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AF - 40988, . +• � . City of Fridley AT T� ToP o� rnc Tw�Ma '°~^� GOMMUNIT� OEViL01�MENT C1Y, � MCT�CTIVR Nf�CT�Qp �/T. � Cm �uu.� s�uo�RY �M� �----�.J �q-NO-sM0 S t:� �i �. ,�....� - ,��i Q �� �.' ; 1� � � xi t- �° -_ , �� intractor .�� �'� �d �r � .nd of Building �� � �., ,e �mp e�ti-on Date : I �I + � � � � '-- 3 °I�i I � : I °"°i •x�,� i '791N I •Bda, •�nNwa � I m 8N19Y8� I� H�lY7 li� O 6NIY21CI '� roo�i � i3 °o �w d IQ �Q u I sa3e►a+g �� � ��q '1Nf70d d HNIt�O �y BArt/1 Q � HSYM �/ 8IINIBI lNIiYY �;�\ � � �� �antl I .....� � �'[ y � ,. 111 � .� O -� �� I I � 0 ' I a I � i , � � iu�Ml�l �I I • I M � � � � � v y'-��-�� W � � � � 0 PLUMB I vr, PERf9I T APPL I CAT I��� eaaress �,� r .:l _ . ��� :��.<=�- ri�� �'�. A ressJ � �- � ��'� , � I � 1 $�0 one � ,�� / - ;`� .. � _'� �- use .}��� �l`� stimate ost 5��, ��—. —�—=--... ____. �_._. _ __.__. Plumbing Fixture Ratea: N0. RATE TOTAL Number Fixtures f�/ x$2 . 00 $%'�. �s'V Future Fixtures � X $1.50 � New Fixture-Old Open. x $1.50 Catch Bastn x $3.25 Water Heater-99,000 BTU _� x $3.00 Ground Run Old Bldg. x$3.25 Elec. Water Heater —! x $2.00 Gas Fitting Fees: lat 3 Fixtures �_ X $2.00 �- �% Additional Fixtures —� X � .%5 �� Gas Range-199,000 BTU x $5.00 ReQaira & Alterationa See Description; Code I S tate Surchart�e .50 ITOTAL FEE $ . � a !The undereigned hereby makes application for a permit foz �he work herein apecified� agreeing to do all work . in strict accordance w ith, the Citq Ordinances and rulin of the Department of Auilding�, and hereby declare that a11 the facta and representatione atated in thie application are true and correct. �`J %-02�-73 'Signature Date � . 1 r � '_ .r City of Fridley 4T TIIQ TOP OP TIIE TM�INY . rL----•--� ca+wu►��tr oev��or�Nr on. � � MqTECTIVR r1t�CTlpry OpT, � r. . � pT1► MA1.L iR10i.R� fi*� (`�� �.J fq' 0�0' 3�M0 Job Address Contractor of Building etion Date � � � � � k �� � I Q O � � x�� �ro b �� 4 ' �-/o - �J�a/��-/' 53-81�-8� 9, 01 i�N�EGT PLUMBI�Vr, PERf�IT APPLICATI���� ��k�.� 7939 East River Road R. �oz�att �i�casso Fr�me s aaress T33 NfARQUETTE AVENUE se Res. � � stimate ost 3-7-75 � lo.00 I �, ,� I! o�! .� ' i �' i O � I � I � I w I .� i� � ! one � �yy�. Plumbing Fixture Rates: Np, RATE TOTAL Number Fixturea x $2.00 �_ Future Fixtures x $1.50 .–.-----_ New Fi.xture-Old Open. x $1.50 Catch Basfn x $3.25 Water Heater-99,000 BTU x $3.00 Ground Run Old Bldg, x 3.25 -_� $ Elec. Water Heater x $2.00 Gas Fittin Fees: lst 3 Fixturea __>�� �_.. �, �� r� r�.��� ,n ;� ' ---. Additional Fi.xtures h��,i��t��L�l,_�i��� � 1��T' Gas Range-199,000 BT[1 R_ e— pl x$5.00 5.� � � Repeira � Alterationa I � See I Description; Code � ----- � State Surchart�e _ 50 �fass '"A" Surcharge .�G¢ � I xo� �E $ 5.50 _____ !The under�igned hereby makea application for a permit for the work herein apecified� agreeing to do all work . ia atrict acco�da.nce wi.th the City Urdinances and rulin of the Department of �uildings� and herebq declare that a11'th� tacte and repreaentatione stated in thia applica ios are true and corr�ct. Cf�R� o�. . ��s�e�r,.