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AF - 38026� /"� � City of Fridley, Mirm.. BUILDING PERMIT Date: Nov. 5, 1968 p�; l3omedale Blders . B�� Same Ad�res8 5217 Wayzata Blvd. Ad�s$ Same �°�`�,/' �G N° 10009 LOCATION OF BUILDING No. - 7�48 g�t � Concerto Curve _._, part of Lot Lot 5 _ Block 2 Addition or Sub-Divis�ton Me 1 ody Manor 3rd Addn . Coraer Lot — Inaide Lot x Setback 35 �� Sideyard 10 � 18 � Sewer IIevation — 881.08 884.08 Top of Footing DESCRIPTION OF BUILDING To be Used as: �l�Dwe 11 in�nt 3 2� Depth 24 � Height 2$� Sq. F't. � 6$ C:u. Ft Gara�e �nt 20' Depth ZZ � FTeight 10' Sq, �,440 �, �, Type of Conatruction Frame ��, �� _ 21 000 To be Completed SEWER LOCATION 78.5' West of Man,hole WATER LOCATION 68.5' West of Manh.ole In cansideration of the issuance to me of a permft to construct the building described above, I agr�e to do the proposed work in accordance with the description above ae forth andi� complisnce with all�ovi�tons of ordinances oP the dty oP FridleY. >� // /i �,a 1� � $100.00 Sewer Connection Cha In consideration of the payment of a fee of $—_��, permit is hereby granted to ��edale Blders to conatruct the buflding or addition as described above. Thispe rmit ia granted upon the express condition that the person to whom it is granted and hfs agents, employees and worl�nen, in all work done fn, around and u�n said building, or any part thereof, shall c:onform ffi all reapecta to the ordinances of Fridley� Minnesota reg lacation, construction, alteration, maiatenance, repeir and. mov3n� of buildings witbin the dty lim4ts and� permit may be revoked at a�y time upon violation of any of the provis�tana of said ordinances. c G Clarence Belisle NOTICE: ihis pseadt dosr aef eevsr t6s �onstwcH�, installatioe fer �rhteg. pinmbteg, pa 6udeg, sw�� w watse. B� suro to re� tha Bnildirt8 le�psctor hr +eparm par+nHs fo� t6ess It�ms. � . - ._,r APPLICATIQN FOR B�ILDINC PERMIT iITY OT FEID7+EYs MINN�SOTA • a� : � : � � �- !�i%!L�/'� � / .� �_r � . ��• ,��. - - - � � � � ---- - �-- - � ��r . � �Li , .� =�';: - // _ , .� . . :� � • > - �+ � _ � �� _�,,� � J , , _. _ _ ._ --_. _ - — • : • ' T 1 • , •' . I :1 • // � / �� f L � ��/L✓ //, y r'� - � �� ,'+H' � 1 � ' i' �� ' 1 � I i SE4�ER ELEVATION TOP OF FOCTI�TG Applicart atitach to this �or�m T�,po r�rtiiicates o? Survey of° Lot and propo�ed build�..g locatio�y drat�. or� �he�� Ce�tificat�sa DESCRIFTiON 0� RIIILDING To Be Us�d A�s ` Fro�t .� �. Depth ` Height �q-uare feet ; � Cubic Fe�t F�o:n.t �2 � Depth ,� '� Height � � Square f�et�!� � Cubic Feet Type of ConstructPi��,�1� E�timated Cost �� To Be Completed Th� undersigx�.ed hereby ma.kes application for a permit for the work herein apeciiied9 agreeit�g to do all work �.n stxict accordance with 'che City of Fridley Ordinance� �,.nd rulitlgs o�° the Department oi Build�gs9 a�.d hereby decla.�es that al3 the facts and rep�EaerLtations stated in this application are true and coxrecto D9TE � �/�� S�G1VAr.ir(TRE .�2��' � (Schedul� oi Fee Co�ts can be fourid on the Reve�ee �ideo) / _� �� „ ;_� ��,�, �. . �_ �� . � . -_.�, n �" ,� / Iw' � � � �-° �'�= � � .� � r_ ° _ i 1 _I � _ _' �4 4I al .I�U I� �; SECTION 2 o The In�pector of Ruilclings shall, �aeiore issuaza.g per�.it� for the E�ection of any buil�.�ng or �tructure, o�° for at7.y addition to any existing �tructure or buiidi�.g9 or ior any a.lter�,tio:� or repairs to �..ny existing building or �t�~u�tu��9 upon applicat�on ther�fo��, �equire the p€�.yment by the �.�plic�.rst fo_r 8uch per�.it oi fee� to the amouxbt he-rei�. below �et io�th a..n� in the ma.