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AF - 41647SUBJECT c�ty of Fridley � i5i AT THE TOP OF THE TWINS g U I L D I N G P E R M I T i • � � R ��d� � ; L __�� COMMUNITY DEVELOPMENT DIV. �� r � PROTECTIVE INSPECTION SEC. q���� 1 � 1 � � �� ���'1 � CITY HALL FRIDLEY �j$432 NUMBER REV. DATE PAGE OF APPROVEO BV ..__.11.' ',� s�z-ssa3aso 910-F15 4/lI/79 � � JOB ADDRESS •733�"32 �V�'t COUY"� N.E. t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ]. 2 �';{7p,1^'t�S Addition SHEET 2 PHOPEHTYOWNER MAILADDRESS ZIP PHONE r�ndborg Bros. Inc. 15354 Fillmore Street N.E., Anoka 55303 434-63?l 3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO. Same 4 ARCHITECTOR�ESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK �❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 38' x 44' Du 1 and a 22' x 44' Gara e 9 CHANGE QF USE FROM TO STIPULATIONS provide a hard surface drive�aay. Provide sod in the front and side yards. Provide City with copy of verifying survey before capping. SEWER LOCATION: Just North of Tntater Service. T�7YE ELEV: Expose service to establish top of footi.ng. WATER 7ACATION: 53.8' West of Manhole, 61.4' North of Hydrant. DRIV�AY I�PRESSION OOST: N/A SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. WOOC3 Fr�C THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION 1672+1056+968 36, 256 Tota. OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 2 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $�6,600 �`3S.3O DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON- STRUCTIO OR THE PERFOFM CE OF CONSTRUCTION. ' S�-4S. OZ tiS`SSO. OO PLAN CHECKFEE TOTALFEE �' „� � � � ..�` .>° � �' � s^�2�i _ $ 36. 26 $1, 069. 58 `9GNATUREOFCON C7 "aoRAUTHORIZEDAGE� IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT / SIGNATURE OF OWNER UF OWNER BUILDERI IpA^E�— s � � Y y��� �/�` !� � BLDG INSP pATE ..,r' .��. . � CITY Of F(tIll�EY APpLIC/1TI0f� FOR RESIllCNTIAL BUFLDING F'ERMITS i�VEW, IILTCR/1TIONS, ADDITIOtJS, OR REPAIRS) � �- �� " �I /� �1�� l � OWti�R: �L..G'h����29 �i� � `T� � BUILD�R: ���Yi � ',, . . Address : /�`� ��1. o��/�� �o �r Address : � ftA j��h ���8 � � Tel . I�io . 5�,� l �,7/ � . �.: �3 30-3���t: 0 IAT: � BLOCY.: � ADDITION: _�(J,oi2�•S ,e��� � � COitNER LOT: INSID� I,OT: S�;TBACK: SIDEYARriS: Applica'r.t attach 'to this fonn �vo Certiiicates of Survey of Lot and propose3 building location drawn on these Certificates. . DESCRI PTTOPJ OF BUI LDI NG �o Be Used As: .j �'��e �c Front: '`'�`'� Depth: il� ' • Height: =.2c� � Square Feet: Cubic Fe�t: -- (_�c�rA e. � Front: "St� Depth: �� � Height: /j� . � Square Feet: �CQ� Gt�bic Feet: � Type of Construction: _ Lf%mpn! ,��.