�_ �aignature MINNEGASC�? Date . , SUBJECT P City of Fridley � 12216 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ' � � � RE � `L __�� COMMUNITY DEVELOPMENT DIV. � � � ��� r � � PROTECTIVE INSPECTION SEC. � 6��� � _ , �� /'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ""'�'� ,'� 812-580-3450 910-F15 7/2/73 � � 10B ADDRESS 7939 East River Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oescR. 4, 5, 6 3 Spring Brook Park Addit ion SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE DeGardner Construction 7950 East River Road N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same � 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. B USE OF BUILDING Residential 7 CLASS OF WORK C�( NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBEWORK �onstruct 42' x 26' Dwelling and 24' x 24' Garage 9 CHANGE QF USE FROM TO STIPULATIONS provide a hard surface driveway. Provide a verifyi.ng survey before capping. Set dwelling 10 feet at right angles to property line. SEWER LOCATION: 205' N.W. of Ma.nhole at 79th & East River Road (Inv. 848.71) WATER LOCATION: 74.5' East of PP 110.4' North of PP Approx. 10' to 12' North of Sewer Service �Q'�1�ED �OR ��1�liVG, SEPERATE PERI�lIIT G �N� SIGNS. 1-SEP►TING, r�L�1��liV SEPARATE PERMITS ARE RE�UIRED FOR EIECTRICAL, PLUMBING, HEATIN�, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. WOOtl Fi2ffie THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION R_1 1092 21 8G.O OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ! ANY TiME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PAHKING 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 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED, WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERM�T L�. LL7 . S$ �.0. C�. DOES NOT PRESUME TO GIV A HORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF A. OTH S E OR LOCAL LAW REGULATING CON- $SL.00 $L]S.00 STRU TION OR � RM CE OF CONSTRUCTION. � PLAN CHECK FEE TOTAL FEE q $337.61 � SiG A/ REOFC¢f�TRACTORORAUTHORIZEDA ' IDATEI WHEN PROPERLY VALID HIS IS YOUR PERMIT 4 %� 0 ; .., 4 � SIGNATUREOFOWNERIIFOWNERBUILDERI IDATEI BLDG INSP qA7E � _, s � a�. � I A�'PLICATION FOR RESIDENTIAL, ALTERATION, OR AllDITION BUILDING PERMIT CITY OF FRIDLEY9 MINNESOTA OWNER' S NAME : ��o � � �y^C7 �ti�� ( ��1YLDER: anD�SS : 7�7.5�0 �, �f �e� � P �n��SS : .9: �-. No:��s�2:_ � � � � � � e� , LOT : S" BLOCK ° 3 ADDITION :,.j trj,� � � CORNER LOT : INS IDE LOT : S ETBACK • �� S I DEYARD ; C� �i �� Applica,tlt attach to thia for� �ao Certificates of Survev of Lot and proposed building locatian drawn on these Certificates. �ESCRIPTION OF BUILDING To Be Uaed As; , � , � Eroat • �_ � r �=� � Depth : �� � , Height : �- °�� �, _ S uare Feet � � � ' , ,-� � q �:� Cubic Feet: >�' -�;� Front : �' � � -- D�ePth : �- �� � Height : � �� � �';- , Square Feet; � =�- `� Gubic Feet: `�� ,' %` -- �`_.:_ 1�pe of Construction. "? � � b� '� �� ','� • ��% ��5/�-f1�1 Estimated Co�t; $ �° , � - �° `�. - Q. ---7-;�_.;- To Be Cotapleted: � Tha undersigned hereby makeB applicativn for a permit for the work herein epecifi�d, a�reeing to do all work in stfict accordance with the City of Fridley Ordinance� and tulings of the Depar�ent of Buildings, and hereby declares that all the fact� aad represent��ioa�a stated in thia application are trus and coxrect. ` s / .a DATE: � SIGNATURE• � (See Revez�e Side Far Additioaa,l Information.) �, r� '� „ , �•,_..ri _ "-� � - �� _ � y , � "" ,. p � .- .- .�; . _' ,- .- -AT� � _ __ �.. � � ,1 � � `I . ���._ _ . _ . � � _, ' -� ., . �., � _ ,. .; �.,. .�i 1 _ t. � �� -- . q � II � . P p 4 . � � ' `'`+ . 1 ' �� � � — , , i.� W . (� �i' ,�� >� v � .i ���--�- — 0 � �UILUTNG PE1�I� ri�,� SCHEDtTLE SECTION 2. The Inspector of Buildings sha.11a before issuing permits for the erection of any building or structure, or for any addition to any existing building or at7'ucture, ox for any alteration or repairs to any existing building or stxuct�are, aapon application therefore, require the payment by the applicant for such per�nit oi fees to th� ��ount herein below set forfch and in the m,anner herein pravided to-wit: UN.CFORM BUILDING CODEo Type 1, 2& 4- -$2.15 fo� each one thousa.nd cubic feet, or fraction thereof, in such cub�cal �ontents. Type 3& 5-$1.85 for each one thousand cubic feet. • � ADDITIONAL I�IFORI�IATION �or the purpoee of compu�ing fees for building permits, iche cubical contents of anY t�uilding or addition, ia determined by multiplying the ground area covered frotn a point six (6) inches below the floor line of the basement or tt�e cellar �v the nverage heights of the upper surface or to the average heig�}t of the roof surface of the main gable of a pitched roof. For repaira or alterations to an existing structure, the fee shall be at the rate of $3.00 ger each five hundred dollars ($500.00) or fraction thereof in the cost oi all proposed work. In no ca�e shall the fee charged for any gse�i� as set forth in Section 2 be leas than $5.00. . VERIFICATION OF FOUNDATION NOTE: Permits fox eonstruction will be issued a minimum of 24 houra from the time of applicatio�s to a11ow £or prope� xeview af th� propoaed structu�e and of tY�e construcCion si*ep A Certifiad Survey o� the lot, showing the location of the foundation, once it has been constxucted, w�.11 be required b�foxe pxoceeding with the framing. GERTIFICATE OF OCC�i'.�`�NCY Ap�lia�tion for a Ce�tificate of Occupancy shall �e �a.de �ers (10) days prior to ths use ox occupancy of any stxuctuxe for whic�x �. building peraiit has been iasueda and said a�xucture shall not be used o� occupiecl until a Certificate of Occupancy haa been issued. � L 0 .aa:� �� w ,=rrs , s.a,>-w �w- � 'F'a��`,�-�'.s'"_" rx'°�"? irvr ar>trr-�-oc �, . - � - - — - — - -- - -, �. � �. .. � ��� .Y . .. _ � . . . . . , . _ -,. ._,. . . : . .". 