50,000 $50,001 to $lOQ,000 $100,001 to $500,000 �500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) � $21 for first $500 plus $2.75 for each additional $100 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 $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for. first $5.0,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $1p0,000 $887.25 for first $100,000 plus $5.00 for each additional $1,OOO�or fraction thereof,.to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to.and including $1,000,000 � $5012.25 for the first $1,000,000 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 �vith 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATIO`T t Pcrnii�s for construction will be issued a minimum of 24 hours from the time of application to allow for proper re��ie«• of the proposed structure and of the construction site. r1 i:�:•tii icate of Survey of the lot, showing the location of the foundatio�l c�nce it has it has been construct�:! ��i:: ��,: requir�d h�fore �r��cecdin� �vith the framinR. 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I�tOI.L�'�I3I?I�A g�dJ.S Ql�i1� X�� . � � :, Client: Address: City: Phone: Fax: Comment: Rottlund Homes 2681 Long Lake Road Roseville, Minnesota 55113 638-0500 638-0501 YOUR BUILDER FOR LIFE Project Name: Reference City: Daily Temperature Range: Latitude: Elevabon: Winter: Summer: Outdoor � Bulb -20 95 Company: Representative: Address: Ciiy: Phone: Fax: Comment: �neapolis, Minnesota Medium 44 Degrees 834 Feet Outdoor Indoor Indoor Grains Wet Bulb $� � Bulb Difference N/A N/A 72 N/A 75 50% 75 36 Total Building Supply CFM: 664 Square feet of room area: 2,054 ��-��70 �v Flare Heating � Air conditioning, Inc. Randy 9303 Plymouth Ave. N. Golden Valley, Minnesota 55427 542-1166 542-3101 YOU CAN FEEL THE DIFFERENCE CFM per square foot: 0.323 Square feet per ton: 1,197.276 Total heating required with outside air: 41,498 Btuh 41.498 MBH Total sensible gain: � 14,608 Btuh 74 % Total latent gain: 5,147 Btuh 26 % Total cooling required with outside air: 19,755 Btuh 1.646 Tons (based on sensible + latent) • � 1.716 Tons (based on 75% sensible capacity) Calculations are based on 7th edition of ACCA Manual J. All computed results are estimates as buiiding use and weather may vary. Be sure to select a unit that meets both sensible and latent loads. Component Area Sen. Lat. Sen. Totai Descri tion Quan Loss Gain Gain Gain 4A wndow Double Pane & Storm Clear Glass Wood Frame 189 5,929 0 5,389 5,389 11 C Door Metai Polystyrene Core 40 1,730 0 444 4�44 121 Wall R-19 + 1/2" Asphit Board(R-1.3) 1,495 7,564 0 1,940 1,940 15B Wall 2-5' Below Grade 8/12u BIk+R-5 530 3,608 0 0 0 16H Ceiling R-38 Insulafion 1.027 2,457 0 1,175 1.175 21 A Basemt Floor 2' or More Below Grade 1,027 2,268 0 0 0 Subtotals for structure: 4.308 23,556 0 8,948 8,948 Active People: 4 0 920 1,200 2,120 Inactive People: 0 0 0 0 0 Appliances: 0 0 600 1,200 1,800 Lighting: 0 0 0 Ductwork: 0 0 0 0 0 Infiltration: �nter CFM: 87.3, Summer CFM: 58.2 229 8,834 1,424 1,280 2,704 Ventilation: Winter CFM: 90.0, Summer CFM: 90.0 0 9,108 