�zer here�.n provid�d to�wit: Uniform Buildixig Codeo Typ� �9 2, & 4 m$1a75 ior sach onz thousa.nd cubic feet, or fraction thereof � �.n such eubical c:ontert�e Type 3 8� 5- $1050 for each one thousana cubi� �eeto For the pu�°pose of co�puti.ng iees for buildi.ng permits9 the cubical contents of any buildi.ng or a,ddition to a uniform height throughout by multiplying the groun�. area covered from a point six (6) inches below the floor line of the basement or the ceilar to the avera.ge height of the upper au.rface or to the avera.ge height oi the roof �urface of the main gable of a pitched roofe For repairs ox alterat�ons to an exiatir..g struc'cure, the iee shall be at the �ate oi $3v00 per� eacr iive hundred dollars ($500e00� or fraction thereof° irs �he cost of all proposed �ro��o In no cas� shall the �ee �harged ior azay permi� as aet ?orth i:� Section 2 bE less thar� $50000 NSSSD Cor�.nect�on Chargea based on location - Area 1 or 2e /`1 a � � � ..„ � � - �'� u.; t'y � �� - ` , �` �5'�' - � Land FMwi►�vq �� sa►�s kstr� C�.nl b A�o! � / � � 3��;.,,4 ,, = .:�: � . ir�.�i.:�:i�+�r 7\� � _ �*' ° � , ,;f ; " . . . . q' L&'� . �ns-��ay. *�� q�� . � ENG i NE.E�ttNt3, lP�t�, � E�� -- En�ineer,s � Surveyors --- . ce�rt��c�te �� s�pEae�r �.: i i�i I e% �j�� CONCERTO CURVE / �4� ..� �:: "'�'�' ,� �� - .. :yp' a� �'`"fr �, � :: �{ � � r�. ,�ti �. t . � •1 -f -. �I�. :Y"'i g,�.+. . ...��: ..S q 5 ; .� ' s '=.� aIIF ` _ .>� ' i , ?-, �: o DENOTES 4RON �DEWOTES DRA�w►�E � un�,RY t�►i��,�ENT LoT S� B�.ocrc_.�...,.Mc�ooY M�►�ut 3ao I�o�Y�oN . �+ac,► c�o� / �e►�eiy ur�'y � �brs a a �r ar�d � npns�itrim �('o srrrty �'14 �s �irc �Iwr �+i jr� �/,s� � �('J�t � �!'rM► bnldlr� , Atiartiw►, w��'rii�ik a�ro/rl� ,ql'ry. }�t ir ar� iM�d.1b mr�!l��rit �s�.. �► ; �l'._.,.,.,�w,�caf_ �A ati�. 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O . . $ : : : ca oo a� w o w o� a� o y 0000a ooSo�+� �� 0 � �� y [5��,, G fD � '�" f�D n y � y � � � � w Q° � g � I : m C7 R `c% `C aa.� �� ». �� y � Y w p�'�t'�p f�D OI�D �� !4 � d°°� � � �� O �� O � p � �� -�: C'f ��y� � �� b ��w A1�H� i+� fA f'Wj f�! oG- �*w °1 0 �Q.�p '7 ~ O �7 � � � � � a��.� o�� f�D M i� � _� �� ;.� :a G � �� . �� :��• D � 1'D" � � m � 2 m C m � M 00 � x 0 m � � � c� V �s �. � � O � � ao o� �d 0 �. _ � � �� 3 � M Q � 0.:� A � �� 3 � 3. O � � � � � D d �� A � � ¢ � � � � �, � �. � � � � cb0 � 0 � .� 0 . 0 � �. � c'tio � � 'b � � �' � � �, � ��' ��o �'� �: � � °�, �. � � O � � � `� °. � �' �� y �1: � �. � c � � �°� to �' b � � R�� y�� •� � �� . � Q �� b y R � ��A�. � �• �, I °N�� '�� "' m �' � o � � � S`I. � M �d ,* s, � a 'b O � �� ' � �' � �. . �� co � a � �b�A,o a� � s:��,� O 'C Fn CZ �p "� O n y� � � y � ��I. ° � o �• �' � o � � � � QJ R. � b r�'i.' C+ � �. � � �• � � � Q � � � � � � � �. �. 0 � � � � o�a y � 0 � � � � � ;, � � � � ara O ►s m � w t� r by �' R. R, � � � �. o�e � o � x � O{{{�� N � � � � A �• � �, o � � �' ts' ,� � � �, r. o' � � � � I� 1 �� _ . � � � �' WATER CLOBETB URINALS BATH � 7U83 ; . ,, SINKS � �• � � �IWASH K G � � I ITRAYS �� p � � li �� : � 4RINK , FOUNT. a � � 'I �' � �' � p � sxoweras n O � • �: ^1 p' m i"°i FLOOR � � � � � DRA(NB �0i � � � � '*1 �• � � CATCH ^�' � � � BASWS m ��+++ i � �y W RAINW. � fIN3y as LDRB. � 6 � � MISC. � �• � FIX. �� aas � � � APPL. 6A8 ��yy? � � RAN6E "• ro � I ai �, � 0 � m w �. � z � � � P �' O _ �' �' -{ n a�- = M � � � � � 1'1� �• 0 q � �� c� � �. + O f1 � �� •o � �, , � \ � - �� I'I HOUSE HEATING TEST RECORD ADDR�55 �` g v APT. F OOR C UBURB �2'��`� OfCUPANT OWNER - ��✓ 6�� HEAT LOSS DATE HTG. INST. ^AS C0. METER BAD # SOLD BY INSTALLED BY