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AF - 43303� SUBJECT P NO. City of Fridley ° 17 7 5 3 AT THE TOP OF THE TWINS B U I L D I N G P E R M� r � � � � � � • COMMUNITY DEVEIOPMENT DIV. � �y-------� �y�` � r � � PROTECTIVE INSPECTION SEC. b � � � � /'��1 � CITY HALI FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV � ��_��.i �.J 612-571-3450 9�0-F15 10/4/84 / / JOB ADDRESS �� eek Park Lane 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oESCR. 2 3 Creekridge SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE — ' Brickner Builders: Inc. 6249 Hen More Drive N.E., Fridley 631-1613 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECT OR pESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO. 5 ENGINEER MAIL AODRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WOfiK � NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 54� x 37' Dwelling and a 21.83' x 13.5` Garage 9 CHANGEQFUSEFROM TO STIPULATIONS provide a hard surface rlriveway. Pravide sod in the front and side yards. �rovide City with copy of verifying sn�vey before capping. SEWER IACATTON: 'rY�" 45� W�st of Manhole, "Y" ELE�7: 880.29 WATER, LOCATION: 4 or 5' West of Sewer DRIVEWAY DEPRESSION ESCROW: N/A r" • '; '�: '�'� ` ' .. ;`=�. =.x ct tf;��,s�v C,: � �:i�,.`; �,. � �� ., , : , .. ._ . ",.`1!` !'�:,. !` t .. at . ,. .,,6 , - , _ . ., i , �E3(�:.��.:; is:,ltv��;i f' ;:�E(�l:�U !'t:,"FY �r;� `€ � ��nr;Ar:�. }'7h1 T�f c �I �"� � Paid Park Fee of $1, 500. 00 �� s,� -� ��` '�*°T..:,.�`ai.G K v �� . �SEPERATE f'Enf4�l.�";:,; � 4: '_ �,r.�� : � -,�F� �so�e d�y;ri;,� ca1��ilCaiG°� 1,�s ,, ._ ,w , , ._ , . ; . . � d � � � �''�' _ EtEC i �,5 t;�.,. H�Iq�� '#»�..�i"`i"�rfPv�g �`�+,s.,} �� j� EP�iO�V� � �� } ; � � .�31.:, s.:.�:. ` �� i.�� :� TYPE OF CONST. OCC ACCUPANCY l.OAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Waod Frame VENTILATING OR AIR CONDITIONING. THIS PEFMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. GU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 18u OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCEO. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT 1 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $90,850 $45. �i3 DOES NOT PRESUME T IVE AUTHORITY TO VIOLATE OR CANCEL THE pERMiT FEE SAC CHARGE ROVISIONS OF AN ER STATE OR L LAW REGULATING CON- TR CTION P FORMANCE OF UCTION. $4OF.00 $CREDIT FOR SCHOOL OL � �a! PIAN CHECK FEE TOTAL FEE .� `' $101.5Q $ 552.93 si REOFCONTRACTOROR u OAiZ AGENT IDATEI WHEN PROPERLY IDATED HIS IS YOUR PERMIT / .�J SiGNATUREOFOWNERiIFOWNERBUILDER� IDATEI f BLDG �NSP �AT ROIVALD F. i�tEYER L� s�tv�oR 4i+o iuwvtv�as sv�orv�s�oir Op�aM ro.=r..oN� 77t.4s�� sss �w�� sr. sT. /ANL. MiNN. ss�o� - I hereby certify that this survey was prepa�ed by me a�d fhat -1 am a duly Reqistered L.:and Surveyor under the laws of the State of Minnesota. � sl � Reg. No. 9051 Oate: _�!�? �� /i�� N� � C.�'EEf� � PA R K ` A N � � � h � � � / � 1. JZ % Jr O O �.. . ;�' ; ' - ;� �.-' � � f_ { ! �� ; L�% {,J� :'; .'�•�.�'�C� ,, .a �M�, 1�J �,,i,,, °��,;�j ' -� . � , r' � � �,��E . � ,.. �� tiKy � .� c.� ,, .. i.� �. ` � � �- f : ,.`��t;'w� � . � , � �.�- � ; � • . � \..._�. �.':4„�:. _��,. e3,�:. $Cil� i 1� s 30 � �' � ' 2 °� �? i�L �.� ir''' �£• �7+ �c' , s ��'Z _ o� ` p Indie�t�s iron �rone�ment place�' � 9� Ei�1t v� � � �: a�� - ` � �, r` , ' � �,; � ' � � . � � r ': ti' t': ,`- ' #i ��" � l �� . _ a' » � �c`� ? r ' . �• �, j o� S�oN o'�scaotia � � � ' {r 5 ; -s rf v�;�,�fy � �.�:.,,�� -1---io 00 ---- Lot 2, 81ock j. CREIICSIDGE. Lnoka Count�. Ninnssota. -- -.-> z � .. _....,.. ! � � Es••�► � :� � � `` � �� `. \\ �� !-�,'..�'. �i �^'... �/ \ � ' /� �'` .. ,v. ca. D � L� : I � / r �� s� �� ` � 4 j�� r� ...j /, r j� �'� 1 i�� ! ~ (' I� �`.f I� % � �, ) � • j / f ;��./ �� / ' � � � �,��..,�� ;� �'� � i2� � � � . , NEW [ ] ADDN. [ ] pLTER. [ � City of Fridley �R-1 AND R-2 Building Peranit Application Effective u/1/84 Construction Address: �ys�y ��,��,� �� Legal Deseription: � � � � ��< � Owner Name & Address : ,, �J/� � �Xlt,l�' � � G/)�( f / �`'' � Tel . # ��/-�i�/ � Contractor: �� %� Tel. # Address • �� ^�� LIVING AREA: GARAGE AREA: DECH AREA: OTHER: Corner Lot [ ] Attach to this applieation, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROYEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width _ Hgt/Ground Sq. Ft. Inside Lot [ ] , � _/ Ft. Yd. Setbaek s v Side Yard Setback � Q � Type of Construction: T�.,�� - Approx. Completion Date: � � G�� Estimated Cost: $ � �--- �,� gs° Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: See Baek Page for Explanation . � � � � '�`� �� DATE: �'� �� _ _ �� APPLICANT: � � Tel. � CITY IISE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Se`rer l�tain Charge r�;1 i� STIPULATIONS: $ �O%t�V Fee Schedule on Reverse Side $ �C� ��v 25� of Building Permit Fee $ �}�.� $•50/$1,000 Valuation $ ei`il,Rt� � T $425 per SAC Unit � � 1��d Fee Determined by Engineering $ C��i� � f Agreement Necessary [ ] Not Necessary [ ] 0 BIIILDING PBRMIT FEE SCHEDIILE The Chief Building Offieial shall, before issuing permits for the ereetion of any building or strueture, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon applicatio n therefore, require the payment by the applicant for such permit of Pees to the amount herein below set forth and in the manner herein provided to-Wit: Total Valuation a1.00 to �500.00 Fees $10.00 (Minimum Fee is �15.00) �501.00 to $2,000.00 $10.00 for the first $500 plus �1.50 for eaeh additional �100 or fraction thereof, to and including �2,000. �2,001.00 to $25,000.00 �25,001.00 to $50,000.00 332•50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000. $170.50 for the first $25,000 plus $4.50 for each additional �1,000 or fraction thereof, to and including $50,000. $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus �3.00 for each additional $1,000 or fraction thereof, to and ineluding $100,000. $100,001.00 and up �433.00 for the first $100,000 plus �2.50 for each additional $1,000 or fraction thereof. DRIVEHAY DEPRBSSION ESCRO�W (Conerete 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 approaeh with 6 inch depth - DriveWay Width plus 6 feet times $15.75 VBRIFICATION 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 strueture and of the construetion site. A CertiPicate of Survey of the lot, showing the location of the foundation onee it has been construeted will be required before proceeding with the framing. �r � � �� . -/ I � �� s a� 3, o0 Ia C�V(o� d� U�C'-vh. 't �.S ayYyU=9rv -(►.sYro,ssi= gy4,�ZS� h 2 Z?x n.5�. y4.o 49v o0 �� 2j•� 4 ��'� 3u� � !$21�,c�to•�� ^' `�AS� w.,c.� f c � i�',sx 3�.3'S Z 5"?�•� an ac -z�.� �'�s?0 � 4.`�q � � 3 GA'Rnc�' ��.5� z-z... 47 3�'tl .'t{ _ 2� . : ,' . , -._ _ �"�� . EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION � `. ' , OttiTNER �� i e! �L��.� �� S I TE A DDRES S!�� •'�� ,'`//�'�� CONTRACTOR �� II�TE �� `� � �� PHONE ��'�� Determine working square footage of each. � i. Total exposed �all� area ....� ��3 sq. ft. x�� _ � � • S� 2. Total rooffceiling area ....�� sq. ft, x' �� = U°' 73 � 7 � Total exposed wall area above floor = a. Total wa11 window area.......................... aa'�' b. Tctal_ door area ................................ 3�� c. Total sliding glass door area ...................�.�� d. Tota1 fireplace wall area ....................... _ e. Total wall framing area (average 10�)......-•.•. � f. Tota1 net wall area above floor ................. 6 g. Total rim joist area ........................... Ix _ �� 2s� - Total exposed foundation area = • h. Total foundation window area .................. �'�'� .. i. Total net foundation area above grade........... g'f.03 _ Determine "U" value of each wa11 segment. a. � o`�/. y X ��U„ • �i� = loL - �,� > b. 3 �. �� X „U.. ' �`� _ �I• �� . �. � q. qti X.