� Estunated Cost: $����, �p�j. °—� Zb Be Completed: o�e�� /, /9�� Alt. A Alt. B Proposed Drivecvay Width If New Op,ening Is Desired $ $ . • (SEE REVERSE SIDE OF SHEET) The undersigned hereby makes applicatian for a permit for the work herein specified, aqreeing to do all worl: in strict accardance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby deelares that all the facts and representations stated in this application are true and correct. See reverse side f r addit' nal information. DATE: � — - 9- 7� s�c�,�T��: ��� Stipulations: P��.�� ►� Ft,I �.ot �� � � s� � 3� .30 2 S� ���_O° t o �9 . �3 - s � � .... _�. . � BUILDING PER��IIT FEE SCHEDULE • � ° SECTION 2. The Inspector of Buildings 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 altesation or repairs 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: NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet. PI�AN CHECK: 25 percent of building permit fee. , DRIVEWAY DEPRESSION: (Concrete G�rb Streets Only) • Alternate A: Removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet x$�5.75 Alternate B: Removal and replacement of concrete curb and . gutter and install a 3 foot wide approach with � 6 inch depth; Driveway width�plus 6 feet x$17.85 �11 � :_ 1 �' : �l For the purpose of camputing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an eacisting structure, the fee shall be at the rate of $3.00 per each five hundred dollars-($SOOo00) or fraction thereof in the cost of all proposed work. In•no case shall the fee charged for any permit as set forth in Section 2 be less than $7.50 plus $.50 state surchasge. ; : � ! � 11: �1 NOTE: Permits for construction will be issued a minimtna of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. � A Certificate of Survey of the lot, showing the location of the foundation once it l�as been constructed will be required before proceeding with the fram�ng. � � � � '�► � _. Application for a Certificate of Occupancy shall be made ten f10) days prior to the use or occupancy of any stzvcture for which a building permit has been issued; and said structure shall no� be used or occupied until a Certificate of Occupancy has beea issued. - L O � � • ____.___-_--____�_3 �.o -22 _:---- _ 73 3G- 3_Z._ _---_-�����- _-__ea�2� _-___-- - -- ----- -------- - ------ _ _ c�P��--- _ -__ - - ---- --_ __ _ -- - _ _- --- -- -- � --------------- _�.� ����- ---- . --- --- ------ ------- - -�X._4_� �:���'?i x �.$� � Zc? �-�,.�__ _ ------___- ---------------_ ���._v�--- � -----_--- ----- _ _- �----=---- _ �_ �_ ___Z��c__94 --__1_�� __ �S=_���_ . �%------ -- -- ---- - - - - -- ----- ��� ---_ _ _ ----------_� ��_4t1�► =� �_`�t �z_�__'��-'I_�i__ e.��r-;i --- -�-------- -__. ----- - � ts'� �.. ----- -- --------- ---------------__-�--__---- _ ----------_-___----__-____-__________ - -- -- -� -- ---- _-- _ - - - -- --1�-�----_x-�'.s'?--- �- ����% �-, �__ __ ______.__ ______ ___ ____ � -- - - - - _ - __ _: - i� - - X �. s �.- __�� ?-���_��.-� �- ----- - _ _ - - - _ -- -- -- - -____. , _. __------- -- ---�---�_--�-�-��- __7,c�8�-3�------_-- --- _ ---- __----- ---- --- =-�_��___ _�_—. _� _ --- ------�r, � L,'�.