7,,. . �4,.� _ ` , n. - .. 4 . . � . . .. '` �r���,� a. �►R��o�. �a�s. � � : �ER�'IFi�/�kT� t�F SUR'1��Y � �� w� �.rt�� s�uu��r, ' -. : , , � �. . . - � _ , _ �a-aWa . , - , , . :. . : :, _ . . . , _ ,- : , .._ 6S4$4 - • , , , . , _:� .:, . t ..; . ; a�.. , a � ' , , _ �J'�i����i F��a 'I . _. , . , -,. DE�A�td�#� REAL'T'Y. � �O�iST: G#�. 4a�to �yRV�oas � �,� f�{� l.icensed, tn$�rred 8� 8ot�d�d :- i �� .� .� .... �Y ;� -. ` � �,/�'�;�o . -:'.� �� 1�. � .. . . `` „1..�„� �\ - ` ° : - ; „ , ' ,' • � _ . _ i . 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I � "� �j' � � � 'e' , � Z -� �' , � a "� `;�. �' �O -� � �.,. � �"��"° v � '�" - I`.�' � °J ^ . � I_ � � � � "� . "'�s :'�h .. . ►�v � 0 � . 90•0�. � n �3 y M /%1�%�� a �;} LEGAI. DESCR 1 PT 1 ON: LoTS �� S AND 6� BLOCK ��� SP.R 1 NG BROOK PARK. HVE HEREBY CERT I FY THAT ON THE � � TH DAY OF .1ULY� � 9%3� WE LOCATED THE BUILDING ON THE ABOVE DESCRIBED PROPERTY AND THAT THE ABOVE REPRESENTATION 1S TRUE AND CORRECT. , ., /H•�� �/ Q� �,,; • �,' , .�,�� ; .- d�,�L� r'�Ld��� _. MtaN, R�o. No. •5648 � �,; � A , , � ,H1 =.-7� `� Y':ia�e nt:` � r e..`•? kA�-SYp�t f z. ,R a`�s L ,� .a�� 4 . r tw _.�.'�4> x g c��. � -,_ v � r� -� .M;� �i: �:' �=:"V. : Y �,+�,,� � "' ' �" y Y � .� `x �'„t�'`,, +d. a � �# �� ,� � ff�� � ..� � ""{x � ,� � +� � .� p � � :J,�3 im �' 'F` :,. `�3 � '� y� �r+ � �. 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City of Fridley 3 212 8 AT THE TOP OF TME 7WINS g � I L D I N G P E R M I T r ; � RECEIPT NO. � ; ��_� COMMUNITY DEVELOPMENT OIY. ��� ��O q ,ts���� � V � PROTECTIVE INSPECTIQN SEC. � ��' �y�� �L i = . � �"'1 � CITY MALL FRIOLE� SS132 NUM�ER REV O�TE v�GE Oi �VvrtOVHD Br �""'�" �'' 612-571-34b0 s�aF�S 9/4/O1 � � lOB ADDRESS 7g39 East River Rd NE t LEGAL �OT NO. 9LOCK TRACT OR ADDITION SEE ATTACMED oescR. 4,5,6 3 Spring Brook Park SNEET 2 PROPERTY OWNER MAIL AODRES$ ZIP PNONE Laura Peterso� 7939 East River Rd NE 786-6131 3 CONTqACTOR MAIL ADORESS 21P PMONE LICENSE NO Grayhawk Builders 3020 Centerville Rd, Little Canada, MN 55117 651-486-9888 A ARCHITECT OR OESIGNER MAIL AODRESS ZIP PHONE LICENSE NO 20174611 5 ENGINEER MAII ADDRESS 21P PMONE LICENSE NO 8 USE OF BUILOING Residential 7 CLASS OF WORK O NEW O ADDITION O ALTERATION � REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (24 Sq) Tear-off 9 CHAN(3E OF USE fROM TO STIPULATIONS Underlayment must comply with �che State Building Code. �erm�# Inspection �ard� T Will Be Mailed � Homco�rn�r T� P�s� SEPARATE PERMITS AqE REOUIRED fOR ELECTRICAL, PLUMBtNG, MEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCV �OAO VENTILATING OR AIR CONOITIONING. THIS PEFMIT BECOMES NULL AND VOID IF WORK Oii CONSTRUCTION ZONING SO. FT CU FT AUTHOR12E0 IS NOT COMMENCED V!!ITHIN 80 OAYS. Op IF CONSTRUCTION OR WOqK IS SUSPENDEO OR ABANDONED POR A PERIOD OF 120 DAYS AT ANY TIME AfTER WOqK IS COMMENCED. NO. DWLG. UNITS