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AF - 42974�* � * PIOIVE�R * eng neer * * ,� * 2422 Enterprise Drive Mendota Helghts, MN 55120 wuu suev�s • crvn. aaN�s (612) 681-1914 FAX:681-9488 LAND PuNNERS . LANDSCAPE Af�H11ECTS 825 H)ghway 10 N.E. Blaine. MN 55434 (612) 783-1880 FAX:783-1$83 Certificate of Survey for: THE ROTTLUND COMPANY House Address: _ 6493.849b.6497 & 6499 Christenson Lane House Model: Ga ble Town.homes :�r: MISS'ISSIPPI STREET S89'46'00"E GA AA 50.00 S89'46'00"E x sao.o Denot� ExtatJng Elevatla� oa Danotes Proposed Elev+otfon ---�-- D�ot� Dralnoge Flow Directton � Denot� Dralnoge dc Uti/Jty Eoaement �-o�- Denotes Monume»t -� Denotes Offset lron BearJngs shown are assumed LOTS 16-19 . BLOCK 2 - DUTLOT A PROPOSEl� BD.iLDING ELEDATIOA�S Garage Slab Elevation: �63•2 (at door) N07E: Propoaed bu4�ng dte gradMg ia in aceadanee wtth ths gradtng piana approred by the city englneer, NOTE: Contraotor muat vsrHy aA dlmenela�a Qe driveway daatgn. CHRISTENSON CROSSING ANOKA COUN7Y, MINNESOTA We hereby certlfy that thls aurvey. plan or report was prepared by me or under my direct supeMalon and that I a duly Iicensed Land Surveyor under the lawa of the State of Minnesota. Dated thts ��W day of A�,�..i't A.D. 19°�. � Signed: PIONEER ENGINEERING;''P.A. Scale: 1��h = 30 eet BY�� F. ��,,� �__ Robert B. Stkich� LS. Reg. No. 14891 or � 16190.62 Tf2B _ Terrence E. Rothenbacher, L.S. Reg. No. 20595 sue�ec• HMIT NO. -'° c�ty of Fridley 2 5 4 21 ' ` AT THE TOP OF TME TWINS g� I L D I N G P E R M I T qECE1prA8_ r ``, COMMUNITY DEVELOPMENT DIV. r � � � PROTECTIVE INSPECTION SEC. ��"'/1 � 1 � � a.2� (.% � � /"'1 � CITY HALL FRIDLEV 55432 NUMBER REV DATE PAGE Of APPROVED BY �----� � ,'� 612-571-3460 910-F15 8/25/97 � � JOB ADDRESS 6493 Christenson Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 2 Christenson Crossing SHEET 2 PROPERTY OWNER MAIL ADOFiESS 21P PNONE The Rottlund Co 2681 Long Lake Rd, Roseville MN 55113 638-0500 3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO Same d ARCHITECT OR OESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO. 5 ENGINEER MAII ADDRESS ZIP PFIONE LICENSE NO. 8 USE OF BUILDING Townhouse & Garage 7 CLASS OF WORK C� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Construct a 26.33' x 30.33' Townhouse & a Garage 9 CHAN(iE OF USE FROM TO STIPULATIONS See notations on plan. Paid $375.00 Park Fee. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATINO, �PE OF CONST. OCCUPANCY GpOUP OCCUPANCV LOAD VENTILATING OF; AIR CONDITIONING. THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONIN(3 SG. FT. CU. FT. AUTHOF;IZED IS NOT COMMENCED WITHIN 80 OAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OA ABANDONED FOR A PERtOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFfSTREET PARKING I HEREBY CERTIFV THAT 1 MAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAWS VALUATION SURTAX Fire SC ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. TNE GRANTING OF A PERMIT $434�591 $21%.SO 434.59 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT fEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CO - STRUCTION OR TH FMANCE Of CONSTRUCTION �2,562.2.5 �3�8��.0� PLAN CNECK FEE TOTA� FEE � � �� $7,014.34 + PF uaEOFCOi �aaCt ORAUTMORIZEOAGENT �DnrEi WNEN PROPERIY IDATED TNIS IS VOUR PERMIT SiGNATUREOFOWNEAiifQWNERBUILDER� IDATEI BLD �NSP � ^ f�TE sn ; , I'i-��a.id Plan Check $ Fstimated O�st $ , Receipt ## CII'Y OF FRIDI�,`Y I' •� I I y' �1 • : I►I 1. ►`j 1: : �� 11� Effective 3/1/96 �} n ��- ��% CA17StYL1CtlOri Add2"�3S ��i"i� � 1'��`J e �,14�� 7Ari1riCj r?�i Description �,U°f Ofe . r�L�� l.A�l`,�E �� CR��i�.1C-s Owner & Address�NE�L, �p��_�VT L��F �,y uti� � r , ��. Tel. # 1p�$-� C�� N T R A C I� O R & A D DRESS _ S l=1 m C ✓-} l4 C3DW� 5 5 1► 3 Tel .# Architect & Address _�i4�71E A� �/E � 1 i M��y pN�.yy�� Kec1• # a� 3 5� E[1g7112@Y' & �C�SS �� w.�c.. . � Z� �Q �RIC�I� Q� i �l OI.IX �'/AL1� �JD �J• # � I 0 � J 5% /�% TYPE OF WORK J� New [] Addition [] Alteration -Describe _�O(�j'� -E ,e� �iT �n�� In�.L,.,±-�c�mE. `��,�� i� Applicant Signature � � Tel # � - � Date � � � S ' � � �Tm,DIlQG DIl�1SICflVS �9� iZ �-�" Width '3Z'_b" Height?�� Sq. Ft. - . �g # of Stories � OFC. AREA: L�ength Width Height Sq, �, WHSE AREA: Length Width Height Sq. Ft. �� '�� Width Height Sq, � , scs. Ft. _�!� x � �,1.5� sq. Ft . / Z UD x$ 3� sq. Ft. x $ [+�t �►o M ��. Cost/Sq. Ft. _ �valuation Gost/Sq. Ft. = Valuation Cost/Sq• Ft. = valuation $ z � �i $Zlqy�) $ ) � . •' • v • Building Use�E�i ►7 �tr,�1L construction Z�pe occupancy c�nup _��J Air Condi.tioning �Yes [] No Fire Protection Provided ❑ yes �To �R�vidH�ES Perf°rn�ance B°nd Am�unt $ {� � See Reverse for Schedule Received [] Yes [] No Pennit Fee $�'j�1, �S'� Plari Check $ �� Fire Sizrcl�arge $ � , State Suz'char5e $ o� /% SU sAC Charge �x9S'r' $ ��' . pp Erosion Control $ Park Fee ��r37s� $ /S—oo.caa Spec. Assessments $ Driveway Escrow $ � $8� See Fee Schedule on Reverse Side In �cess of Prepaid Amount - See Reverse Side .001 x Pezmit Valuation (1/lOth o) $.50/$l, 000 Valuation (See Sc11ed,, for >$1 Million) $9.Q'8 per SAC Unit (Plans to Nb�TCC for deteYmination) $450.00 Cbnservation Plan Review Fee Deternuned By Engineering Agreement Necessary ❑ Not NecP.ssaxy [l feet x $13.50/foot $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 1,000,000 1,000,001 and up $1 to 2,000 2,001 to 25,000 25,001 to 50,000 50,001 to 100,000 100,001 to 356,000 Over $356,000 BUILllING PERMIT FEE SCHEDULE $21 (Minimum Fee is $21 plus surcharge) $21 for lst $500 plus $2.75 for each addn'1 $100 or fraction, to and including $2,Q00 $62.25 for lst $2,000 plus $12.50 for each addn'1 $1,000 or fraction, to and including $25,000 $349.75 for lst $25,(}00 plus $9.00 for each add.n'1 $1,000 or fraction, to and including $50,000 $574.75 for lst $50,000 plus $6.25 for each addn'1 $1,000 or fraction, to and including $100,000 . • $887.25 for lst $100,000 plus $5.00 for each addn'1$1,000 or fraction, to and including $500,000 $2887.25 for the lst $500,000 plus $4.25 for each addn'1 $1,000 or fraction, to and including $1,000;000 . $5012.25 for the lst $1,000,000 plus $2.75 