��8-�_- -- � - ---`i � r �-�► �- - ._ - -- -. __ ___ _.. _ - -- -- -- - - - --- -- - -- � --------- -- ------------QRctw�_`__�-__-_ �'�,'���--�.-�_��_ _4 __�--_: _ _ _l_��'�•. __- ------ _�_. � �. '� � - -------- ------ ----- � _--- �------------__-_ _______ ___-_--1-------------- �� . -.�t�-------------_._�__�__- ,._�____.�_�_.----'�o-- -_�____-_-_-._.�.____________ ____ �. 3a_� _______ _, , __ __ ---------- ,- ---= ---�. ---- -c�'� �'�_ ___ - ------ ------ - gS� � _____-----__ _---- -----__-------� O�i4._� ---- --- -- -- --- - -- -_ - ---- -- ------- ------�----- -_____----_----- -- ------------.--�--�--- ---_ _ - ----- ----- -- ---------- � __ ----- --- _ _ __. _ , �j fJ�URO�M . E iek; ��NOIN�ERINO !; ,'„', �i _ `,, Y,� _. � r _ _ . �wt _ - . � — _ -:e. _�_ . --.- -_-___ ._.-_� ,i ��,.i.,a NsaJ rt. �� . .� h Ai� _, .. • � n, ..^�; � `--ri i..� _� � i... , ..rtA • =•;r ! ir...��g � � ..,. � � , 4.� . �� . �~ � ..?�..i.. Certificate of Survey for � y 6= �l �� 1i►Y�N ��� . � ----� — - � �Oenotes iron monumenf ��@n��es l�r�ina e� No R TH Utr'Ir�'ty Eexsem�n� ' ��� �rr�+ oF FRibY.EY �oa N�Y GvARA�►�.. .�. " ACGURACY OF Ulll.i'dY LOCA710NS AND E1EVA �Gr�;. THIS DATA IS FOR INFO�►710N PURPOSES ONL AN:J p�RSONg �SIi�K', R S1�IpUIp VERlFY THE INfO i1��N oH nie si�. I —�-- . ��, .. � ��N I�' 160_ 9� 0 $ub�ert fo ecr�emen �� � �—�, R - SO e��4 � � J � � ���N� '� � ° c��t ���a� ��ili�e� � ����� dl����+� �� �� I � ����Q��° ��+ 9 � j i _ ��,p� �� � V�� �a��-�''' � �, r� rerorq , � f �anJr. Ar�Qk'A CovwrY t h�r�b� s�.�i1� ►hof eAis is o Iru• ond �on�sr rapr�a�nlalFew ol o di�erib�d Ian19, and o/ tA• loia►fon o/ oll build{n4�, th���e�, aed all v •oid Jond. A� s�rr�y�d br rn• �hi• der oi ah r A- . 1V � S'cale� f ��40' ; ,. s �uRs br 4ot Publ,st�eA All R�ghts Heserveti •r ef ►h• boundori�s ol t6� obor� • �ncsoochanyy��, i4 anr, Irom m �u RI , INC. ►v�rOif ���� - --- a �c�s i /�, � � ��t�� ��rrsi ��. 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N�p �j (�p � v a ro C x a � 5� p' o 0 �o 0 o°o °o c o D � � � � �1 .-7. Gi � � A - .w .'�1 '�'+ � b'U'�U � y '~ w�•a a K � y y�j � f�D •t r Y D S' �yyy i-r tD � � � � �M1-' � � y w � � M � � oo�n� � � a n N N � � n � X � O p, w n +n •° tn o O Q �o 0 +Q �t �1 .? N .P +1 d N � C D O O O O D D O� -M +pf ��LA iA fA in �N d/l «� D A r � +n w � �+a� x �W� �++rw� a w c� xL�aw h � � H itl D ft ►•- +S M tD W � � �a'r � w � ,m�� o K � � �i o � � rt�N� n '� s m +-a� n't''z�o � � W a w � ���rt �� �'w wo b � R � b'wdo n a � M �n��"aro � a��� � a E � � �w �h � ���� °'�� $ 8 "�; � ���� .I� '"�w�. .� " � m+n�-m r�� ��� i�n,�r W i+� N N� o� � +� +- w �, 0 tt � � � m � � � r � m N C"� S b � m w � 'D '� r n a -�1 O Z 97 0 � 0 � m ."O A � � Z O ai d a --1 GZ °z v c�i � a � � � � � --1 f'� R1 O 3 O � r d � m m < � f') .