Electrical Work By Gas Line By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS SIG � CONVERSION MAKE MAKE OF BURNER Model � � � Model Sxia l �� 0,� ""'�� Max. BTU Rating INPUT �� MAKE OF FURNACE Model CONTROLS �+ THERMOSTAT Heat plug Vsn4 Size Valve � KIND OF LINER ZE�NONE Limif Draft Hood Regularor Limtt Sstting � Ftlters Size Number Fan Setting �� O�� C.himney Loeation Inside -4� Outaide Pilot Type Chimney Construction Pilot Make � `/ Pilot Model ° �� Smoke Bomb Wiring �� Pilot Timing -'r � Draft � Test Tag b� L.W. Cut Off ^�o Presaurs Lighting Inst. Prossure �•'� Per" n �O�` , a a Tsated �"�� Input CFH l�� P��C2` .� � � mpany Testing � � � Staek Temp. � Pereent CO , � Name of Tester Form 235 � � � O � � a � r m� � m m � � � � o D � o r � � O W C = � �' m o �� nv`D x O ua � � o � �p °o o � D D '� �• c7Dn �a � z v a -r-� m � � z i N � a �n Z a � � z c m` v � � � m � � m 0 � a { o � c r m C ? � � z ° � � m � � � -� � � '� � z � � o v � � co m 0 � � �, �� , �. oD��2�fn�n��QZ � � � � � P1 C � � O m p. � � �tntn.-..�.�3�Af m '� � 3l (�D � � '� � 0 -rl � � A� � � 0 'D � � (Q � � � � � � � � � C "o � m m �*' m � � � 3 �p m -� -, � � < r tn, y _ v, � i� co �� m Z � � a, c�i v � m � .., .-► - 3 TI � ci � � c � m � c CD � fl. � � � � I zl I I�I I I I( I I I 0 � � � � � � � � � � � � � � O O O V p V V V V p1 �A V � O O O O � O O O O O O O 000 0 � -D r c � Z �ii O v Z � m � � a�, � fl. 0 ry-► �` � 1 � m � � --1 Z O �. fej ._� � � � ; �� : - � � � � 4 � �� +i. �; � c� � r u � t � � � � � � a ? aa� m u c � � � Qa m N y �1 y � o��cQ .-► � m � om�a � y � O � " Q p- a �►. ; p � ac°a?3 v � 5. o m S y � fA sy � � v a�� a�� =m�'� � m � -* � � o 0 c�aw�' �� c � m � m � � � �yr*� � � � ? o o .. m � m ¢—' ci m �"''�o �D o � � �- � c�n �' m � 'D r C W Z � "n C � m ao -Di m � z 0 � -�i m � O a r � � � ir � �. w �7 rn (� V =. Ja Nnw� � 1 O� � � i� � < -n wyv N < '� m Z Z m� -D m c� -i Z v < � m � m O � � c � � c''o co �..► SUBJECT ' P City of Fridley 2 7 310 , ` AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ECEIP . r � • COMMUNITY DEVELOPMENT OIV. �4�� ' j y ��-� f � � PROTECTIVE INSPECTION SEC. i . , � � /'�'1 � CITY HALL FRIDLE� SS4� NUMBER pEV OATE PAGE OF APPROVED BY �----'�'• •'� 612-571-3460 910-F15 8/19/98 � � JOB ADDRESS �448 Concerto Curve 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACNED DESCF. 5 2 Melod Manor 3rd Addition SHEET 2 PROPERTV OWNER MAIL ADDRESS ZIP PNONE Russ MOlencam 3 CONTRACTOR MAIL ADORESS 21P PHONE IICENSE NO. Renewal by Andersen 350 73rd Ave. Fridle MN 55432 502- 7 d ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS 21P PMONE LICENSE NO 6 USE OF BUtLDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ fiEMOVE 8 DESCRIBE WORK Replace 5 windows in home with ocket insert windows 9 CHAN(3E OF USE FROM TO STIPULATIONS Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of house. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV �OAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING. MEATING, VENTILATING Of; AIR CONDITIONiNG. THIS PERMIT BECOMES NULL AND VOID IF WORK OF CONSTRUCTION ZONING SQ. fT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTpUCTION OR WORK IS SUSPENDED OF ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE fiEAD AND EXAMINED THIS APPLICATION STALLS GAHAGES AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT 3115 �1.SS 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- STRUCTION OR TNE PERFOAMANCE Of CONSTRUCTION. $8].2,rj Fire .SC, �3.11 PLAN CHECK FEE TOTA EE Li S 5. 