for each addn'1$1,000 or fraction PREPAID PLAN CHECK FEE SCHEDULE $29.25 $29.25 for lst $2,000 plus $5.85 for each addn'1$1,000 or fraction, to and includ.ing $25,000 • . $163.80 for lst $25,000 pllus $4.225 for each addn'1$1,000 or fraction, to and including $50,000 � $269.43 for lst�$50,000 plus $2.925 for each addn'1$1,000 or fraction, to and including $100,000 $415.68 for lst $100,000 plus $2.275 for each addn'1$1,000 or fraction, to and including $356,000 $1,000 (Balance due with issuance of building permit) PERFORMANCE BOND POLICIES When a building pernait is issued for a commercial, industrial or a multiple dwelling residential project which requires outside imgrovements,a Performance Bond or a Letter of Credit shall be submitted to the City. The bond will cover all outside improvements, including but not limited to landscaping, irrigation, curbing, blacktopping, screening fences, lighting, and storm drainage systems. Calculation of bond amounts will be determined by the building permit values. The bond amount will be 3% of the nuilding permit value up to a 2 million dollar project or a$60,0�0 bond. Actual amounts will be rounded to the nearest $100. The City reserves the right to require greater or lesser bond amounts based on unusual circumstances. Projects «ith no outside improvements, generally will not require a bond. Bonds must remain open until the project is fully completed. All bonds will be held over one winter and through the next growing season to insure the survival of all landscape installations. The City will then inspect these properties in August of the year following the initial planting. Bonds may then be released in October of that year if all improvements are satisfactorily completed. �> O � � � �i Z � � � O z � w � � � � C4" � � �` - Z \�.,j1 F� v p a� � _ � � � zd c� z �Z 0 �o � U �� o �� O F U � � � a o Qo 0 Z ` U � � a w �z —e-- z m � � Q � CS'O o '� � m v �� --o�m� �� F— � v tV �� ^�� 4� m O a � � c 'm � � � L � - oV ~ �� 3 �-- m U �m�� t � :� � a � .� _ m �� `o�.�'� .•- � m � � o � � � � m o t � � c � . w �- � 3 0 0, E � � � � o p 5 a -Q m o � m . t C �p N • � ' •� � °° � C � � -� � � � m a � � � � �. C � o. r- � m V �D `C�,�. , � ` � � P = -• � O t�-6, � � � 8 S °C � o � � � � 0 w _ � oC � � E � � Y '� .Ze "c� 3 O m m C � ' O � �� -°o � i � d t �>� �mm�n. � �ac�.n. � �LLa � W 0 � G� � \ � � .� � �� \� z � � a � � � � ¢ � W 0 U � � c� z q� � � � � � � 3 . rt 0 z °w � �. m �� c � O U a� � � -- CU a �, � � C � O m � � ZF-m \ 0 � � � � � S S S. O O N � � � rn � � � 0 � N � � ._ 0 c U a U � Z 0 � Z� �3 � .:. O � � �d. � �s fl- �a 0 � m m � =o s� � r 3 `o U � � �Q. �� 0 c m c� � � o � EN U � -� --.__ � J � � � °w � o �p z° m " � z � Z m R � � m m � � �r � � 8 z � � � 0 �, � p1 s w � � ti Q � O � 1 . � 0 c i�. � U � � � L � � � � _ m 3 0 � o. 0 a C c 0 � � c 0 � �. � � . _ _ _ __ _ ._ . .-- . o, ^ �_ i - . HOUSE EATIN�'r'TEST RECORD /' �� , - � � ., � ,..� �'" r ��r� � �' ` �� ,. A�DRE55 �!_"� � � ; � �� s ' �`"{� �� '' ° a �" "' 1�PT. FLOOR CITY „�� SUBURB. ,�' �� '�' � y i ✓ � OCCUPAN�.