-. m � � � 0 a � m � � � m � a --1 O z D 2 C ,k ;� �� . ���� ;� � C\� � � � a � --�'-i -< 0 -r7 T :v d r � � � � HEAT LOSS CALCULATION ° TEMP. DIFF. Customer Name - �'" � • Type Construction City Windows Storm Sash Dealer Name _ ��� %"�� (V� �.14�1�' C.`PA'hr�i��et�n��a ,: , Walls Ins. Street �6�� �AOF1':4��5'ic�S B7.vd ` Ceilirn� Ins. I City �� �i�[3iG%. i�lf�P �54,� Floor , _. ��,y�l.� �� Room � Length Width �"� Heigh Q �'' FL� � �„� Room � Length � Width •� __ _Windows and Doors-Crackage and Area Windows and Doors-Crackage and Area No. W�dth Meig�t No, of Lineel ft. A►aa Witlth Haight No. of Linaal it. Araa of pane ot pene Lip�ts of creck sq. ft. NO• of parre of ana li �ts of enck tq. 1t. � �. m . . �.,.. , __ . �"� . •? �. e:�.. �' �` �G °� � � . --t--- - ' _� Coef. Btu � Infiltration _ _^_ / �'` �' " ,�`LL�"4r; , Infiltration ,7 - � Glass " "�`'� �' - '� -----_ -------- - ��--i w, � �r'%�? Glass % - ,� Exp. wall----_---- — .��, Exp. wall �� Net exp. wall ----- — : �� ,�� :,�; � � Net exp. wall ��:�, Int. wall Int. wall Ceiling --- Ceiling -_�; F loor F loor Total Btu. w�'` '` °� Total Btu. � - _�Fl.) �f�f�! �-�° Room � Length � �,� Width �' Height� � FI.� "'°'�i���' ' Room � Length � , Width � Windows nd Doors-Crackage and Area Windows nd Doors-Crackage and Area Width Hai nt No. of Lineel ft. Area Na T g WiOtb Helght No. ot Lirreel h. Area of pane .1 01 oane Liahts ot erae�c �a_ ft. No. _. ____ _ _ __ ._ _ _ . Infiltration G lass Exp, wall_ Net exp. wall Int. wall Ceiling F loor R Total Btu. ��"FI.� f�``�� Room � Length % Width Windows and Doors-Crackage and Area ^ N� . WiA�h He�qht No, of Linesl ft. Aroa n� nane of neno L�gAn oi erack sq. h. 1 JP'4I.°� _" �� � Infiltration G lass Exp. wall Net exp. wall Int. wall Ceiling r ioor Total Btu Btu � I nf iltration G lass • Exp. wall Net exp. wall Int. wall Ceiling � F loor Total Btu. 5.- � .I 'r„a;t; '� ,�''F I r�' f-;�F,�! Room � Windows and Doors• Ne Width L Height � Btu . �_ I nf i Itration G lass Exp. wall ;,,�`�i Net exp. wall Int. wall Ceiling Floor �— Total Btu. �`9� -s ; : �• Btu � '��'O€�l a�� °�a�� _.�.� �� � �� ef. Btu «� Width / Height �� and Area ,}' real h. Ar�a ��; .'>.A. C� �,,; crack. sq. h. `� � �7 .�� �at ,,,,� •� r� f '` .,�.�.,� `� � �? � `� ,�' e �, .. , W r HEAT LOSS CALCULATION ° TEMP. DIFF. Customer Name f���`��,� .�''-i� �� p Type Construction City Windows Dealer Na Walls _ Street ����• Ceiling City , ' � 5 � ' Floor FI Storm Sash 1 ns. Ins. � •� J�� Room � Length Width Height F1.� . Room � Length �"' Width Windows and Doors-Crackage and Area Windows and Doors-Crackage and Area ! Width �—Heigh[ T—No. ot Lineel /t. Area Width Height No. of Uneal it. Arsa NO' �� aene ot pane ' Liphts ot creck sp. ft. NO• of pene of sne Li hts of crack p. 1t. � � ; � ;,�' �' ��.�__ �° ' -- - ___ _ f _ ' . --- = _ --� -- -------_ . $- - --_ �___ ----1- - — --- . � -- Coef. Btu Infiltration _ �'9 "� �, Infiltration . $ �F� G lass G lass � --- � -_.. ------ °�' • ' Exp. wall Exp. wall -- -- - - - _ . --- ° Net exp. wall ---- ----- - f'' r3 � ,�*i Net exp. wall � Int. wall Int. wall i __.---- ------- � �, � �. . 9 ��, Ceiting -- --- — �," � Ceilin 9 Floor Floor - _ - - -- ------ Total Btu. r,-¢- Total Btu. FI.� � Room � Length i Width Height FI.������"„ Room � Length � Widt Windows and Doors-Cracka e and Area � ___ 9 Windows and Doors-Crackage and Area No. W�dth T Heignt No, of Lineel h, Area '���°A ,�'k, Width Haight No. of Unee� tt. Area - ��--. - _4� of aene of pane . Lights of crock sq, ft. '�, No, of pe�e of.pane Llqhb of e►aek sq. ft. --- � � �" � : �� . � ': ,�< _ .�y��= .� �t �'f� �` 9 1.�:�� ��'-T�T.� �� Infiltration G lass Exp. wall---- Net exp. wall Int. wall Ceiling F loor -- - ---- Total Btu� � FI.���J`° Room � Windows and Doors- Nn--_�.. W��Th He19ht � M nann ot n.lnc Infiltration G lass Exp. wall ___ _ _. Net exp, wall Int.walt------ -- Cei I ing rioor Total Btu. igth �1 � y Width ackage and Area ot Linealft. Area ts of erack sq. lt. ��� > Coef. Btu Coef.l Btu � _� I nf i Itration G lass Exp. wall N�t exp. wall Int. wall Ceiling Floor Total Btu. FI.� Room � Length Width Windows and Doors-Crackage and Area No. W�dth HeigAt No, of Lineel ft. Aree of pane of pana _ Lighh of crack � sa. ft. I nf i Itration G lass Exp. wall Pg� % Net exp. wa�l.-�,,._ Int. wall Ceiling Floor Total Btu. -a i F.,—:d e _„ . ?;� Btu � Coef.l Btu Btu � E � ��� 6 f } p /Y� { • , $'� ,�� c��r'� o� ��l����r _ i -_ 8431 UNIVERSITY AVENUE N.E.� FRIDLEY� MINNESOTA 65432 ,. � ,:"' • TELEPHONE ( 812)571-34b0 � �. � September 13, 1979 , Y Landborg Bros. Inc. 15354 Fillmore Street N.E. Az�oka, MN 55303 Re: Final Inspection of 7330-32 Evert Court N.E. Dear Sirs: A final inspection was made on September 13, 1979 of the above address and it was found that the structure does meet the City's requirements for a two family dwelling. Please contact us if you have any questions on this matter. Sincerely, AARREL G. CZARK Chief Huilding Official DGC/mh a P.S. The lower level of this structure can not be used for sleeping purposes unless an additional fixe detector is installed in this level. ,., _ SuB�EtT City of Fridley AT TME TOP OF TNE TWINS g � I L D I N G P E R M I T r � � ; ; v _����_ COMMUNITY OEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. , � : ' ����� � CITY FIALL FRIOLE� SS�Ji. NUMBER REV DATE �----�: �.� 612-571-34b0 9t0-F15 8/6/99 JOB AODRESS �330-32 Evert Court NE t LEGAL �OT NO. BLOCK TfiACT Op ADDITION oesca. 1 2 Evert's Addition 2 PROPERTY OWNER MAIL ADDRESS ZIP Dean Olson/Wayne Nelson 3 CONTRACTOIi MAIL ADDRESS 21P Midwest Timberoof 1001 E Cliff Road Burnsville 55337 808- 4 ARCMITECT OR DESIGNER MAII ADDRESS IIP 5 ENGINEER MAII ADDRESS ZIp P�GE O: � � EtFiM1T NO. 30020 E ICE PT NO. ������ vt10vE0 8r SEE ATTACHEO S►IEET 651-639-0954 PMONE LICENSE NO 9 20147336 PHONE LICENSE NO. PMONE LICENSE NO 8 USE OF BUILDING Duplex 7 CLASS OF WOqK ❑ NEW ❑ ADOITION O ALTERATION � REPAIR O MOVE ❑ REMOVE B DESCRIBE WORK Reroof duplex (30 Sc{j Tear-off 9 CHANOE OF USE FROM STIPULATIONS TO Bui.lding Underlayment must comply with the State Code. SEPARATE PERMITS ARE REOUIRED FOR EIECTiiICAL, PLUMBING, MEATING, �'Pr vF ca VENTI�ATING OR AIR CONDITIONING. TMIS PERMIT BECOMES NULL AND VOID IF WORK OR CONS7RUCTION IONING AUTMORIZED IS NOT COMMENCEO WITMIN 60 DAYS. OR If CONSTRUCTION OF WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANV TIME AF7Eii WORK IS COMMENCED. NO DWIG. I MEREBY CERTIFV 7HAT I MAVE REAO AND EXAMINEO THIS APPLICATION AND KNOW THE SAME 70 BE TRUE AND CORFIECT. ALL PqOVISIONS Of LAW$ VA�UATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO WITH WHE7MER SPECIFIED MEREIN Oii NOT. THE GRANTING OF A pERM1T �2622 DOES NOT PRESUME TO GIVE AUTHORI7Y TO VIOIATE OR CANGEL TH� pEFMIT FEE PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR 7NE PERFOFMANCE OF CONSTRUCTION y�i83.2S PLAN CNECI Lice SiGN4TUpE O� CON'AACTOA OA OU�MOA�2EO AGENi IOAiE� M S�GNntUAE O� OwHEa i6 OWNEA BU40Ep� • �O�iEi e. ST. C S0. FT CY LOAO OFFSTpEET PARKING STALLS GARAGES SUFTAX �1.31 SAC CHARGE Fire SC �2.62 TO AL FEE 92.18 VAUO , D r S iS V UF1 P ir � � � � o�rE _��. I'��.1 - t: �_ ! i•:i q i I I � iJl I 1= 1 I�L� � l i i [;� ._;; �i� l F. �:Jl �1,� � �r��'' " � � LfCective 111;98 �UN C ] CITY OF FRIDLEY ALT1;P. f �(1 SINGLF �AMIY.'Y �VD DLIPI.EYES R-1 A�'VD R-2 � � ° � � 2 • � � � �j �ilJiLllING Y�RMIT APPLICA?ION � �irj n1� � �� CorstructionAddress: _ - � 3�j(, d� -13�� �v�P r� � r �- � �. ' V� I.egat Description: O�vner Name & Address: .�➢n ��e �� 1�� �.1�� �P�el. /! __� �j-(o�_ (��. Contractor: (� ��5{- -rL�Y-,,��.� MN LICENSE �1 0� 0 _ O <F7.33fo Address• IC�C� 1� J��� �?r,t -. I�tl�om�� � I I� � Tel.�._�la-�(�K-11�1q' Attach to this applicalion, a Certificate of Survey of thc lvt, with the propuseci const:vct;r�n dtawn on lt to seale. 17ESCRIPT1pv OF IMPROVEI�NT _ LIVIlV� AR�A: iength ---._.____._._. Width �Ieight __, � Sq. Ft. (,hRAGE AR�A: Length Width � Height Sq. Ft. �,,,,_ D�CL� AREA: Length Vidth HgU�round Sq. Ft. ___ OTHER: (� C;onstruccivn Type: }�r�r hF� C� ,r� �'�r�� �� Estima�ed Cosc: $_ 1��,T� ��� {�'ee sahedul e on saek) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ �$ DATE: --- ��Zr`..�.__,_,._ APPLICANT: - QQ�� a � . ��ltiv 'xel. # t01 �- �SO �S - 11� q' Fermit �ee Fire Surcharge S[ate Surcharge 5AC rhazge �.icense 5urchazge Drfveway Escrow Etpsion Cotitrat Park Fee Sewer Main Cliarge TnTA.L STQ'ULATIONS: $--�S�o �� $�, �. C�`� $ �a 3� � � �e � $ $ $ = � r - . CITX USE ONiY Fee Schedule an Reverse Side .001 of P�rmit Valuation (]/lOth%) $.SO/$1,000 Valuation , �i r�a,� �;i .�in� iJllii - . $5.40 (S[Hte Licensed ltesidential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation plan Revi� � � . Fce Dntcrrnined by �',ngineering A�reement Necessary ( ] Not r ��. .C.e"°t - �","��-�/� ���.4'� �� ��� ����� 1 11