9 .91 S�GNAIUFEOFCON'RACT0�70RAUTNOAl2EDAGENT IDATEI EN RO IDAT �H}S IS VOUR PERMIT I' S�GNATURE OF OWNER iIF OWNER BUILDER� iOATEi Bl �NSp DtiTE � NEW � [ ] ADDN [ l ALTER [ +� co��c�onaaa��ss: '� y � CITY - OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERNIIT APPLICATION � - ��c�c��!�� Effective 1/1/98 � -� — -- — _ .�r� _ �.� .e -�. �- � •� � •� �- .n- : �� - % r_" I_1 .�/ Ir i I i� ./. . ri �_17/, �' l.I_: - � s� �� •� • L,�yi, / �, ' II a��ii I - ..� r �: i — ,. �� 1:��:� -_�� , i� � _ . LIVING AREA: GARAGE AREA: DECB AREA: OTHER: Attach to this application, a�ertificate of Survey of the lot, with the proposed construction drawn on it to scale. I�ESCRYY''TI�N OF �R�i��ii�t'I' Length Width Height �^ Length Width Height Width �: , � , � y � Sq. Ft. Sq. Ft. Sq. Ft. � Construction Type: Estimated Cost: $�, �� (Fee Schedu.Ze on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ �� _$ DATE: �°/ APPLICANT: � Tel. #� ��i'�� CITY USE ONLY Pernut Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ �� . �S $ �• I I $ � �,� $ ° � �- e» $ $ $ $ $ �� I Fee Schedule on Reverse Side .001 of Permit Valuation (1%lOth%) $.50/$1,000 Valuation $1000 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 [ ] -�,�n��-/�%��r � .�s �� y /a � !1 . �... /" � /, w BUII,DING PERNIIT FEE SCHEDULE The Chief Building O�cial 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 $25,0(10 $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 (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?5 for fust $2,000 p�us $12.50 for ea�h ad�itional $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 $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,OQ0 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,0(}O,Q00 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 with 6 inch depth - Driveway width plus 6 feet times $15 .75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. sue�ec. �' PERMIT NO. ° City of Fridley "� 7 5 5 0 AT THE TOP OF THE TWINS g� I L D i N G P E R M I T � � ; ` RE �� ' COMMUNITY DEVELOPMENT DIV. i j V �"��'; � �� / r � � PROTECTIVE INSPECTION SEC. � � � i_.•. ��'�',,� CITY HALL FRIDLEr SS032 NUMBER REV OATE PAGE OF APPROVED BV t �� 612-571-3460 910-F15 9/3/98 / / JOB ADDRESS �448 Concerto Curve 1 IEGAL LOT NO. BLOCK TRACT OF; ADDITtON SEE ATTACHED DESCR. S 2 Melod Manor 3rd Addn. SHEET 2 PROPERTY OWNER MAIL ADDRES$ 21P PMONE Russ Molencam 786-6083 3 CONTRACTOR MAIL ADDRESS 21P PNONE LICENSE NO. Grand Exteriors 9601 W 16th St ST Louis Pk MN d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO. 5 ENGINEER MAII ADDRESS ZIP PMONE LiCENSE NO. B USE OF BUILDIN(3 Residential 7 CLASS OF WORK � NEW O ADOITION ❑ ALTERATION �] REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof house and ara e 22 S Tear-off• reside 9 CHANOE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Call for building wrap inspection before covering. TYPE OF CONST. OCCUPANCY CaROUP OCCUPANCY LOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATINO, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. PT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I MAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF IAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT ZISSS .5.94 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TNE pEf;M1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- ST UCTIO OR T PERFORMANCE OF CONSTRUCTION. LH%.ZS Fire SC LI.BH � o`�� PLAN CHECK FEE TOTAL FEE Lic nse SC 5.00 210.07 - SIGNATUp O N�RACTORORAUTMORIZEDAGENT IDATEi WNEN PROPERLY V I ATED THIS IS YOjlji PERMIT ,� � SiGN4TUREOfOWNEPUFOWNFRBUILDERI �DATE� ' — L BLDG NSp � r�aiE � -s NEW [ ] ADDN [ l ALTER [ ] CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 Effective 1/1/98 �� BUILDING PERMIT APPLICATION �f� � � G� .. 