�U„ .� q = a3,/� . � „U,. e. / V �r l�� IItT 11 �, f . 1 � L�,S� --- X ��U �� g. °�1 x ��U„ h. S�• ��_ __—X ��U„ i� �i n • _- - _s__- �? 3. ___X U • �9 ---- ' � �----=-- -- � __�-��- -� __-__ --- — --_ '_� � __^ _ ,L 3. ..............................Total � . _ `6. � _ _ �_�' �._�� _ . �_ �__J_� _ _� � ' _� � ___._ �� 3g- �.� _ 3��. � - - ____._ __�_ __ � � - { / �� . .� _ . . . . . ' ._ . ' . � �+. T,OT/�L EXP�SED ROOf/CEfLItlG CALCULAi't0!tS: � . '. Total expased roaf/ceilinc� area........ sq ft j) Tota1 skyt ioht area...... sq ft x"tf" _� � _-- k) Totai roof/cei�inq framing a rea (Ave raQe 1 �q) . . • . . ' sq f t x "U" _ - ° _ _ - � 1) Total net insuiated �'� S/'� roof/ceil inq area....... � sq ft x_��t1�� • - , . ..� , �. , TOTAL j) th ru i) ��-0-� if total of uj� is the same as, or less than i2. you have met the intent of • • S.S.C. Section 66n6 (c) 1. . _ ..: . : s.,,.;�.:. . . . . • • . ' . . . : : i'. • . . . ., � . . �-_ : .. �- . • . . . . : •. - ' ' •,� . . . . A�TERPIATE E3U t LD f P1G EP�VELOPE DES t GN To utilize the total envelope 5ystem method, the values established by the sum of items �3 and ?`4 shall not be greater than the sum of items /�1 and �2. : � . + .7_ . - � f 3• + t►• — _ - � .. . . . , 0 C E R T ( F t C A T t 0 td t hereby certify that ! have calculated the "U" factors and "R" values herein and tt�at' the buildinry here described m�ets or exceeds the State o� Minnesota Ener4y f.onservation Act. _ Sic�nature � ,. (Date) � �� ``� � � � � 6fM �'?� ��i�Z��.(,f-t �� ,� .f � u 3 �� -�`�, ,�- / �%z �� ..� �/� ��'�:��. I �` � ,. y� �.v� 6-�� .�� : c�,,,� ��,,::,. ' �� ,a� l� � : � �� .�. ,�� ,� r � . , y�'` � �,r-, � � o -� � ��, r��;�- 3 �� <, /� ,�� L �� - •1 `� � ��''f'- l��^'�-� „�-�' �� o� = � �� .��;�� -�- � � / � ��I�� . � f/ � � �� .i � �, �-�� - �,� ��. �� ,�� I Y �� , �� ;�� .�? �7��_ ..; � �� . � � J . � •��'� � � , , /r w�� 2 / z'' �� %` � � � �� ,� � �� i J� � ��-- � �/ �t �� , S� . �`� i�� 1� �y : �� . � ,6/ y �t�-� .� , �_ � �� - ..� �. . . c r CiTY OF FRIDLEY APPLICATION FOR POWER P�ANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AlR CONDITtONING SYSTEMS ANO DEVICES RATE SCHEDULE iESIDEt�TL1L Purnace Shell and Duct Mork, Burnei lAlso ssplacawant turnece) Gae Pipinq (pipin9 n��d�d rlth nev [urnace) Gae Renge Ge• Dryer RATE $ 20.00 5 10,00 5_10.00 $ 10.00 • Alr Conditioninq (all aizes) $ 10.00 All Others/Repeirs and Alteretions lf of Value of Appliance or Nork COMMERCIAL/INDUSTRIAL 1� ot Value of Applisnce or Mork Stete Sutcharge TO'f11L !ZE Retn�p�ction few (S15.00) Rough Insp. Date �_ Final In�p. (� 1 Jr'� 1J' Date J►pproval for Psrsit � � NINIMUM FEE FOR ANY HPATING PERMIT IS 510.00 P4US S.SO STATE SURCIiARGE F.ffectivc Auy. 1, 19H1 ( � 1 � (! �/ �_ �:; � i i',. L r TO'fAL .1ob Addrece ��J"��7' �L,� �y.�� o �' $ �`� . S� 5 $ $ S S S .50 S�. D s �a�, SU �.X.L— Att�cA st�ck veri[lcation to�s with replac��a�nt [urnace pernita •Alr Conditioners can n�t lN• pleced in v�d�• yard ritlwut rcttten �N'[Oj98Wp [res� sd�oi�urry rr.iyl�bor. be{�artmen[ of euildlnqsr 6dJ1 Unlversity Ave. N.E., F[ldlay, MN 55�132 City of Fridley Tel. �571-Jd50 The undersiqned hereby maked application for a perwit tor the wrk ha�aln s�.rciCied aqreeinq [o do all �rk /n s[rict accordanca r1tA ths Clcy Coda• and rulinqs o[ the Depart�aent of Butldinqe, end hereby declara• th�t �11 th� fac[9 and repreeentacione s[eked in thie applicatlo� ara trua a�d corr�et. Fa-ldley, lilnn. %�— 02,� . 19� OMNER ��a��^1L(/j �(s� � )L.CII�O�f_S _ KIND OF BUILDING �ys��y�y /�, useo tis c� Ji Q�.cQ 70 BE COMPLETED A80UT FSTIMATED CflST �� OLD - Nt1+ BUII�ING PENMI? N0. PEAMIT NO. �/ �escrurria+ or rva��ce/eura�a NfJ1TING or POMER PUNTS, Stea�, Hot M�teC, t� A1 No. naa� naeu� C`avvtirw sis. wo. „�C��.�/QO—_� Capacity Sq. Ft. COR B1V �t HP 7bta1 Connected [nad KLnd o[ twl !//rlyLi (9tY��': BUNNER - Trade Naae SSie No. Cayacicy Sy. Ft. EDR 8'N HP ComNany � 1 Siqned By Tcl. tM. %s%'�(��/[� �� HEAT LO55 CALCULATION ° 1�EMP. DIFF.. Custom�► Nsme __ , Typ� Cornt►uction City Windows Storn+ Sah DNIK Name __ Dependable Heat�r� ��4. C. yy��= _ ��, gq.� 2619 Coon Ra�ds Blvd. Gilinp In�. City Coon Rapids. 1Kn..55433 F� � FI.� Room j Len9th Width Hi t �1.� ' Room � L Width ' t Win�iows and Doors—Gsckage snd Ar�a W�ndows and Ooor:—Gsckaq� and ArM W�dtn N��yn� No. of � Linw1 /t. ArN No. W1At� /Ni�ht No. Oi IIMN k. A�M No n1 a�n� o� p L nu o/ enek . f of n� ot n� l M N ene . h. � 3� D 3 .- -- -- - �,S 7�' _ - �� i coef. et� _ co.t. 9w Infiltration ��p Glsss , Exp. wall Net exp, wail Int. wall ' Ceiling F loor 7otal Btu. . F1.1 ' Room) Length �� Wi window: and 000►:—cndage,�a i►r« No. W'At� ►+��ym No. o/ Linrl H. � 01 •M OI M l • O� k ■ / �Q Infi{tration G Isss Exp. wall � � Nct exp. wall Int. wall Ceifing a Flocx Total Btu. F1.) �.�n . Room� Length %�Wi WmAc�ws and Ooors—Cnckaqe snd ArN Nr. W'�tn H.pht NO. OI L�n�l h. I n1 r.� nl ne l � O/ C 4 M O Ini�ltrat�o� G1ass ' Exp. w�ll N�t exp. w�11 Int. wstl Ceil�ng Florx Tobl 8tu. . • Exp, wati Net exp. wail Int. wsll Ceilirq � %� F loor i TotalBtu. !, , FI.I Room�L h Width Windows and Door:—Gadcap� snd ArM No. WbM M�t Ne. M LUwI h. 3,- Of M M M L� b O: i�K.� 8tu � ��2rL_ Infiltration Glaa �Exp. wsll ` N�t exp. vwll �Int. wsU � Ceiling F loor Totsl Btu. ` F I.I Room I l�tf+ %�� Wi Windows snd Ooa:-Gsdca�e and An� ' wa.n M•iM. No. a �wrn n. � Ne. �� . �� ..r.. �a r.d� r 8t?�rInfihration L�_ GI� Exp. wall � N�t exP. wsll Int. wall �_ Gilirq Fioor '�%'�%� TotalBtu. f. 8tu � y=� HEAT LOSS CALCUTATION °�EMP. DIFF. custom.r Nsn,. �_ _ t�►p. comen,ccion City Wirdowt Sto►m Sah DNIK N�me . _ WsHt . {�t. -- Str�t --.----- Gilinp Int. ' City -- Fbor F1.1 Room I Lenyth Width H�' t F�•I R�� h W� Win�iows and �oo►s—Crackage snd A�q Windowt and Dows—Gsdcpe and /kM No w,�e.n N., �� No. o� Linwl /�. Ar« ww•� N.�n. wo. a u� n. �•.. n► �n of nin� l M� � o/ eneM q. h. No. 0/ n� o/ n� l M �f M. ft. Coef. 8tu Co�f. Btu Infiltration 7 ''f Infiltration G Isss Exp. wall Net exp. wall int. wall ' Ceiling F loor J Total Btu. F I.� Room � lerpth � pt Windows and Duo�s—Cradage and ArM No. W'At� N�Hnt No. of Ll�w11t. A� 01 1M ol • l tf 01 CIKM q. h. D o'� I�(iltation Glsa Exp. wsll IW:t exp. wali {nt. wall Cei6ng � bcx Totsl Btu. F1.) � W�nticn N.. w�mi M rwr V IntHtrat�on G�u E xa. w�11 N�t txp. Int. wall Totsl Btu a �� . _ � � Width Hti� t snd ArM a� , `O iNl/t, A�N eneY N. It � � n � — � 7 �� (',O�i. BLU Gla� Exp. w�ll Net exp. wall Int. wsll Ceilirq F loor ToUI Btu. FI.I Rown�Luqth Width Windovrs snd Doas—Gadup� snd IRrM No. w�� M't Na. of LIn�N h. A�M 01 M sf M L� M N i� h. Inf iltntio� GI�� Exp, wall N�t exp. vwU Int. wsll Ceiling F Icw Total Btu. Fi.) RoomlL�th WidN Wi�dows snd Doas—Gadca�e and A►M Nn. � Mt� � i�t `o. M L� 1 h. A M Inf ihnt�on • G1sn Exp. wall N�t hcP. wsil Int. �11 Clilirq Floo� ToqlBtu. 9tu � CITY OF FRIDLEY APPLICATION FOR PWMBING AND GAS FITTING PEHMIT >, a �o u • x d Water ,q � e � M C�-�i w �i + w w � Neater +V/ Y itl C Y10 N � ap[i � M � C� Cl 4 � M N U � W ql 1[A i Q�+ � Gu U Iq K 3 V S C9 O dS 1CC �.t 3 � � . 2nd 3rd 4th (R) � Puture Connection apening Connected with Sewer (�) � llav Fixtur�, Old opaninq water RATE SCHEDULE PLUMBING FIXTURB RATES: New li:turer lutura lixtures Old Openinq, New ti:tusa eear Dispanser Blow Off Sa�in Catch ea�in Rain Mater Leadez Hydraulic Valve Susp or Raceiving Tank Mater Tre�ting Jlppliance Hot Mater tl�ater Gas Ranqs Gas Dryer N0. � � � i ALL OTHERS AND/OR REPAIRS AND ALTERATIONS lt of Valua of li:ture or /►ppliance Reinapection ree S (515.00) RATE g 5. 00 g 3.50 S 1. 50 S 4.00 $ 5. 00 g 5.00 S 5.00 S 5.00 S 5.00 $ 7.00 5 5. 00 S 10,00 $ 10.00 State Surcharge TOTAL PEE TOTAL s � �� S %_(J � S S S S S S S S s s. va S S s��-.