� �` %' � � OWNER -�f �- < «. .. ,,a:.a.� -°� a �->. ,� HEAT i.OSS,; _—DATE�ITG. INST�. �° -�f."� t � ��"' , ° - �., � - SOLD BY/ ''- '` s``"f"� ''�`° ''` ,��__ _ � INSTALLED BY ��/� �' , ``' �_ � � El�etrieo WorkvBjr"�� Gas Lin� dy !„�''`�- a. TYPE OF HEAT GA FA �`HW STEAM SPACE HTR. UNIT HTR. OTHER -= � � G/lSs,� D�FSIGN CONVERSION � `L� .�� tie'i;,'p. � �..n6,/f�jy ; MAKE 8 " y�� - �'�"' � MAKE OF BURNER Mod•I °� �=` `'° � � �� Modol �° c,, .' r. �, S�rial Ma:. BTU Rating INPUT ``�� ' �� f'�-� � MAKE OF FURNACE "��.t Model THERMOSTA � �— Valve Limit � Limit S�ftiny Fon Setting Pilot Typs � Pilot Make Pilot Model � ONTROLS �},t� %� ��P �, F,I��i!''Plug ` Vsnt Size ` `pf �'� KIND OF LINER J SIZE ,• NON�— z�'' ��.>' � � '"-, .� DraFt Hood Ta R,eqularor � �.' _ ,��-� t ,� � �, °" Filrors Size � a r" umbsr " ,rr """� f` � �- ` �� `-� Chimney Location � Insids, Outaids ��; � ' � �°�" �_� P Chimney Consfruetion Smoks Bomb ",�� 0 a y�n'��i!'�.. F`' �faft Pilot Timing ` t ,�� n.. L.W. Cut Off �� Door Pressuro_ �-� r... �' �„ � Preasure � � ✓ `f '� I ��d �� Date Tested — ,�� ;�__ Psresnt COZ —�.- Input CFH �;�� Percent OZ �"�`r�� Compony Tesling Staek Temp. � Peresnt CO Name of Testsr _ Fo►m 235 �j' � '`� Wiring — Test Tay Lig�hptinq .�' f6n v�A .O` � � rn rn .- z � � � � � O m > � d w � � Z 0 .F w � W Z Z Q � v � � � � N Z u. > � o O � � a°i � � U � �i u^i '1 � � � Z � � W � � � Q m O � m rn rn � � � � �. � � \ � �� d c 3 0 I � �� .� � � � w a � � .� � �a z � J V � � u � av n �� u r z a .. � � � o U y U � m � � Z N C • � m W � '� E � � 7 f~il J m w a v� O � � 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 � �: v,ci r ti�: r: o r: o 0 0 � � � � � � � � � � � � � z �I ( I I I I I I I (. I I Z � w � W � X LL C7 z m � � a 0 0 ui � N N %' v � � '� � d v U V � ,�-t C � �`' � �. N 3 � � a °� c° c Z a� c �� rn W � d � �f N �C . � •N C ��., �,d,, ' s • d N C U) C _J « U � a w� m'Y�° � F`- __� Z` LL a� ii o0t3 a� � ..o�p a a�'i � a�i � m ' o � � ' � � � � � ~� zommUa�cn333c7c7m � � o i O � � ( m � d ; LL O � $h'. ( � "s � s�' m � 0 � c LL m � 0 c I t rn � 0 � a m � > O a a a � 0 � � � � . m ! �rn � t U i a � a � . a �, � � ' o i �, � , � � LL i o I � ; o , a �� W w � � H � _ _ C� � I OF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNNERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 57 I-3450 • FAX (612) 571- I 287 July 23, 1998 Rottlund Homes 2681 Long Lake Rd Roseville, MN 55113 Re: Final Insgection at 6493 Christenson Lane NE, Fridley, MN Dear Sirs: A final inspection was conducted on July 22, 1998 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, BARRY RIESCH Building Inspector : 7 ii � ADDRESS PIN LEGAL DESC CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 FAX: : 6493 CHRISTENSON LN NE : 143024320205 : UNAVAILABLE : LOT l6 BLOCK 2 571-12i37 PERMIT NO.: 2004-02309 DATE ISSUED: 12/21/2004 i ' � � �� v. PERMIT TYPE : ELECTR[CAL PROPERTY TYPE : COMMERCIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION . NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. PH:763-784-3729 1;1 # INSPECTIONS # 0-100 