2,203 1,980 4,183 Sensible Gain Total: 14,608 Tem erature Swin Multi lier: X1.00 Buildin Load Totals: 41,498 5,147 14,608 19,755 fotal Building Supply CFM: 664 Square feet of room area: 2,054 CFM per square foot: 0.323 Square feet per ton: 1,197.276 Total heating required with outside air: 41,498 Btuh 41.498 MBH Total sensible gain: 14,608 Btuh 74 % Total latent gain: 5,147 Btuh 26 % Totai cooting required with outside air: 19,755 Btuh 1.646 Tons (based on sensible + latent) 1.716 Tons (based on 75% sensible capacity) Calculations are based on 7th edition of ACCA Manual J. All computed results are estimates as building use and weather may vary. Be sure to select a unit that meets both sensible and latent loads. Component Area Sen. Lat. Sen. Total Descripfion Quan Loss Gain Gain Gain 4A Window Double Pane & Storm Clear Glass Wood Frame 189 5,929 0 5,389 5,389 11 C Door Metal Polystyrene Core 40 1.730 0 444 444 121 1Nail R-19 + 1/2° Asphlt Board(R-1.3) 1,495 7,564 0 1,940 1,940 15B Wall 2-5' Below Grade 8/12" BIk+R-5 530 3,608 0 0 0 16H Ceiling R-38 Insulation 1,027 2.457 0 1,175 1,175 21 A Basemt Floor 2' or More Below Grade 1,027 2,268 0 0 0 Subtotals for structure: 4,308 23,556 0 8,948 8,948 Active People: 4 0 920 1,200 2,120 ' inactive People: 0 0 0 0 0 Appliances: 0 0 600 1,200 1,800 ; Lighting: 0 0 0 � Ductwork: 0 0 0 0 0 Infiltration: Winter CFM: 87.3, Summer CFM: 58.2 229 8,834 1.424 1,280 2,704 I Ventilation: Winter CFM: 90.0, Summer CFM: 90.0 0 9,108 2,203 1,980 4,183 I Sensible Gain Total: 14,608 i Temperature Swinq Multiplier: X1.00 ' Zone Load Totals: 41,498 5,147 14,608 19,755 i .:.:, ............... ..��..�....� ....... .....•.,••:::....,•... •. •.. •.,, .... •. ...�. .. . .:., •.:.,..... :•..:•: .: :: �.....::..::.::.:.. ., . .. .:•....:.:: .:. . . . ... ....... .. f .,....�;:.:•::4:•'•.a :^.,�.}}•.'v.:�i:::::ih�•:•. 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U.....� ... .�... .. �'�..� . ♦ .. ..... ..�.... ..e .. . � �.v. . .».\......Z`. . ��?. . ..... ... v.a . \ . .}} .V: ..:.•. n.v.» ., •n tvh v•' \.N ,�•:•\s •: •`.•:: ... y,.,•. • .,. ;....� ... ..:. ............ .V'�. •. x\•�4 ti.. �..�. ..�. .. .n�\.� .S...L\. � . � ..\ ... . . . .. .� v... . ..\...� �v.�\ .\v .v...�44•ro: ....•4 . :'C:8 .ti.. a. ..aL.. �"�:�\ �:iti8?"^Ct.4:ti:^.n.•::v'o `. .� . v ��'ti• ..81�Y�..u_....1�.1Mi....•..•....�....A�..�...___._v`E..\....w�.....x.n..4...c......�.\\�.`�0...�....n...v.v�4_.�.._4\.4_._.xL4......__`______.__._`".__.."...._._�..... ..':s__..i......•.•.^\�4h•.•.�hh:.:r......'.�tt�.�.........A.\..1..�:n.u.."s._"S.o'�..•... :�'�::...a I � 5upply CFM: 664 CFM per square foot: 0.323 Square feet of room area: 2,054 Square feet per ton: 1,197.276 : �4�':.. . \ :• '�:..ti .' :•:•.\•:i�.tA�::4:•:'ti'.�v.•.•.••.• :•.Ltiv�\'uti�.�.' •d :4 �,•.;.}i.;.•: •.:kv.:•::. • i'•y4�\ .. i. . :•.ti\C•:•:'v:: •vi.,•,x,..�•v._.}y:.v. 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''c.:. x ..4 .�.,. .� . .,.4 :•. ..:...:........,...........,. ....,.;;ti� ......•.::..,` � �.... ..; .. .:...... ...;.>;.....:::...•::::...aa••x.�'`�::•>: , .e•.. `.