� v S .50 5�� kttective Aug. t, tyel f,. � .. •� ,, Job Address � � � , [� � �_'�`L.,w�.�/,i/d� � Department of Buildings City of Fridley Tel. N571-3450 The undersigned hereby makea application for a psr�it for the work herein apecified agreeinq to do all work i� atrict accordance with the City Codea and rolinga of tfie Oepartment of euildings, and hereby daclazes that all the facts and representations stated in this application ars t=ve and wrrect ,�,,�� Pridlay, Mn. f��- � J , 19-�=� �// ,t�7 � ,� � QiNER KIND 0 useo i►s ,� .I�(�1 - TO BE 00l�LETED 118QUT � �-- / � � � ESTIMIITED CO6T OLD - NEiI BUILDING PERMIT NO. PERMIT N0. o:� � Oo�psny � Signed By Tel. No. ROUGH INSP. Date / FINAL 2NSP. t �� u � oa te APPRO'VAL FOR PERMIT _t�� HININUM FEE FOR ANY PLUMBING PERMIT IS 510.00 PLUS TNE $.50 ST4TE SURCHARGE �� C�TYOF FRlDLEY 0 CIVIC CENTER • 6431 UNIVERSITY AVE. N.E.. FRIDLEY. MINNESOTA 55432 • PHONE (8121 571-3450 Januazy 22, 1985 Mr. Tom Brickner Brickner Builders Inc. 6249 Ben More Drive t1.E. Fridley, NIId 55432 Re: Address Change for Dwelling Under Construction Dear Mr. Brickner: We are listing the following change of address for your dwelling under construction in Fridley: NAME: Dwelling Under Construction FROM: 1454 Creek Park Lane N.E., Fridley, NIN 55432 TO: 1414 Creek Park Lane N.E., Fridley, NIN 55432 LEGAL: Lot 2, Block 3, Creekridge We have notified the foZlowing companies of this change and also various departinents in the City Hall. If you have any questions on this change, please contact me at 571-3450. Sincerely, � � i � r. � i 1 ,, ' , t i ^� ` 1 ` � � i DARREL G. CLARK ` Chief Building Official DGC/mh CC: Minnesota Gas Company Northwestern Bell Telephone Northern States Power Co. Minneapolis Post Office Depart�nent City P7ater Billing Department City Assessing Departsnent City Police Departrnent City Fire Department *1454 Creek Park Lane is on Lot 4, - Block 3, Creekridge sue�ecT PER O. City of Fridley 18380 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T f ; � RECEIPT . � `L _.__� COMMUNITY DEVEIOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. Q�Q �i 1 . � I l---- � ��'��;,� CITY HALL FRIDLEY 55432 NUMBER . REV. DATE PAGE OF APPROVED BY i " 612-571-3450 910-F15 4/17/86 / / JOB ADDRESS 1454 Creek Park Lane N. E. 1 LEGAL �OT NO. BIOCK TRACT OR ADDIT�ON SEE ATTACHEO DESCR. 4 3 Creekridge SHEET 2 PROPEFTYOWNER MAILADDRESS 21P PHONE Mike/Karen McCulloch 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Brickner Bu.ilders Inc, 6199 Heather Place N.E., Fridley 574-9871 4 ARCHITECT OR DESIGNER MAI� ADDRESS ZIP PHONE UCENSE NO. 5 ENGINEER MAIL ADDRESS ZIP pHONE LICENSE NO. 6 USE OF BUILDING R2S1C12Tltlal 7 CLASS OF WORK �l NEW ❑ ADDITION ❑ ALTERATION O REPAIR � MOVE O REMOVE 8 DESCRIBE WORK Construct a 44' x 30' DweZling anc3 24' x 24' Garage ;WfRIN Q��ED FOR 9 CHANGE QF USE PROM TO STIPULATIONS provide a hard surface driveway. Provide sod in the front and side yards. Provide City with copy of verifying survey before capping. Paid Park Fee of $1,500.00. SEWER LOCATION: "Y" 75' West of M.H. "Y" ELEV: 879.65 TOP O� FOOTING: 882.65 Min WATER LOCAIrION: In same trench as sewer. VVARNI�iG THE CITY OF FRIDLEY DOES NOT GUARANTEE TH� Before digging call local util�118S ACCURACY OF UTILITY LUCATIONS AND ELEVAI-I�iVS, TELEPNONE -fLECTRIC - GAS Etr, THIS DATA iS FOR INFORMATION PURPOSES ONLY� AND PERSONS USING THIS INFORMATION SHOULD. REQUIRED BY L�,�'�' VERIFY IT ON THE SITE. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Frame VENTI�ATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OFi CONSTRUCTION ZON�NG SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PEfiIOD OF 120 DAYS AT R�- ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFBTREET 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 SUFTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OF NOT. THE GRANTING OF A PERMIT $108,650 $54.33 DOES NOT PRESUME TO GIVE AUTHO TO VIOIATE OR CANCEI THE pEAMITFEE SACCHARGE PRO ISIONS OF OTHER STAT R OCAL LAW REGULATING coN- 455.50 $CREDIT FROM SCHOO S7RU T N PERFORMAN O NST CTION. S PLAN CHECK FEE TOTAL FEE �— �✓�� $113.A88 $623.71 +PF GNATUREOFCONTRAC R HORIZEDAGENT �onTE� WHEN PiiOPERLY IIDATED THIS IS YOUR PERMIT lc.ai U S�iGNATUREOfOWNER��FOWNERBU�LDER1 IDATEI BLDG �NSP OA7E NEW � City of Fridley Effective 4/1/84 ADDN. [ J � R-1 AND R-2 j ALTER. [ ] Building Permit Application Construction Address: Legal Description:_., Owner Name & Address: Contraetor: Address: / 5 g LIVING AREA: GARAGE AREA: DECR AREA: OTHER: Corner Lot [ ] Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTIOA OF IMPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground Inside Lot ,�] Type of Construction: Approx. Completion Date: Sq. Ft. Sq. Ft. Sq. Ft. '' /U Ft. Yd. Setback � f Side Yard Setback Proposed Driveway Width If New Opening Is Desired: s Estimated Cost: $ ��J�i�b�tl Alt. A Alt B $ $ See Back Page for Explanation / DATE: / J�'� �� APPLICANT: Tel. � Jr?..�� CITY IISE ONLY . Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge T�TAL STIPULATIONS: � ySS.sc� $ 1 � '� .'� g $ S $ ' $ � S''O d . r�1� � �..�� $ Fee Schedule on Reverse Side 25� of Building Permit Fee $.50/$1,000 Valuation $4�5 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] BOILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of ar.y building or structure, or for any addition to any existing building or structure, or for any alteration or rep�air to any existing building or structure, upon applicatio n therefore, require the payment by the applicant for sueh permit of fees to the amount herein below set forth•and in the manner herein provided to-Wit: Total Valuation �1.00 to $500.00 �501.00 to $2,000.00 $2,001.00 to $25,000.00 $25,001.00 to $50,000.00 $50,001.00 to $100,000.00 $100,001.00 and up Fees $10.00 (Minimum Fee is �15.00) $10.00 for the first �500 plus $1.50 for each additional �100 or fraction thereof, to and including �2,000. $32•50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and ineluding $25,000. $170.50 for the first additional $1,000 or including $50,000. $283.00 for the first additional $1,000 or including $100,000. $25,000 plus $4.50 for each fraction thereof, to and $50,000 plus $3.00 for each fraction thereof, to and �433•00 for the first $100,000 plus additional $1,000 or fraction thereof. DRIVEHAY DEPRESSION ESCROii (Conerete Curb Streets Only) $2.50 for each 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 approaeh Nith 6 ineh depth - Driveway width plus 6 feet times $15.75 VERIFICATION OF FOONDATION Permits for construction Will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. �g"�. 4'7.�1 �3,'YSc S°1'� �; ►�„�- � l, � C�'�� i�� •r �V�t �`�35� �i� �$�►`�� Z��► �� .�a. �33 ' ��x ��.�� c. � ��,�� ''t �'�`� .�___ �_ �. � --°-- .� 1�q`�c ��;� - il,a�l,�s. 3%,�7�� .�.�--- '�,�� '�J 'S' I y,r�� i4t�, � "� ' • .'�'" �� ►,. ��;� ��1 S�� ro t2,�� t�?,�'L + �� ' �, .� �, �a�r +��,'�� :�� Go � � � �►G�,�. RONALD F. MEYER LAND S�iRPEYOR 11.ND SURVEYING SUBDIVISION DBSIGN TELGPNON! 771-4866 flB�S JESStE ST. ST. PAUL, MINN. �S�S1O1 k I hereby certify that this survey was prepared by me and that l am a duly Registered Land Surveyor under the laws of the Stafie of Minnesota. r—�' Reg. No. 9451 Date: G. ..� .�9� � � � 4 Indiaates iron pLced P � � Sca7.e: 1" = 30' ' `� � � ` i Q � ,� 0 ' �� % , \ ��;�. , �� .�� ', �Z ��;�� . /� /� � i �� .� �` ° �o � ''q N R° �9� / � Lot 4� Hlock 3� CREEKRIDGE,, Anoka County. Minneaota. �� . „��`� � � a��°a °� J'.� ti — 1 '� � � --, v.i � .,.1 R'� �� .- �R _ �� d �i� , �� o�ya 4 � ,� ,� � �s�` � i �0� �,�`� / / l�t� / �' �Lo e ra9 �h� , 9rd� � �' `"�. �i � , 8 "" / ' � _.. � I ( / � J { � � 'J // {a � � //' � //� ��\ C � A //�/ r ! �. r! ��/� \�/ / Y V '•_. / '/ - �Y / r ! � 1.