AMP CIRCUITS 2 # 101+ AMP CIRCUITS APPLICANT LAZER ELECTRIC 8164 ARTHUR STREET N.E SPRING LAKE PARK, MN 55432 (763) 784-3729 OWNER GITTLEMAN MANAGEMENT CORP. 6493 CHRISTENSON LN NE FRIDLEY, MN 55432 ELEC PERMIT FEE - MIN (NON-RESI) , ELEC AMP SERVICE FEE ELEC CIRCUIT FEE (0-100 AMPS) ELEC CIRCUIT FEE (101+ AMPS) STATE SURCHARGE, ELEC FLAT TOTAL PAID WITH CHECK # 42761 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and exainined this application and know the same to be true and correct. All provisions of laws and ordinances governin;; this type ofwor} will be complied with whether specified hcrein or not. The granting qf a permit does not presume to give authority to violate or cancel the provisions of any other �state or local law regulating Construction or the performance of construction. Applicant Date Bldg Insp _Date, SEPARATE PEItMI"1'S REQUIRED FOR WORK OTHER THAN �ESCRIBED ABOVE. 0 0 0.00 30.00 � I1:90 ��`� 0.00 0.50 42.50 From: Cirv of Fridlev To: 7637542908 Paae: 2/� Date: 4i' 6/2009 11:00:09 AM 3dll1d111 � �nspections ?�3-572-360u ?6 �-5�7'� -4�?--� �'1-� ilATE � � � �- � �i �� 1��.��1�T�'�.�� ,�� '�C�T'�' SIT�:Allll1:�SS �vyri� ��'�IS'�t✓�d�+''s THIS APPLIC,aNT l�: D OWNER PROP�It'�'1- OWN�R/ 'I'ENAN'E' CON�RACTOR ��.' C�� ' ��' �rrr:�Tivz _-� �-��, Y(�Ul: �-MA1L AUlllt�SS La•, � N � �CONTRACTOI: Permi� No.: - - . . ��„�! �.-�. � I�C,, NAM t: 'l I Q. n !�I L�+°��, ADll1t�S�: ��-1 � JT ��f � Sl� .-� ,�e, n �►J A+� CIT1' ��@. � AI+.� 5TAT�,M� 'L1P �S y jat PHON t: CQMPANI•' NAMt: !�. �.. i C��4 �� L�-� SUBMIT A COPY OF CONTAGT Pt,1tSON: C�I�• �c J ►..,a� YOUR STATE STAT�, LIC�.N5�, t+ �XP DAT�. LICENSE WITH ADUIttSS: po�'} b ir0-��t �� N� C1TY �f$�t3��y STAT�.�ir� 'LIP��3� APPL[CATION pHONE 763 as�F d.( �C ai r•Ax PG�9Ii'-�1�� TYPE OF WORK: �� N��'� I1,Y _ � TWn FAMiLY �R�.PLAC�M�NT ❑ TOWNHnUS�. ❑ ALTERATION/KL'M011EL DETAILED DESCRIPTION OF WORK ��s��a �j �.T��.CeM.-..C- �O� 4. C� 6��L� �� s'+��✓ F�L+'5 AI2N, BASLD OV $10.00 PLR F17C7'URL:, LXCLP7' I�VHL�RL� VOTED. FIXTURE5: (L�IDICATL'fOTAL VU�7BL�R OF �ACH BL+'�U1� �quipment lnstalled MNG: i�v v� MADtL• I,�A P�. 0;90 .pA�� Sl'LNJBTU e.D � a f �✓l r /�!C �25.00 A1R TQ A1R k'.JCCHANGE�R $ IS HOILNR $35.00 CHIMN�Y L1NtR$]0.00 UUCT �A'ORK $10.00 MFG: MQU�L: narG: MoDtiL: F1R�PLAC� (GAS) $ I5.00 NIIttiPLAC�. { WOOD} $35.00 FURNAC� $35.00 GAS DRY �lt $10.00 GAS PIPING $10.00 � sur.�ru s��ru GAS RANGYJOV�N $10.00 N�W GAS GRiLL $10.00 GAS UN17' HTR $10.00 POOL HEAT�R $35.00 VENi1LATOR $ I5.00 TH1S IS AN APPLICATION FOIZA P�1tM1T-NOT VAUU UNTIL PRQC�.SSED I hcrcby apply for a building pormit and I acknowlcdgc that thc information abovc is complctc and accuratc; that thc work wrill bc in conformancc with thc ordinanccs and codcs of thc City of Fridlcy and with thc Minncsota Construction Codc,.�; that I undcrstand this iti not a permit but only an application for a pc:rmit and wark is not to start without a permit: tl�at thc work will bc in accordancc: with thc approvui plan in thc ca.tic of all work which rcquires rovicw and approval of plans. SIGNATURt.OF APPLiCANT � �IL� O �b`*A P P1tINT NAMt li � r � `� � �"l�� DATE. �o- / �° � � �— �— C�ty vi ]F'ridley �uilding �nspec�ions Depar�men� fi4�i 1 University Avenue NE, Fridley, NLN �_i43? 