\..Lts, ,•.,•: •.:+..•;::a:::a;y`.•;:.: , ••.,ti.a.�..,,., ....•.�s.'?:•> . .•,.::..:...:::::.�::::...... ...:••.t•:t:..�: •:�, �'�... .•:s..*o-:,... .�\\., ...\,�.:...,.. ......,..:, tit �,•..•....+?•:.`•.:..•:: :....,..,,,.:.....,..:\..,,.•,•.'°.`,+ . . . \....'�. ... .\ ..............,,'\ .... .. ?..:....... .. >q• Total heating required with outside air: 41,498 Btuh 41.498 MBH Total sensible gain: 14,608 Btuh 74 % Total latent gain: 5,147 Btuh 26 % Total cooling required with outside air: 19,755 Btuh 1.646 Tons (based on sensible + latent) 1.716 Tons (based on 75% sensible capacity) � ,J . ': , � [, i% .�' -. .. r •. _. -. .-.',.. ! ..-�P.:..,. ....� .. . . . . .. .:.�."�. ; ...a Y -.a .. : �. r' k_. HOUSE H TING TEST 1 RECORD i,�� i �' s , J � ; �� . ADDRESS -` �� -- � • � APT. FLOOR CITY �_.SUBURB Sl�E'.S �: �NT OWNE R � HEAT LOSS D T ST. ° " SOLD BV y��a�-� INSTALLED BY �� Elschieol Nlork Br Gas Lins Br TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER r S DESIGN MAKE MAKE OF BURNER _ Mod�l Model Serial �' Maa. BTU Roti�g __ INPUT MAKE OF FURNACE • AAodsl THERMOSTAT �� Valvs Limit Limit SsHing / — Fan Setting J ' Pilot Type Pilot Make Pilot Model �� Pilot Timing � Inq Vsnt Sisa CON V E RSI ON KIND OF LINER � �IZE N�r ` Draft Hood I�,s�ulotor Filters Sise � umber �� Chimnsr LocaHon � � (nsids�0utside Chimney Construction Smoks Bomb D►aft L.W. Cut Off Door Presauro._ Prossure �� r�Peresnt CO2 �� Dote Tssted — Input CFH Psresnf OZ p, '� Compony Testing Srock Tsmp. ___�� Peresnt CO � Name of Tsatsr _ Form 235 Wiring ; ��est Tap ��ight�►i,,9, Inat. ..-�'/ � � rn rn � � ld � � � � C O > � N W F- � � W a C7 2 � � Q c7 � Z Q C7 Z m � � J a � O � z O F a U J a a a � � Z O ►_- w � W Z Z } Q rNi ll1 ,a, 0 y � � u' > � o ti �c �p 0 � � C9 �I ('� '� N U c�o ti uni � � C� � � � � 1�w VJ � lJ.� � 0 Q m O � � rn c °� � m m � � � w Y � � � 3��U \ m U ip � t m � ` � L V � •� r�,, • al � � .� 3 � � � N U U 7 B. C m �.''. � �o a m � � a � 0 0 -fl C U � O O � t N f�tl � 'a U o � c a a � i° a a c � �a � Y O m Y `o •> ~ � 3 � � � � �'o �, 0 5 °: a�i � a � t p� m C N . 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N.E. FRIDLEY, MN 5543? •(612) 571-3450 • FAX (612) 571-1287 October 24, 1997 Rottlund Homes 2681 Long Lake Rd Roseville, MN 55113 Re: Final Inspection at 152 Christenson Court NE, Fridley, MN Dear Sirs: A final inspection was conducted on October 24, 1997 for the above noted townhouse. We found that the construction of the building complies, to the best of our knowledge and belief, with all the requirements of the building codes of the City and the State of Minnesota relating thereto, and permission is hereby given for the occupancy of said building. If you have any questions on this matter, please feel free to contact me at 572-3603. Sincerely, ' G' BARR RIESCH Building Inspector RJ/mh SUBJECT City of Fridley � AT THE TOP OF TNE TWINS g U I L D I N G P E R M I T „ ,� � • COMMUNITV DEVELOPMENT DIV. � � �: ---•-'� � � PROTECTIVE INSPECTION SEC. L_.-.