\,_r / .. ! � ( �l ((/ �� . � � L__ i % � � �� i � �� 'i� �� G G � � lll fi / �� y � - / �.� � � O`� � �� /l l (.i �l' V �� , r / � � / � . _ ' � � ��. � l � ; �',� /�� T l: � j�� .�, � �* ._ � I � . J I ' �ti:�..,.�.. � . • ; � � � EXTERIOR ENVEIAPE AVERAGE "U" COMPUI`"'rsTION �. . L _� OWNER �I/�Ctc � /t �(%ZE�t/ �G �-Uc�.C•{�G� - SITE ADDRESS � % � 7 �!�CCi('%,/�/Qx L.�%• � CONTRACTOR �� t�/✓EfZ I� U/LQ E�,' S' DA TE /�� 6 pHONE -1 �� 7" 0 7% , � • Determine working square footage of each. 1. Total exposed wa11� area . . . . �'�� sq. ft. x � � � _ / / �" �� . . . , as� _ � �/•6 2. # otal roof/ceiling area ....� Z � sq. ft. x - � - Total exposed wall area above floor = a. Total wall window area ..............:........... °Z7y' 9� , b. Tctal. door area ...................... ..... s' ... .. c. Total sliding glass door area.......... S9• qh� . • . • • • • • • • d. Total fireplace wall area ................... ... S�•,�T— e. Total�wall�framing area (average 10/)........... / 9.2 v f. Tota7. net wall area above floor ................. /a�3•OV � �g. Total rim joist�area ............................ ?�(o , • Total exposed foundation area = �� h. Total foundation window area ...................._ i. Total net foundation area above grade........... � , • � 0 0 � � Determine "U" value of each wall segment. a a'1'��//•�% x ��U�� ?��1/ _ � ,g - . _ , . . � b. � .�� X „U., ,S� _ 3/..�� . �. .��. �Y X „U„ , 3 v _ . / . . . ' tiv ti a .S� �. ,� X �,U „ . _ � . � . . e�, `LL X��U��,� . U g _. �'� . D 1/ . f. l 7�v3 - o v X„U„ •��____ --�,� I v_ s g ti6 X„U„ . o� _ a..�� . . � • h. - X ��U �� _ . ' i l�7 .� X ��U �� . � _ . � � ' �� ' . . 3. ..............................Total � _ L �� . . � � ' . • i� . A � �� . . .. 1 -2- . � e I ; if item #3 on previous page is the same as, or less than i�.em #i, . � you have met the intent of SBC 6006(c)2. � . , i Total exposed roof/ceiling area = ��g ti . � j. Total. skylight area .......................... � k. Total roof/ceiling framing area (average 1C�96) l. Total net insulated rqof/ceiling area........• � 1 Determine "U" value for each roof/ceiling segment. i . �� , ; X „U„ _ . i . . ; , k. X ��U �� = i . i. � ti °I ti x �„U.,� , (� v = 1i.�-� � � � 4 ...................:..............Tota1 = - � ; If total of #4 above is the same as, or less than #2, you have met the intent of SBC 6006 (c) 1. : . � A lternate Buildinq Envelope Desiqn To utilize the total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than�the sum ' of items #1 and #2. , � 1.• +2. _ 3 +4. _ x , l � �� - �� '� '' . ,��cr��t� • f � L ., � S' � z ,�� ' �� ; _ _ ': ��`s i _��-� ' �. • �G. u� /� �� - .�7 _ �-t �;, ��. , � �o`�' .- �, � � � � �� l Z '' ��'� _ ___ l - 2 � C� � ��C�- �� __ 2•/3 = �7 _ _ _ _ _ _ __ _ ��;. _��____ . �� _ _ . _ r , , o �17 _ � '�,��:�.��. _ - y.� ; ; . rt -�'�� .�a _ _ __ _ . _ _ __ _ -_ ___ ._ , . � ��,,.., • � � _ �� ,,; �,�,,,, _ _ �_ � , �� _ ; �z '' .�°�,�,�,�-�/ • yS' _ _ �l_= �� = - al 93 , _ _iG_ Q�� _ _ 1 � _ _ _. __ __ ___ _______ __ _ .� . _ � i 2�,� 2, v.� i _ _ ___ _ _ _._ ___ ___ __ _ _ -_ _ . �i ��- 4��.,� _ �� _ _ , . _ _ _ _ _ - _ _ __ -._--- - - ; �' .t� �- . ��. � ! _ ._ __ _ __. ': - "' - ��`=-- ----- - - __ _ - - /LI i� - � �---_._ ___� _..__.._._---------� .. . � � j 23.�3�.o��y ; _ . _ _ _ _________ _ _____ � � � _ ___ _ _ __. ____ ___ ___ ; � . ,, __ � �'� _� �- _ . � g __ _ _ __ ___ _ __ __ __ _______ ___ _ _ � ; _ _ _ ; �_ `' ��?�P � � _ . _ _ _ _ . _ _ __ _ _ _ ___ _ __---- _ , � ' � r2 '' _ �� _ _ � - �9 _ . , . . _ _ _ _ - --_ � iz� � , L � � L• a� � _ ,_ . _ �� ; f�.�,,,,.,:� ._� � _ _ _ - -- _ ; � �� _ ' ,� � �� ; ,. . � � � - � a� � � � ; _ _ � �. � , �' _ � __ _ _ �� , . _ _ ____ _ _ _--___ _ __ CITY OF FRIDLEY APPLICATION FOR PWMBINti AND GAS FITTING PERMIT � an q u • K v Mater ,� p N � °i c a e� i w w 5 Neater a a~i aC ,G °c �wt H,��CC u � w .c c bg a�i �s • 0�. N M O •.1 ai a C N•�+ � O S a� w u m g m N � v�i u a o� i� ai s o w ai w u r� � s 3 i'� i� o s lec / �at � 2nd � � 3rd 4 th (R) � PUtura Connection Openfng Connected with Sewer (�j � New Fixture, Old apenirig Nater RATE SCHEDULE PLUMBING FIXTURE RATES: Mew li:turet rutura Fixtures Old Opening, New Pi:tur• Bear Dispen�er olow Off ea�io Catch easin Rain Natsr Leader Hydraulic Valre &ump or Receivinq Tank Mater Treatin9 1lppliancs Not Mater deater Gas Ranqe Gas Dryer N0. �i � � ALL OTHERS 11ND/OR REPAIRS AND ALTERATIONS 1� of value of li:tur• or Appliance Aeinspection Pae $ (515.00) RATE $ 5. 00 S 3.50 $ 1. 50 S 4.00 $ 5. 00 g 5.00 $ 5.00 S 5.00 S 5.00 $ 7.00 S 5.00 $ 10.00 g 10.00 State Surcharge TOT11L FEE TOTAL g ,�',00 S • DO S S S S S S S S S �� v0 S S S S .50 S �o�%• 5� Effective J►ug. 1, lyal J ��" GvW Jo�i Address Department of Huildings City of Fridley Tel. M571-3450 The undersigned hereby makes application for a p�rai! for the aork herein specified aqreeing to do all work in strict accordanct with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in thia application are true and correct � Fridley. Mn. �' � � "- �� . 19 01iNER �JYYI'i �fir/ !.[�!'_\i`�� /LJ KIND OF BUILDING USED AS TO BE COF�LETED ABOUT ESTIM7ITED CaST OLD 7' NESi JBUILDZNG PERMIT NO. PERAfIT NO. /�� L� , Cowpany Siqnad By Tel . No . t,�� S� ROUGN ZNSP. oate FIN11L INSP. - 1 � O" /�� Date �� APPRONAL FOR PERMIT �� HINI�IUM FEE FOR ANY PLUMBING PERMIT IS 510.00 PLUS THE S.50 ST4TE SURCHARGE , CtTY OF FRIDLEY APPIICATION FOR POMER PLANTS AND HEATING, COOLING, VENT1lATI0N� REFRiGERATION AND A1R CONDITIONING SYSTEMS AND DEVICES RATE SCNEDULE lESI OEt�TUL Purr►ace Shell and Duct Nork, Bu[ner (Aleo replecawent turnsce) Cae Pipinq (pipinq naaded with nwr lurnac�) Gae Renge Gas Dryer • Air Conditioninq (all sizesl l►11 OtherslRepairs and Alterations lt of Value o! Appliance or Work COM!lERCIAL/INOUSTRIAL lf o! Value o! Appli�nce or ltork RATE TO'fAL S Zo.00 s o%,m� S lo.00 S, p�oo S 10.00 S 10.00 S 10.00 State Surcharge ��G'�.� Reinspection E'ee (515.00) Rouqh Insp. Date � F'inal Insp. �U ate Approval for Persit ��---- MINIMUM FEE FOR ANY HF.ATINC PERMIT IS 510.00 PLUS $.50 STATE SURCIU►RGE F.tLective �uq, 1, Iqq► Job Address / ��t� � ,jZ.IrX�- �.!R:2I� /�� Deparcment of Buildinqs 6111 univereity Av�. N.E., Frldley, MN 55172 City of Fridley Tel. N571-3450 s The underslqned hereby Take! application [or • penit !or the wrk h�r�1n speci[ied aqreeinq to do all wrk in strict •ccord�ncs vith tha City Code• $ and rulinqs of the Oeparqaent ot Buildinqs, and hereby d�clare• that all th� facts and representatio�s ststed ln thLs applicatlon ars true and corr�et. $ �ridl . Minn. J� v�l�' r l��p OMN£R S —T _ _ RIND OF BUILDING USED AS S 7'O BE COMPLETED ABOUT EST2MJITED C06T �� D,O � V S . SO '� ` OLO - NEN BUII�ING PEPMIT N0. PEAMI'P NO• _� 7 7 S s �a. �� Jlttach stack veriftcation`foif vith replacaoent furnace {�eneits •Air Conditio�cr� cen not b�� plrced in tiid�• yard vitJwuG vritten pi•cnissio� feaa �dinininq rxeiql�tx�r. DESCRIPTION OF £UPN11Ct/BURNER HFJITING or POM R PIJINTS, Stea�. Hot Mater, Man Air- No. Trade Ne�ne Sis� !b. [�Cv O�� < 7 � Capscity Sq. Ft. CDR S'N Mp 7btal Connected tead Kind oi Tufl _�� BURNER - Trade Na�e Slze No. Capacity Sq. Ft EDN 8'N Mp Company , � � Siqned By Tel. tM. "" � � sua�ecT PERMI c�ty of Fridley 19908 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � ECEIPT NO � • COMMUNITY DEVE�OPMENT DIV. ' ; y_ _ � � r � � PROTECTIVE INSPECTION SEC. � y 1 � , ' � �'��1 � CITY HALL FRIDLEY 5S4$Z NUMBER REV. DATE PAGE OF APPROVED BY �'.---�; �.