0 - �� ConstructionAddress: /' y� �(�'� (',��d' �,(��--; Legal Description: Owner Name & Address: T �� e,�, �' �b��,j � � � Tel. # � �(,�--�� J�� Contractor. ��`�1� J ��.�� MN LICENSE # Address: � � (il l�.i/(�"� ��. ,��, (a(� `2�,,, Tel. # ��—,� � � Attach to this application, a Certificate of Survey of the lot,� with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Length Length Length DESCRIPTION OF IMPROVEMENT _ Width Height _ Width Height Width Hgt/Ground �,•�,� - �� Sq. Ft. Sq. Ft. Sq. Ft. ��_.—C) -- ��r��. Construction Type: � � � / 1�.E5 °� Estunated Cost: $ � � �1c� �� (Fee Schedule on Back) Driveway Curb Cirt Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �� ,�� - �� APPLICANT: ,i�%��2,�1-�I� G2k'� vt� � � . i. Tel. �� / 1�-:S� � � Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $��" Fee Schedule on Reverse Side $ 1/. �� .001 of Permit Valuation (1 / l Oth %) $ � . �`� $.50/$1,000 Valuation $ $1000 per SAC Unit $ � - G' � $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ J Not Necessary [] $ �?/C�. C> � . . _ a� BUII,DING PERMIT 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, oz 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,OOlto $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 (Minimum Fee is $21 plus surcharge) $21 for first $SQO 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,(}00 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 $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 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,OQ0,000 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 with 6 inch depth - Driveway width plus 6 feet times $15.75. 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. ^ � CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE � FRIDLEY, MN 55432 ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE VALUATION ENTER FEE AMOUNT 572-36U4 l+'AX: (763) 571-1LS"/ REPRINTED ON 12/IS/2004 : 7458 CONCERTO CRV NE : 113024140022 : MELODY MANOR 3RD ADD � : LOT 3 BLOCK 2 • : ELECTRICAL : RESIDENTIAL : FEE SHORTAGE d APPLICANT ASHLEY ELECTRIC INC 8201 CENTRAL AVE NE STE M SPRING LAKE PARK, MN 55432 OWNER STAUM LINDA L& MARK R 7458 CONCERTO CRV NE FRIDLEY, MN 55432 40 AGREEMENT AND SWORN STATEMENT T'his 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 examined this application and know the same to be true and correc� All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construcrion or the performance of construction. Applicant Date Bldg Insp Date PERMIT NO.: 2004-02289 DATE ISSUED: 12/15/2004 FEE SHORTAGE AMOUNT TOTAL PAID WITH CHECK # 19789 J�YAKA I G Y�KMf1J I(�tlU11t�U NUK WUKK U1�H�K'1�HAN U�SC:KIB�D ABOVE. 40.00 40.00 ORDER FOR PAYMENT NO. �- � ��''��- C� d-'` Installer of 1Alteing _ � �-� _�- -.•► � r- � � Owner/Occupant e� % � •-� -�, Job �'�� . � •'�`�� r c Property Addr�s 4� � � ` � ``�e �r2 � T� � �-�-• re ��--. Zip �^ .3 � Date Permft No. ��'� 3~• �'3 � Date Filed [�f• �i-c''f O Add�ional rough-in Inspectlon was required. O No acxesa - scheduled inspectian. ee shortage - see computat(on. O ReinspecUon fee. � � %� � �� //s� (J Fee Computation: �� -- r>e�! ,� e4-`r✓�.. L �;.' d°Ylrf� � s c c �C � �0 � `� � � �^ � ��A � � � �' l f'� �► F �'2t�� /- ��i��E�. .� ��., �1 �� . � � � � �4s��a- p _- �,o ��,., Please return this order with your chedc in the amount f ��3 aayable to the city/ townshiP by (date) - l Z- �� -- G' �. Inspector [ ��-�-- Teiephone � �/�' �'� %'" ��"�5 RETURNTHIS ORDER WITH PAYMENTTOTHE CITY/TOWNSHIP WHERETHE JOB IS LOCATED. RC-02