� ��"' �,� CITY HALL FRIDLEV SS432 Nue�BER pEv � 612-571-3460 e�aF�S JOB ADDRESS 152 Christenson Ct. t LEGAL ��T NO. BLOCK TRACT OR ADDITION DESCR. (� 1 Christenson Crossj 2 PROPEFTY OWNER MAIL ADORES$ Anna McGonigle 3 CONTRACTOR MAILADDRESS Minnesota Exteriors Inc. 8600 Jefferson Hwv 0, 4 ARCHITECT OR DESIGNEFi MAIL ADDRESS 5 ENGINEER MAII ADDFiES3 8 USE OF BUILDING Residential 7 CLASS OF WORK OATE 7/16/98 21P ZIP PAGE OF / / PHONE i500 PMONE PNONE �26669 o. ��l APPAOVED B SEE ATTACFIED SHEET LICENSE NO. )2877 LICENSE NO. LICENSE NO. O NEW O ADDITION ❑ ALTERATION �7 REPAIR ❑ MOVE ❑ REMOVE 6 OESCRIBE WOHK 9 CHANOE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PIUMBING, HEATINd, rrPE OF VENTILATING OR AIR CONDITIONIN(3. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON3TRUCTION ZONINO AUTHORI2E0 IS NOT COMMENCED WITHIN 80 DAVS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONEU FOfi A PERIOD OF 120 OAVS AT ANY TIME AFTER WOFK IS COMMENCED. NO. DW I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS ypLUATI AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. TNE GRANTING OF A PERMIT SOO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRy!' OR THE P NC STRUCTION. 2], .( � PLAN CM r Lice� SIGNATUHE OF � RACTOR ii AUTMOiiIZED AGENT IDATEI � SiGNATl1RE OF OWNER i1F OWNER BUILDERI IDATEI � STALLS CU. FT. OFFSTREET PARKINC IGARAGES C CHARGE Lre SC $.50 iTAL FEE / >7.00 TNIS �OUF _P�� • 1 // � LOAD JUL-16-1996 11�08 FRQM CITY OF FRIDLEY TO �DDN [ ] . ;,, - ,.: CTl'Y, OF FRIDLEY . . . �,..; : :: � , . .. . LLTEiZ [ 1 SYNGLE FAMII:Y =AND � DUPLEXES R-1 AND R-2 �, �,. � . . , : BUILDING PF�.tMIT APPLICATION . -,: . : „ . . . .: .:-, . ; . :o�hvctionAddress: � 1� �, � �Js.or��.�,. � ��'� • ��1 �o, � 4933689 P.02i02 �� . ��,�7.. . � � �� -;� . egal Description: � � �- . . . � ►vvner Name & Address: ��. f�.� �� o�T�,� � , TeI. # �� °�� 'omtzactor• �,, �,�.�,�,�... � �,�: �, ,�,;�• MN Y.iCENSE � ��S a `� . , .ddress: �f� ��.�� `�e,�A c ��3�� Tel. # �8°�,`� �'�� .. '`�' ' Anach to this application, a Certificate of Survey of the lot, aith the propased construcaon drawn on it to scale. . . . . , , .... DESCRIPTION OF IlViPROVEMENT . ..., r . , ,._ ;.�:.. . .:,:� . _ . . . . . , 1VII1IG �12�A,: Length � Width � H�ight Sq. Ft. ARA►G� A1t�A: � � � . .. � .'Length �� - - � Width � Height Sq. Ft. � ECS AREA: � Length � �� Width � � � Hgt/Ground Sq. F� �� , Ir ►nStLIlCt10II �►pE: FSL1II12,t� COSL: $_ '"� r---�LA-� ' ��='��''��•�' -- ' • � � . � . � . lFee Schedule on Bac3c1 , . : iveway Curb C�t Width Needed: ��'�� Ft: �+ 6 Ft =� Ft x$ � _$ � .TE: ""� � �° � . � APPLICANr; . Tel. # ��'� �-� �'� . .. � . � . . .. CITY USE _ONLY �it �� $ �/ -�� Fee Schedule on Reve�se Side �e S�r�hatge $ ��.::: �.00i of Pen�nit�Valuation (l/lE)th°!o) te S�rc�arge $ � $.50!$i,000 Valuation .0 Charge $ $IOOQ per SAC Unit ' ense Surcharge � �- C� �' $5.00 (Stat� Licensed Residenual Contractors} :�eway Escrow $� AIt. "A". or Alt. "B" Above �sion Coauol $ $450.00 Conservatian PIan Review �C Fee $ F� Determined by Engineez�ing .. ver Main Cb�rge $ Agreement Necessary [] Not Na:essary [] 74TAL �'ULATIONS: �. ��a f * . TOTAL P.02