� 612-571-3450 910-Ft5 5/22/89 � � 108 ADDRESS 1454 Creek Park Lane N.E, 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 3 CY'eekrldge SHEET 2 PROPERTYOWNER MAI�ADDRESS ZIP PHONE NLike McCulloch 1454 Creek Park Lane N.E. 572-1975 3 CONTRACTOR MAIL ADDRESS Z�F PMONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR � MOVE ❑ REMOVE X 8 DESCRIBE WORK onstruct a 14' x 20' 338 sf) Deck AdditiQn 9 CHANGE OF USE FROM TO S7IPULATIONS See notations on pl.an SEPARATE PERMITS AAE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST, OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIFi CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZON�NG SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR lF COMSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DW�Ca. UNITS OFFSTREET PARK�NG I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND OROINANCES GOVERNING THIS TYPE OF WOpK WILL BE COMPLIED Wl7H WHETMER SPEGFlEO HEREIN OH NOT. 7HE GRANTING OF A PERM17 S2 � 4OO - $I. a 2O 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 THE PERFORMANCE OF CONSTRUCTION. $S4.00 PLAN CHECK fEE TOTA� FEE $55.20 • . SIGNATUAE OF CONTRACTOR OA AUTHOR12ED AGENT IDATEI �h/ N PROP R� L� A D THIS IS YOUR PERMIT • � �J i�0�"V � SiGNATUAE Of OWNEA I�f OWNER BUILDEAI iDATEi INSP qATE NEW [ ] Effective 5/1/88 ADDN [ R-1 AND R-2 AL'I�2 ['�j Buildirg P�ermit Application Construction �: �� y C.+� FE K P14J� �C �� , Legal Descriptioa�: owrier Name & Address :/i/� (�cs /�'1 c CN ��o� � I yS y CIt�� iC �iM (c (�4 . Tel .# S' 7 2- I 4'1� (w.� Sl �( _ �f q 6/ O�ntractor: Scst �, Z�e1. # A�dress: Attach to this applicatio�, a Certificate of S�vey of the lot, with the prq�ed oonstruction drawn on it to scale. D�IPTI�T �' LIVIIaG AREA: Length Width Height Sq. Ft. C;�►RA�E AREA: Ier�gth Width Height Sq. Ft. � n�c �: � � y� wiatn 2.0 ' xgt/cro��a y- 9' sq. Ft. � 3r� " 33 oz�: �S .� : Z`1�5.�c. Oorner Iot [] Inside Iot ['� Ft. Yd Setback Side Yard Setbac3cs Z�pe of Construction: Estimated Cbst: $ Z-�o ��i 0 tl Approx. Oo�letion Uate: '1- i- g q Proposed Driveway Width If New Openir�g Is Desired: Ft. $ $ Width + 6' See Back Page OATE: AP'P'I.SCAI�r: Zie1. # Permit Fee $ .� State Surci�arge $ � . � SAC Qzarge $ Driveway Escrvw $ 1>ark Fee $ sew�er 1Kain ct�arge $ To►rp,i, $ SS .'2�d �4Y : 1 : M •:,� CI'1'Y DSE �Y F'ee �ule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit - Alt. "A" or Alt. "B" AUove Fee Determir�ed bY �gin�'irig Agreement Neoessary [ ] Not Neoessary [ ] Z�U 6 I- 0 V a �- �� 7 VS � � �(, a � (: 1�� . i-a:��4 j:il =��:1��.1► " The Chief Buildirg Official shall, before i�Q»*� permits for the erec,-tion of ar�y building or structure, or for any additiaaz to arry existiryg buildir�g or stxucture, or for ariy alteration or repair to any existir�g buildi� or stzucture, upon application therefore, regiire the paym�ent by the applicant for s1x� permit of fees to the amount herein below set forth and in the aanner herein provided to-wit: ZI�TAL VAT�JE S1 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 E��a.? $15 (Mi�i�un Fee is $15 plus surci�arge) $15 for fiYSt $500 plus $2 for each additional $l00 or fracti�a'1 tYyereof, to at�d includiTXj $2, 000 $45 for fixst $2,000 plus $9 for each acklitional $1,000 or fractioa� thereof, to arrci including $25, 000 $252 for first $25,000 plus $6.50 for each additional $1,000 or fraction thereof, to ar�d includiryg $50, 000 $414.50 for fiYSt $50,000 plus $4.50 for each additional $1,000 or fraction thereof, to and includir�g $100,000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction thereof, to arxi including $1,000,000 $1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional $1, 000 or fraction thereof �tIVEi�Y D�PRffiSI�T FSCtmW (C�rete Airb Streets On1Y) Alternate "A" : R�emvval ar�d repla�nent of curb ar�d gutter only - Driveway width plus 6 feet times $13.50. Alternate "B'� : Re�moval arid replac�ement of curb ar�d gutter ar�d install a 3 foot wide approach with 6 inc� depth - Driveway width plus 6 feet times $15.75. l'��:��;�M�� ; •i�:��.� .��:� � I Permits for oonstructioai will be issued a TM�ni�*m of 24 hours fra�a the time of application to allvw for prq�x review of the prq�osed structure and of the oo��struction site. A Oertificate of S�.irvey of the lot, s�hvwit�g the location of the faux�ation onoe it has it has been construct.ed will be requireci before pr+ooeeding with the framing. .; � - � 1 a J .. �• •� � �L - � . � •� � �C � � �- o c � � ` � 3 � � � � � e c � � � �' _ � � ,? �- � � r ^� � '? � v � � � � � � _ _ � �e o . ( t . � ! ( z Q � �/ � r . - '3 � ` _�� s ` c � � _ � _ -� i, ' � x � ' , � � `� . " • i � � � \� ' �,^F ` �, �, � � v � Q L� �: �i � ., �- , , �-------��__ j ; , � /� �i . � � ' �- '� N O, � � a � � ^ \ /. `►•� � � - v S � � / /.-' �' � {" ; � , � i" ;;; � �Q 4 0 � ! i , __ � _ _ � a � , ,,, _ ;. � ,� � � � � � � —,,.� ; � � ' = .. .� 2 t . , _ .., � . �� ! �- � � _ _ , :.-, ; � � ; y �` � �J. v . ^ � , ..r . .''` " _ N . ' � � . , � ,.. Q � i r � ,` � ( � ` . 4 . . �� s i. . .? tl . � 1 �. • �i � y • ` � i �i I rr . �� % � � � . � f • _ Q � � � ,� y � �' , �Q �� `"`._.. Q .. j .-�..t ,.\ _ _ � ' . � ° ' 1/ • �. - - V,. : -- � Q•' �S,y � l � _ _ V -:µ r . � __ - � �-= _� - _ _ -- -- � l �� — - - t � C'�� ,.�:. `` � � = , r�- t�. rc,. • ^ � � y� � P� i. C�- S � .: � �� !► p . .s 9� l--v � l� e � � '\� 4. 't _ � ' � �' `J . " � .. _ . =. �.' (� � - " ' � j ._ . . � • � _ I— � _, �,i- - L : c � : � :;�, - , ' ,� ` 7` _ -. ' . `- t'7 � . � N - _ � ...-/ _ ' c, c3 r CC' � � , _ - � � � �1 � ,J 3' �' � � � ' = .� `J' " , � � r r _ — .y {�,� 1.., � � � _ _. - . � ' b C ; ,, � : _ _ �, � � � � 3 ..r _ -=3 r ,� � � � ,� ■ LLAMPERT -_ - . . �: _ rF � ,=�� rt � � r ( _ Date ' ' ; � S `•� .r �. . � :{ � ERIC MATTSON � ; . SALES REPRESENTATIVE � j � � � - � � � - ^ � � � � � � � ,�fV� {�� . � . . . i " . . . . _ . . � � . .. � � � . � . . . (6121784•5855 � 1 ,.. . _ '. �. -_. : .,:�:' :. _ . �. - �, �.�. ,� .= �..�-.�. � ' � � . . . � . . �- : . 7600 HWY. 65 N.E. • FRIDLEY, MN 55a32 _ _ l . �C..-w. �.: -. -�.SrJ N� �1�,��; << _ . , . w � , . _ _ .._. � ----------------- -. - . _ , ;. . :- -- - - `"fi - : .-. 1 : . _ '", - ; L � - . . belivery Address ' "" . ` ' � ,.Thie is an estimated amount only'ol the materials needed, and is NOT A":..1;Typ80� DW@Illf19 � . •. �tVe GUAFANTEED LIST. We agree to fumish (or the price quoted only [he items + ' . , - and quantities listed. Any rtems furnrehed l�at are not included �erem will be ' SI280f B�dQ � : _� � billed as extres. • � ;. .. .. .. �... `;�. - :�.. . .. .' . � . . . . . ' � Ptease review carefully to be sure that this esttmate covers everythu�g � - � -TOtdI $G Ft � _ � "� J�� C ��'� � � � �s � - want.d, as we cannot be res0onsible for anything omitted. Clerical errors -' � � _.. . u:b��a to correction, and all agreements are coMingent upon strikes, Lt�. Ft. EXt. W311$ �i '.. '� acadents or other delays beyond our controC ._ : . .... - � . ��The prices oa this estimate are good only�far 15 DAYS lrom date ol estimate ., ljn, Ft. �nt.wal�3 '� � - � � � � � � above. Sales tax not included. All orders subject ta aoprcval by credil . _ � � � � � - � . � �� . � mana5er. Goods are at the purchaser's risk after unloaaing. . � -. � - � • - - - � -' � -- � � - � � NO. I SKU PCS. - :: : DESCRIPTION ` `: _ PRICE AMOUNT PRICE AMOUNT Tteads � .. '.. - �. dta.� a �rs�.� .�( � 2 ; t 2 a� n—; i -�', �i�,,,-�e,,� - � '� _.-. . - . . . 3 ._. . _.. . `?�occ - 6 . �i��;.�u.l � � - . ==:- t . . . ,, 2a-co -- t 2 ` f -. , t I . �' � ,. � � : 5 � _ � _:. 2:. . _20�.. — ,r� - _ � �a 1�1 1 � �:ssed — � � _ . � � - � s , , _ f G: � ;, ' : . -... - __::� G � - � �Q _� �.� -. . ,, . � .. Yalley .. _ p , : . . : iuds � 8 � � O� U _ e�c�-� • •� _ 9 (l C�"'1'"'�' $ � : } L....,,E s�`Gxb C.�✓-'-' VlCGK. '' � ` �� - . ( � -� �.. .�Gy � "�a ..<_ ` �- F;% :: '�,. 2 �`� �,,Q.t,�,,.� _ �-�.�;.