OfFSTREET PARKING I HEFEBV CERTIFV TMAT I MAVE REAO AND EXAM�NED TNIS APPLICA710N 1 srn��s GARAGES AND KNOW TME SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAW$ VALUAt10N SUR7AX ANO ORDINANCES GOVERNING TMIS TYPE Of WORK WI�� 8E COMPLIED @ WITM WME7HER SPECIFIED MEREIN Ofi NOT. TME GRANTING Of A PERMIT W2�573 $1.29 DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OF CANCEL TNE pEqMIT fEE SAC CMARGE PROVISIONS OF ANV 07MER STATE OR LOCAL LAW qEGULA7ING CON- @ STRUCTION Op 7HE PERfORMANCE OF CONSTRUC710N W83.25 Fire �', �2.5% PLAN CHECK FE TOTA EE Licen S $5.0 .11 S�GN4TUAEOFCON'AACtOAOAAUTHOA�ZEDOGENT IDATE� EN AOPE � LIDAT D S IS V R PEji 1=�� � / C S�GNATUAE O� OWNEp��� OWNEA BU�lOEA� �D�TE� �� Bl0 �h5o � r��TE H1JG-C_�b-?t�►�1 11 ��1 F�'�t�1 �:I T'r' UF FRIDLE'r' TD NEw t l AF�DN j) , CITY pF FRIDLEY ALTER (] �1MGL� FqMILY AND DUPL�(�S R•1 AND R-2 BUtl.DlhtG PERMITAPPLICATlON Construction Address: j Le9al Description: �wner N�me & Address: � _C��'� i''� ����� ;�,✓ , �� Tei. #� Y �h� '���� A �' , )1AN UCENSE#,,,� `� � -���'����L� � � t �( � �'��� '� `��Tel.# �7� ��-� �° l��S�'� _ � 6�14r^.,�c�:�;? P. �1. "��' Eff�cfive 9h1200� (763j 572-3604 Bldg ltisp IMNG AREp: GARAGE AREA: DECK AREA: OTHER; Attach to this appiication, a Certi�icate of Sunrey of the 1at, with the prcposed carr,atructicn dr�wn on it to sr le. D�SCRlP_T[t��Lp�=_�gQ1[��LT — - - ��� �� ,-.----.-.�. H�ht__.____�--- S�q. Ft �� Vlfidtt� Neight �- pt -�.. �� �� _�,_,___,_ HgtlGrovnd Sq. Ft � ,-�� � � Consirt��tion Typ�: d'J' Es�mate<f Cos� $_ � ` ��"� - . � • � ��`� Driveway Gurb Cut 1N'+dth Neeaied: Ft + 6 F� - ", �_ t __„Ft x $ _ g - _ DATE° � � 7 ° • ___.��.� APPL(CAN • , Tel. � �� � • � C�7'Y USE ONLY - Cali (T63y 572-3644 tor Permit Fees if m�iling in appC�catiort Permit Fee $ �, � 5 Fee Schedufe on Reverse Side �re ��'c��� � _ o S - .�0� of P��°t a'a��a�n �3f���°f�} -- State Surcharg�e $_ f � a�$.g0�g�t,pp0 Vatuation SAC Charge $ �1'15� per SAC Unit � License Surcharge $ � p o_ 55.00 (State Licensed Residenfial Contractors) Driveway Escrow $ Alt "q�� or Alt. ,�B�• Above Erosion Coirtrol $� !$450.04 Ccnservation Plan Review Park Fee $��Fee Determined by Engirmeering Sewer Main Charge � qg��,m�nt Ne�ssary �] Not Nec�ssary 4] TOTAL 5T(PULA710NS: $ ��,1/ � sue�ecr � City of Fridley AT TFIE TOP OF TME TW�NS � � r L D I N G P E R M I T i � � � � ` _���_ COMMUNITY DEVELOPMENT D1Y. ��� �,��,����� r � L � PROTEC7IVE INSPECTION SEC. }', �°�; y��-�' i = � � �'�'1 � CITY HALL FFiIOLEV SS132 NUMpER REV OATE vAGE Oi �'""'� � �'' 612-571-3450 9t0-F15 9/18/O1 / / JOB ADORESS 7939 FAST RIVER RD NE t LEGAL ��T NO. BLOCK TRACT OR ADDITION oesca. 