763-�72-3b04 PAj�i: 763-502-4977 �uiiain�� I �' �;.., �T�/.�� L inspe�tions , ��' + �T�'�:� _��.:��.t�� y'�� 7�...1.�1 I?�J�CJ�'.' ' !�I T /b,_�02-=�� % / F<� " I �'�'� ��' ��..�� 1 �.�EC�v� �-z �� SIT'� ADDRESS THIS APPLlC.�NT IS: PROPE�TY O'9VNEyZ/ TEN�'�T CDN�CTOR SUBMIT A COPY OF YOUR S'I'ATE LICENSE, BOND t�ND CERTIFICATE OF INSUItANC� PERNIIT TYP� �E oF �0�: YOURL-VIAIL �DDRESS 1 i S�l L� r�.�� Q OWNEP. ONTIL'1CTOP. NAML-: 'PlI� ADDRESS: ` `'7 e � TI'Y_ PHONE: � � � � 7 _ NAME: K-ll/ii� �1��%�.d�i�'dViI9�1 STATE LIC�NSE # STATE BOND � �Dx�ss: �d'�A �/�U%1/l Sf" AI��f ctz� U PHONE ��7' ��' �� F113C � iSll SINGLE FAIvIII.Y � NEw DETAII,ID DESCRIPTION OF WORK ❑ TWO FAMILY ❑ TOWNHOUSE �' ' �I' • M01� 171 P°:mit No Rec�ived By:�_ � � �aie � �o� �ff' DATE �CP DATL- � .,....„,....,-�°" � sT�.� � zrn �S, �� PER MS 168.665 the permit fee is a minimnm of �1.5.D0 or 5% af the total eost up to S5fl0AU, whichea�er is �eater, for the impmvement„ installation or replacemeat of a resideatial �e, excluding the fnciur�s. �(This should reflect only the cost of labor ) Labor casi under $300 =�15.00. Labor cost betweea $3Q0 to $500 = cost of labor x.OS = ' pius SO surcharge � OR FORFRO]E�TS WFIERE LABOREXCEEDS i500, FEES ARE BASED ON $] 0.00 PERFi}CI'URE, EXCEPT Wi�RE NaTED. FDLTURES: (II+IDICATE TOTAL NiJMHER OF EACH BELOV�. N�fIlv1iJM FEE �15.50. BATH SINK2AV ' Fi.00RDRAINS SFiOWER _DJATERPTPING gqTgT[7g GASPIPING(NEIDCITYLIG7 SVVID9VlII1GPOOL _WATERSOFTNF.R(835) CLOT�S WASi�R KTTCF�lY SINK WATIIt CLOSET _BACI4ZOW PREV. (�15� DI9AWASiIER LAUNDRY TRAY ' �WATER HEATER (�357 FOR IItRIGATION — _ WATER METER ,_ OTE�R Pesmit Fee $ , Surcharge _ .50 TOTAL DUE $ MIJM �15.�0) ' Number of fixtures (a� �10.00 x $10.00 = $ Number of fixtures (c� � 15.00 x$15.00 =� OR I�lumber of fixtures �$35.00 � s�35.00 =$� State Surch��e = � 50 � � � (MINTMUM �15.50) Total = $ , �b� _ THIS IS AN tIPPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED [ hereby apply for a plumbing permit and I acicnowledge that the informazion above is complete and accurate; that the woric will be in c:onformance with the ordinances and codes nfthe Ciry ofFridley and +,vith the Minnesota Cunstruction Cudes: that I understand tihis is not a permit but only an applicarion for a permit and work is not to start without a permiC on site: that the �,vork t,vill `be in :iccordance �:virh the anprov lan i the case of all �.�vorlc �vhich requires revie�v and approval of plans. :;IGi�ATtIP.L f�C :\PPL �drT 1 �� GU"✓�%v�- °R1MT1IAA4�. i�`�iL �� nAZ� _ � � � � ,•�I'PRdVCD 131' ;7f.:,L::_SL:'•.((j,. - :yE��.F.,i_.:1'T�?EiZi�tl7'::',,lZ�' �A77; P��?R3.l1TL'�11�IC,:..�i.L'r:.'Tf21C:`�L :�i�11) �•>•1�'��'r'tii��T�.`1L.:�ri�Rlti �:i:sT �DY .�',.:tfl�B'�r �efll&(Ek'.1? �"13B'�'��Ul(1S J�'�3.:1&".'!",1�°�1t �u� i _,iiver�i�r .-..ve:�ue �E. ;•idle�� :•,�il��f :�--__ -��=-..__-: �.,(i:� _ ..j _. -:;=-� � i=--��_ �