�:� � �s � I'ti �i . ��es �-. _ : y.: �- :^,y - -HiPb. 11 � �V{.� � 'c. s�•'{•�., (�/��_,!�� ♦! . .e y, - 12 . . . - -` -��...rc �`C �'S"l{.S �x•-�� 1 14 � • � O - •^ �,I� _ � ,< � .� � � e - s �.S - - .�56 . ��_ : �,�sn ,s v 1.� �- Zo��G C�i�,�, ; :: �`� : � � . '16 - � - . - 3 � L.. �; i. � C.e�.u.� � S 4, S � t "�'�' ..- . •�% ..I> � ' .2 '.a-��/ C' `�� _ 1• ..�'' -1�5.�� .� ;.:P� - �a_ . , . y � �• } - • �• . _ `s �� . . �� 1� ` � � W�y3� ..� L'�Y � �. �t{nfl � 18 :� ..:-, v �,Z-{, U .� ;�nJ G t - � � ;� �+ �`` � ;�i��s,'�: �. w� � � � Q s e � � d� � )+� ' .i`��'f��% :,r��g"y�`b t :a� s�,ei�* ,�'„±:Q,• �... _ .�.I � �' s,y.�s' �F�,...1�4�• : r ° w' ' � :�: `'F .� � �r� ,� �;i '} �c �{�^.� S C "� �.9 K �If+�.wl.�l �e v �� yA,�. � . .` b � '°6 t , �+ � � _ ,�..L _�r�N ;,. ,� , y � i S. .. ��.� � �� % �• S:�'�( � /� �j�3T.y��/'� ~� j�.i��'S' .�p � /�/� � . 5. , .� :'i!,?� � ,Y e��, /� . � �2p a �+�.'b!. 1r.. �.� •.. '�'I i �_.(1 �•'-•}�;�Q �... t�.- - pi �� 1�.. <s .W . _ l t�' J �j��.✓'V �� .i:' Y . - C�� V Y I'r � Y��.� � .3,. �` • t A� l. � l� TZ � �� +?a � �• �t �yr�.} t '=•�.:" "`'Si�� X � � '�4 �� . A !.`. �.�� ..�� f ` �t •�:. �� k •=5,�� " - �� ;'�` � �S � 1 i� rt • � . . � .. �M �♦ +G ?�y��i �,Li" . .. :•�� :;4 =,.t'� . • ! � . . . . � Y�. ti .� _.�� `0.�•o, Y �� '.�f1'.�'+�x� Yi T �� _.. � � . ' . . z �.� Q(l'� il�.� '�as P' ��• L �_ � . x .� ` . � �... a � �,r5 � �4�v t`'n�'�s.�F:KJ .. yrr^��"15" ��. :�a��!e' ��i .7� � . i � � !� ' .� `'� ��. •.. v:Jt YIT'��"•� � �UL.7 `�.'' • :� � i ` -'4 Z.3 , - � G , r w �� >'y� � .. � � � „�;,r . tr''i�'�t � ,� �'i a-. s � .. � f w � � tr ` . ` s Y 't�o �sy �L ,�' '� �r • _ :� . � ' Z4 . . ..� y 'x) -?�'�`.�/ �:_4 '�-��' �iPra. . ��K� s9a.. i;f'�T�.�w� iG r. �� ••�iY = '�?� � _ ` , t1�, >; ' � � .=�j.; ._ � . 25 . 2� ( (� � �� . . �. { : � � ' 26 Z " • _ . , �� ' xetsA 27 � �� .SFI.�r� .-' � •.. - - j � - � -. . . � - ��t,, .` "�, �_ _ .-- _ - .� � i � �' ' _" ' r.._._ _ : ,,, ,' il I I U q I �� RONALD� F. 1�IEYER �.Axn sIIxv�ox LJ�ND BURVtrYIN6 SUYDIV1610N D[SiON Te�CrHOHC 77t-asaa G8S JCSSI! ST, ST. PAUL, M1NN. �SS1O1 I hereby certify that this survey wos prepared by me and that I am a duly Registered Land Surveyor under the taws of the State of Minnesota. � Reg. No. 905i Date: . / d � . ,Lo c. /yla1r / , /9�' 1� 4 Indicate►a iran pLeed p! �. , Scals: 1" = 30• . �� `\` � � a0 , PP �. . �}� . � �s�^ � ,1 / , �. �2 j��''i ��- ., �� fi. ayq p �0 ti . R'� �` ' �90 ., �� ;'' ��. � '� �� .� , � � .z _�. \ . i�ot 4� Dlock 3, CREEKRIDGE, Anoka County, Minneaota. --, � � �. . , , , . r,3 _ o � •, w��i ,�q• . ,� ,��ti 0 �- "' �/ p' \ ��• �i' � o'i',� .a �s / �~ � � �i'� / (�� / / � �� e ��a9 � � h' , , � ._ � i �� i � 8 w' • / , ' � .� / ' � � � SUBJEGT � � - City of Fridley A7 TME TOP OF TME TWINS g � I L D 1 N G P E R M I T r � . , � � • COMMUNITY OEVEIOPMENT DIV. r� � � � PR07ECTIVE INSPEC710N SEC. , , � , i_-_•�� "" �'� CITY NALL FRIOLE� 55132 NuMeEt+ pEv L 612-571-3450 9�0-F15 �oe nooRess 1454 Creek Park Lane NE t LEGA� LOT NO. BLOCK THACT Oii ADOITION DESCR. �F 3 Creekridge 2 PROPERTY OWNER MAIL ADORESS Mike/Karen McCulloch 1454 Creek Park Lane NE 3 CONTRACTOR MAIL ADORESS Matcon 9783 4 St NE, Hanover, NiN 55341 1 AFCHITECT OR DESIGNER MAIL ADORESS 5 ENGINEER MAIL ADORESS D�TE vaGE Oi 1/22/99 / / 28862 (tCffP� 1�t0" `/ V� �PAOvEO Br SEE ATTACHE� SNEET 572-1975 ZIP PHONE LICENSE NO 612-477-4803 7533 ZIP PHONE UCENSE NO. ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ AODITION � ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Basement finish 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. TYPH OP CONST. SEPARATE PERMITS ARE REOUIRED FOR ELECTf11CAL, P�UMBING. HEATING. VENTI�ATING OR AIR CONOITIONING TMIS PERMIT BECOMES NUII ANO VOID IF WORK OFi CONS7RUC?ION 20NING AUTHORIZED IS NOT COMMENCEO WITHIN 60 DAYS. OFi IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOO OF 120 OAYS A7 ANV TIME AfTER WOFK IS COMMENCED. NO OWLG. UNITS I HEREBY CEA7IFV 7HA7 I HAVE READ AND EXAMINEO TMI$ APPLICA710N 1 AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VALUATION ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPUEO @ WITH WHETMEfi SPECIFIED MEREIN OR NOT TME GRANTING OF A PERMIT W2O�000 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqMIT FEE PROVISI S OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCT R THE PERfO MANCE OF CONSTRUCTION �ZS7. ZS PLAN CHECK FEE L' SC S�GN4iUAE OF CONraACTOQ OA sUTtiOQ�2ED �GENi IDATE� MC Dan � a eu��oea� iO�iE� OCCUPANCVGROUP IOCCUPANCVlOAO SO. fT CU fT OFFSTREET VARKING STALLS GARAGES SURTAX $10.00 SA HARGE i e SC $20.00 A� FEE 00 $322.25 ��V VA ED THIS ISJ/OU� P�RM� �/y / _ / /i L � r��rE NEW ADDN ALTER [l � �� ConstructionAddress: Legal Desc;iption: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERNIIT APPLICATION � �� Effective 1/1/99 � �� ' �� ; ,L� /�� Owner Name & Address: Yv� ��, � j�i �cti, � C Gu LL D�,,J� Tel. #� S 7Z -�I�s , Contractor: � a,{� or� MN LICENSE #�S 33 d�AddJ � a v�owcr- v� �..r 53 3�/ TeI. #�01 Z- 17 -`i�o3 ress: — l_ � � . ��'` �f 1� � t-�' ! � Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LNING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF Il�ZPROVEMENT Length Width Height Length Width Height Lengtb Width � Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: �t �►S� ��{ -w�,cr�-�' Estimated Cost: $ Z dR �D. W (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$_ _$ DATE: �� 1�j'� `� APPLICANT: C..� ,1�'�'�G�o'K� Tel. # b � z' y �� 3 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ o`��, 2� Fee Schedule on Reverse Side $ � � .001 of Permit Valuation (1/lOth%) $ J�- `� $.50/$1,000 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 [ ] $ 22.2� � � � 8 __ _ _ _ _ __ ____ _ _ CI7Y 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 Shetl and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Need�with n� furnace �c � �� . ��lf � Gas Range Gas Dryer *Air Conditioning — All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1°� of Value of Appliance or Work Commercial/I ndustrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $ � �� $10.00 $/d — $10.00 $ $10.00 $ $ 25.00 $ State Surcharge TOTAL FEE Effective0n January 1, 1998 JOB ADDRESS � V� �/V 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. ��:� l ,1 g9�` OWNER �rP��,��'.��1�D�1� _ BUILDING USED AS ESTIMATED COST ��C� �� PERMIT N0._� � S��: 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 $ .50 $ �� . .S�' MINIMUM FEE FOR ANY HEATING/COOUNGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Burner Trade Name BTU HEATING Signed By Approved By Size No. � EDR Tel No. — � , Rough—In Date Final Date �9 *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STA(j'K VERIFlCATION ON written permission from adjoining properry owner. REPLACEMENT FURNACE CHIlVINEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: l. Has been carefully examined Yes () No () 2. Is free from rust or deterioration Yes () No () 3. Has no foreign objects lodged within Yes O No O 4. Is securely supported Yes O No O 5. Meets all cunent Code requirements for size and total BTU's connected Yes () No () 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No () 8. Has combustion air been provided for water heater Yes () No () List ALTERATIONS Being�Done: HEATING CO: Signed By: Date: sue.,ecT PER . City of Fridiey 8893 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T r � � � � �0 O � • COMMUNITV DEVEIOPMENT DIV. � bV �'�� r � � PROTECTIVE INSPECTION SEC. � S � � �'��1 • CI�Y MALI FRIOIEY SS��Z NUM6ER REY OATE PAGE OF APVROYEO BY �'""'�� '� 612-571-3450 910-F15 2/3/99 / / JOB ADDRESS 1454 Creek Park Lane NE t IEGAL ��T NO. BLOCK TRACT OR AODITION SEE ATTACHED OESCR. 