4,5,6 3 Spring Brook Park p PROPERTY OWNER MAIL ADORES$ Laura Peterson 793� East Rive� Road NE 3 CON7RACTOR MAILADORESS Same 4 ARCHITECT OR OESIGNEIi MAIL ADDRESS 5 ENGINEER MAII AOqRESS 8 USE OF BUILDING Residential 7 CLASS OF WOfiK YIP 21P "32171 ER CEIPT NO. D SEE ATTACMEO SMEET PMONE 786-6131 PHONE LICENSE NO PMONE LICENSE NO PMONE LICENSE NO � NEW 0 ADDITION ❑ ALTERATION �l REPAIR O MOVE 0 REMOVE 8 DESCRIBE WORK Reroof House & Garage (26 Sq) Tear-off 9 CHANOE OFUSEFROM STIPULATIONS TO Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED fOR ELECTRICA�, PLUMBING, NEATING. "r ��• ��••V. VENTI�ATING OR Alii CONOITIONING. 7HIS PERMIT BECOMES NULL ANO VOID IF WOFK Oq CpNSTRUCTION 20NING AUTNORI2ED IS NOT COMMENCED V'IITHIN 80 OAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO fOq A PER100 OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DW4G. UNITS I HEREBV CERTIFV THAT 1 NAVE REAO AND EXAMINEO TMIS APPLICATION 1 AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VALUATION AND ORDINANCES GOVERNING TMIS TYPE OF WORK WILL BE COMP�IED @ WITH WMETMER SPECIFIEO MERE�N Ofi NOT. THE GRANTING OF A PERMIT �y2 � 787 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMI7fEE PROVISIONS OF ANY 07MER STATE OR LOCAL LAW FEGULATING CON- STqUCTION Ofi THE PERFORMANCE OF CONSTRUC710N �H3 . ZS O�CON'AACTOpO e THO 2E04GENT IDAfE� . 9���/ � �� OWNEp��� OWNEp BWLDEN� iD�iE� — � ' s� . STA�LS cr �oA� CU FT OFFSTREE7 PARKING IGARAGES ` $1.39 SAC CMARGE Fire SC $2.79 rorn�Fee $87.43 > ED T►+15� UF,�M�T� � � -U �1�. 7 E NEW [] ADDN [ ] ' , ALTER [ ) Construction Address: Legal Description: � CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMITAPPLICATION A Effective 1/1/2001 (763) 572�604 Bldg Insp Owner Name & Address: _ �i � ) ���� � Tel. # %�m — (0 � Contractor: MN LICENSE # Address: Tel. # LNING AREA: GARAGE A�REA: 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 Sq. Ft Length Width Height Sq. Ft Length �_ Width _� Hgt/Ground Sq. Ft Construction T e: �:/ � % � v YP o�� � Estimated Cost: $ C� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: � /� = a� APPLICANT• Tel. #_ �� �o ""� / /% CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $ c� 3�°�� - Fee Schedule on Reverse Side -- — $—�— .001 of Permit Valuation (1/10th%) $_�, 3 $.50/$1,000 Valuation $ $1150 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 [ j � � ,� � t, 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 srivcture, or for any alteradon or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such �rmit 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 $25,001 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 $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,0� plus $14.� for each additional $1,�0 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $SO,OQO $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $5(�,(1�0 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,0� $5,608.75 for the first $1,OOO,Q00 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete C�trb Streets Only) Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. 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 $23.25. VERIFICATION OF FOUNDATION Pemuts 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. New Houses Onlv