4 3 Creekridge SNEET 2 PFOPEFTY OWNER MAIL ApDRES$ Z1P PMONE McCulloch 1454 Creek Park Lane NE 572-1975 3 CONTRACTOF MAIL AD�RESS ZIP PHONE LICENSE NO The Fireplace Center 12460 Wayzata Blvd, Minnetonka MN 545-3797 3119 a ARCHITECT OR DESIGNER MAII ADORESS Z1P PMONE UCENSE NO 5 ENGINEER MAIL AODRESS ZIP PHONE UCENSE NO 6 USE OF BUIIDING Residential 7 CLASS OF WOHK O NEW O ADDITION OX ALTERATION ❑ REPAIR O MOVE O REMOVE B OESCRIBE WORK Install direct vent natural gas fireplace 9 GHANGE OF USE FROM TO STIPULATIONS Install per manufacturer's specifications. TYP�OFCONST. OCCUPANCYGqOUP OCCUPANCVLOAD SEPAf;ATE PERMITS ARE fiEOUIRED FOA ELECTHICAL, PLUM8ING, MEATING, VENTILATING OR AIR CONOITIONING. - THIS PERMIT BECOMES NULI ANO VOID If WORK OR CONSTFUCTION ZONING SO. FT CU fT AUTMORI2ED IS NOT COMMENCEO V�1ITHIN 60 DAYS, OR If CONSTRUCTION OF WORK IS SUSPENDED OR ABANDONEO fOR A PERIOD Of 120 OAYS A7 ANV TIME AFTER WORK IS COMMENCED NO DWLG. UNITS OfFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ ANO EXAMIN�O 7HIS APPLICATION 1 STA�LS GARAGES ANO KNOW THE SAME TO BE TRUE�ANO CORRECT. ALl PROVISIONS OF LAWS VA�UATION � SURTAX AND OROINANCES GOVERNING THIS TVPE OF WOAK WI�� BE GOMPUED $1�000 �.SO WITH WHETMER SPECIFIEO HERE�N Oii NOT. 7HE GRANTING Of A PERMIT DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL THE pEqM1T FEE SAC CHARGE PROVISIONS OF ANY OTHEF $TATE OR LOCAL LAW REGULATING coN- �34.75 Fire C y�1.00 STRUCTION OR TME PERFORMANCE Of CONSTF7UCTION PLAN CHECK FEE TOT F E Licens $5.0 1.25 S�GN4tUpEO�CON'AACTOQOA�UTHOp�ZEDOGENi �o�rE� EN P OP A IOAT NIS IS YOUQ PEAMIT �� _ - 9 $�GtisiuQE O� OWNEpi�f OWNEpBU�LDEQ� �DATEi � Bl0 �NS� � � ��E NEW . AIaD�1 ALTER [l [l [l CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERNIIT APPLICATION Effective 1 / 1 /99 �� 1�� 0 � �� ConstructionAddress: � �'�� ( ��,k- i'w � �,, ,r� � LegalDescription: �0�2 Owner Name & Address: �i � C,,, j � d c� �.,,,m,� u,.S c.�1� � � e Tel. # rj� a-� 9� S Contractor: ��; C e Di u� c^e �o��-es' MN LICENSE # 3� � �i Address: � a�{ (� 0�r��,c��n g� J� �iyi � n n2'�0�� N'i (J Tel. # ��- 3 79 % ��IVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length _ Width Height Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: ...�5�� ;tQc� Up,✓rt �c��'��,,� �'�[�f�ur�eEstimated Cost: $ <<�D l"� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: APPLICANT: c�n,� Tel. # c� �0 - l�(� Q Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ , 7� $ ! �U $ , � $ $ �� e� � $ $ $ $ $ � Z� STIPULATIONS: � � 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 Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY INSPECTION DIV. 6431 Universfty Ave NE Fridley, MN 55432 572- 3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On January i, 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 NO. RATE TOTAL � Water Heater - Gas** _ 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 $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Apptiance /� /� ,�� :� � State Surc rge ,��r�u""�"'! ' � �O'''t � SaQ, �° TOTAL FEE �� G CYi' JOB ADDRESS � �� C �� C'� Pa ✓' � 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 a!! the facts and representations stated in this application are true and correct. � ' 3 - y '��` , 1999 Owner i"G'!�7-�'c�'c�l�' /"�ctcos7 L°9h S-1' Building Used As �� s/��h fs Estimated Cost PERMIT NO. /�� PLUMBING COMPANY ��3-�S ��h/ii � /'/'o ��'!c � �,SZ� SIGNED BY � Approved B� $ .50 TEL N0._,S�G /',� �-s � Final Date `%�`�� r� MINIMUM FEE FOR ANY PLUMBI�GAS PERMIT_IS $20.00 � $ �/,-S� PLUS THE $.50 STATE SURCHARGE **COMBUSl10N AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ lNCHES. CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 1999 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOBADDRESS I � �� /�JG1. � RATE SCHEDULE Residerrtial 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 All Others/Repairs & Alterations (LIST ON BACl� 1% of Value of Appliance or Work Commercial/I ndustrial 1.25°� of Value of Appliance or Work Rate $ 30.00 $ $10.00 $ $10.00 $. $10.00 $, $ 25.00 $ State Surcharge TOTAL FEE The undersigned hereby makes application fer a permit for the work herein TOTAL 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 c rect. �� ,199� OWNER BUILDING USED AS �� `� .�(C � ESTf MATED COST �C�CJ PERMIT N0. DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name 5ize No, BTU HP EDR $ Fuel Total Connected Load $ .50 $ aS�� s; �� MINI MUM FEE FOR ANY HEATING COO - ION �p Q--� � REFRIGERATION AIR CONDITI G PERMI PLUS THE .50 STATE SURC GE REINSPECTION FEE $42.00/Hr Burner Trade Name Size No. BTU HP EDR HEATING Signed By Approved By *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR written permission from adjoining property owner. �II � • � �• i Rough—In Date Final Date �/�-� 'RIFIf:�Tlnl�l ('1N RFPI A[:FAAFNT FI IRf�I�C:F �� CHIlVINEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1: Has been carefully examined Yes O No O 2. Is free from rust or deterioration 3. Has no foreign objects lodged within 4. Is securely supported 5. Meets all current Code requirements for size and total BTU's connected � 7 ,� Has total heating BTU's of All other BTU's TOTAL BTU's Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) Has a liner been provided for water heater Yes () No () Has combustion air been provided for water heater Yes () No () Remarks: HEATING CO: Signed By: Date: � .�% sue.,ect PERM . c;ty of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T I r ; � RECEIPT NO. • COMMUNITY OEVELOPMENT OIV. ' j V � f � •� � PROTECTIVE INSPECTION SEC. �� / � � , ' � /'��1 � CI7Y NALL FAIDLEY SS�3Z NVMBER pEV DATE PAGE OF AVPROVEO BY �---.�: �.' 612-571-3450 9�0-Ft5 4/28/99 � � JOB ADDRESS 1454 Creek Park Lane NE 1 LEGAL ��T NO. BLOCK TRACT OR ADOITION SEE ATTACMEO DESCR. /{ 3 Creekridge sNEET 2 PROPERTY OWNER MAIL ADDRESS 21P PMONE , Karen McCulloch 1454 Creek Park Lane NE 572-1975 3 CONTqACTOR MAI� ADORESS ZIP PHONE LICENSE NO NOrth Metro Construction 525 Tower X Pond Ct, Anoka, MN 55303 712-0522 1 AqCHITECT OR DESIGNER MAIL AODRESS 21P PMONE UCENSE NO 20098397 5 ENGINEER MAIL AODRESS 21P PHONE LICENSE NO 6 USE Of BUILDING Residential 7 CLASS OF WOFK ❑ NEW 8 DESCRIBE WORK Reroof House & Gar 9 CHANf3E OF USE FqOM O ADDITION ❑ ALTERATION (33 Sq) Tear-off TO �7 REPAIR O MOVE O REMOVE STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. HEATING, "� v. �v..�. VENTILATING OR AIF CONOITIONING Th11S PEftM1T BECOMES NULL ANO VOIO IF WORK OR CONS7RUC710N ZONING AUTHORIZED IS NOT COMMENCEO WITHIN fi0 DAVS. OR IF CONSTRUCTION OR WORK IS SUSPENDEO OR ABANOONEO fOR A PERI00 OF 120 DAYS AT . ANY TIME AFTEF WORK IS COMMENCED. NO DWLG. UNI' I HEAEBV CEATIFV THA7 I HAVE REAO AND EXAMiNEO THIS APP�ICATION 1 AND KNOW THE SAME Tp BE TRUE AND CORRECi. A�L PROVISIONS Of �AWS VA�UATION AND ORDINANCES GOVERNING TMIS TVPE OF WORK WI�L BE COMPLIED WITM WHETHER SPECIFIED MEREIN Oii NOT. THE GRANTING OF A PERMIT �2�828 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME pERM17 FEE PROVISlONS OF ANY 07HER S7ATE OR LOCAL LAW REGUTATING COM• $74.75 STRUCTION OR TME PERfORMANCE OF CONSTRUCTION PLAN CMECK fEE . ,�. �,,� y-ag-a°� Lice S�GN4TUQE0 CON'aACTOQOQAUTtiOAIjEDeGENi IO�TE� _ ,,,= e :UPANCVGROUP IOCCUPANCV�OAD FT CU fT. STALLS SC $5 0 i Y VA STREET PARKING GARAGES TAX $1.41 CHARGE SC $2.83 AL FEE $83.99 Nai qEO�OwtiEa��v wHEQBU�IDEp� iO�iE� I� ��/,�� iV u o i r, itico r,nrf + � . NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 `� BUILDING PERMIT APPLICATION �� Q\ D � �� ConstructionAddress: �� 5 L� 2��G ��c' �C �-�1 � Legal Description: �� - (b p -� Owner Name & Address: �C..r� '(V�GC�,� R p� TeI. #�� oZ- f �l 7 S Contractor: I�o.r--}-�, �/l e-�Ya '�r� 6-�-C'�-`�-�� o✓� MN LICENSE # a06 8 3�t"� _ Address: Sa� o w e r �e �o� C-'�"_ �o �� V�'\ n. • � `��Tel. � � � � -- o �a a LIVING AREA: GARAGE AREA: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Length Width DECK AREA: Length OTI�R: Width Height Height Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. /�r��'�� 3�f Q� Construction T e:� ��/�� Estimated Cost: $� ��p. YP (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$. _$ DATE: -1- �$-� APPLICANT: �.�w�-,. � `1� Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control $. $ $ $ � $ ��6t� $ $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (5tate Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary [] TOTAL STIPULATIONS: $ 83, 9 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTI�lG PERMIT MARK NUMBER OF FIXTURES TO BE �tvsTai i Fn nN Fa�:H �i nnR Effective On May 10, 1999 PLUMBING FlXTURE RATES: New Fi�ures 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** � � Gas Range** Gas Dryer'• Back Flow Preventer Required ()Yes () No RATE $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.Q0 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 TOTAL JOB ADDRESS I�j� C�%� �/2� iC./U• Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance �D dD State Surcharge TOTAL FEE 0 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all wor6: 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 As ��!�%-�� a Estimated Cost � �� p �� --�� , I �� PLUMBING COMPANY 6250 lndustry Ave. i�. #1�� , SIGNED BY 421-6140 TEL Nd. 429- - r��w . Approved By � Rough-In Date Fina! Date ',� r � . � : . �: "*COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES. sue�ecr P . City of Fridley 3 i 4 0 8 AT TME TOP OF TNE TWINS g � f L D I N� P E R M I T r ; � RECEIPT NO. COMMUNITY DEVELOPMENT OIV. � � �96 r � v � PROTECTIVE INSPECTION SEC. l.__- �,��;'� CITY NALL FRIOIE� SSIJZ NUMBER pEV OATE PAGE Of APVROVED 8Y L 1� 612-571-3450 910-F15 9/18/00 / / JOB AODRESS 1454 Creek Park Lane NE 1 LEGA� LOT NO. BLOCK TfiACT OR ADOITION SEE ATTACMEO DESCR. L} 3 Creekridge SHEET 2 PROPERTY OWNER MAIL AODRESS 21P PNONE Karen McCulloch 1454 Creek Park Lane NE 763-572-1975 3 CONTRACTOF MAIL ADDRESS Z�P PHONE t,ICENSE NO Renewal By Andersen 350 73 Avenue NE, Fridley, MN 55432 612-502-4777 e ARCHITECT OR OESIGNEii MAIL ADORESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL AD�RESS ZIP PMONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION ❑ ALTERATION � REPAIR p MOVE O REMOVE B DESCRIBE WORK Replace patio door within existing opening 9 CHANGEOfUSEFROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Seetion 310.9.1,2 of the 1997 Uniform Building Code. : � ��'� ��pe�tion �� v:� ..�� '� �Aa�iled ..�� ,�� o Qo�� . �� > >.� TYP@ Of CONST. OCCUPANCY GROUP OCCUPANCV LOAO SEPARATE PERMITS ARE REQUIRED FON ELECTRICAL, PIUMBING, NEATING, VENTILATING OR AIR CONDITIONING TMIS PERMIT BECOMES NULL ANO VOIO If WORK Oii CONSTRUCTION ZpNING SO. fT CU FT. AUTHORI2ED IS NOT COMMENCED NfITHIN 60 DAYS. OR If CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 OAYS AT ANV TIME AfTEfi WOFK IS COMMENCEO. NO- DWLG. UN17S OffSTREET PARKING I MEREBY CEFTIfV THAT I HAVE REAO ANO EXAMINED THIS APPLICATION 1 STA�LS GARAGES ANO KNOW THE SAME TO BE TRUE ANO CORRECi. ALL PROVISIONS Of LAWS yq�VATION SURTA% ANO ORDINANCES GOVERNING THIS TVPE Of WOiiK WiLI BE COMPLIED WITM WHETHEfi SPECIFIED MEREIN Ofi NOT. THE GRANTING OF A PERMIT �4,736 $2.37 DOES NOT PiiESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEI THE pEpMIT FEE SAC CNARGE�y� PROVISIONS OF ANY OTHER STATE OR IOCAL lAW REGUTATING CON• �111.25 Fire SC� �.1;,X11tA ��F.7�F STRUCTION OR TME PERFORMANCE OF CONSTRUCTION PI.AN CHECK FEE TO AL FEE Licen C $5.0 $123.36 S�GNGIUQE O� CON'RA(;TQR Op AUTNOA�ZED �GEN� IOATEi ME PROP .�VAI,IOAT THIS IS U�E IT ✓ a� S�GtiatUAE O� OWtiEA��c OwHEQBU�tDEA� �O�TE� iNSP � �iz�E �[ ] ADDN ALTER Effective 5/10/99 [ ] CI'I'Y OF F1�I,LY ,ji] S�tGI.E FAMAL,Y �ND DU�'LEXES IZ-� ANl) �-2 BiJILDIlVG PERMiT APPLICATION �onstruction Address: �`�S�{ �(-Q.-Q� t�G.'C fC. L(�j : L.egal Description: _ Owner Name & Address:.��r� `(`�C, �,V�� 0 C,1r�, �,� Tel. # �3 • S�d • � 9 �'� Contractor:, RENEWAL BY ANDERSEN �N I,ICENSE # Address: 35�-73RD AVE. NE Tel. # rRIDLEY, MN 55432 Att' ( 612 ) 502°4777 rvey of the lot, LICEI�SE #20130983 . it to scale. LIVING AREA: GAItAGE AREA: I)ECS AREA: , � , �onstruction Type: DESC�IOl�t t,�F ��:i.:Vr;11�N'� . � Length Wi�th Height Sq. Ft. Length Width Height Sq. Ft. Length iTVidtli Hgt/Ground Sq. Ft. On .. � n. r. _ � ,-. n. �� ,, n � _ . ._ \,. .�n.._ .. . _ .: .► t - - — . n. . r I • - ^ Estimated cost: � 4 ��- 3(0 �� Driveway C�rb C�t W idth Needed: Ft. + b Ft = Ft x$ _$ 11 � � , • • � ' ' .a�. �.� sL ` A► . � • Pernut Fee F�se Surcliat�ge State Surcharge SAC Charge Lic�nse Surcharge I�riveway Escrow Erosion Control Park Fee Sewer Main Charge � ��a� �� - � y� $ $ �� $ $ $ . $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Psrmit Vaivation (1/lOth%1 $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.OU Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAI. $ I � . � � _ , .�/ �LL S'TIPULATiONS. �� _6�1�� 1��/1�0� m.�. � � -��/"��S' � -�i.�c�--- - ''�'z.l� � �`'� �?� ��• �, /, �--- e�' �'.�� o��- . _ . _ . CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATIORi FOR POWER PLANTS AND HEATING, COOLING, VENTILATtON, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 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) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1°Jo of Value of Appliance or Work �ommercial/Industrial 1.25%0 of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTALFEE MINIMUM FEE FOR ANY HEATING/COOLING/VENT�LATION 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 prop�rty owner.. Ltie�t�ve �u►ivaiy i, �uv� JOB ADDRESS %�� r�eK �c�!`� :�a��'_, OWNER Gcr'e/t ��= �-u-��vCIL ' TOTAL BUILDING USEDAS�s��r�i� $ �, � ESTIMATED COST �rv"O�• v� _ PERMIT N0. �--�_� $ $ $ $ $ $ $ .50 �;?�.�� DESCRIPTIQtI OF FURNACE AND OR BURNER —�. No. of Heating Units-= ; l Circle One (Steam) (Not Water) arm Air ' Trade Name__= ="_- : Ne.==�- f-�%�v Size No. BTU .jU oc�c� FiP EDR Fuel A1w� • Total Connected Load Burner Trade Name Size No._ BTU HP ED �s��. // NN<<f � G l� �.:J r"«,�1� c� �'`'/ � J The undersigned hereby makes application for a permit for the work herein specified agreeing to do all ��vork in strict accordance with the City Codes an rulings of the Building Division, and hereby declares that all the facts and representations stated in i;�is application are true and correct. DATE ��i U3 HEATING CO _s �ei Gus /-; ��rs �, _ Signe Ct . �CYr� TEL # ��'�'��- �� 7 FAX # 1a�5 /-%/�� '�?% � _ t �� Approved By � Rough•In Date Final Date �� S d� � FIL� 0�T BACK S�DE FOR STACK VERIFICATION ON REPLACEMENT FURNACE �,bo�� o��'�`1 NEW [ ] CITY OF FRIDLEY ADDN [] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: � � �. �- C 1(` � � �f%r �� .'1\l, Legal Description: Owner Name & Address: ��-�v�� (��,� rrr 1� t 4 �,Cv�Ce� �Pl� Tel. #7G3�57� o? �/ �� Contractor: �`��j� � � 0 � � � � _ MN LICENSE # � � � � Address:� � � � �.� �� 1W�., Al �3Yl��b ��v/1 ��k, l'Y)1�, Tel.# �63 �3��3�� LIVING AREA: GARAGE AREA: Attach to this application, a Certificate of Survey of the bt, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. DECK AREA: Length OTHER: Width � %� � round Sq. Ft. � `('�� / Construction Type:�'c°ar�'�'2`�D(7� ��N� Estimated Cost: � lr'7� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: APPLICANT: �'�v'�`1 �F .�R ��c� Tel. # �, �� 16 3 G G G� Cal! (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge � r. d� $ $ •� $ �e � $ $ CS - C�O $ $ $ $ C��'1��.'3��7►1A'1 Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 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 [ ] TOTAL $ �� /- T I STIPULATIONS: