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AF - 42051:�� ,� ��-��s3� City of Fridley, Minn. i � � � � + �: ; _ - y 1. .: : - - ; r . • .,/ i: , /' , , ., �> � �> ; . ii�::�>� �' -/� '�: �. � � Y r � _ LO TI N B ILDING No. � � Street f��'�� .�-e�'' ��art of t Lot �__ Block �- Addition or Sub-Division � Corner Lot _ 7ns3de Lot ,�e Setback _.�� Sideyard �� °'�.�,� � Sewer IIevati��(�� l� _ Fo�mdation IIevation ��.,� %�� DESCRIPTION OF BUILDING To vsed • ' / � .�� Scl. �� F'��.E�! �-f�-4� Front Depth Height Cu. o Fra t� Depth fTeight _�� Sq. Ft °�� Cu. F't Zj►pe of ctf F�t. ��_.._�To be Completed In consideration of the issusnce to me of a permit to construct the buildiug described above I agree to do the proposed work in accordance with the dr�scrlption above set forth and in compliance ypith a�l provlsfons of oi�lnsnc�s of the dty oP FYid1eY• , �a a1' � In cam�deration oP the payment of a fee of $� , permit fs hereby graated to to construct tt►e buflding or addition as descrYbed above. Thiape rmit is granterl upon the egpress candition that the person to whom it fs grented and hia agents, employees and worlQnen, fn all work dane in, around and upon said building, or anypart thereof, shall conform in all reapecta tn the ordinanc� of Fridley� Minnesota �segardtsg loc:atton, conatruction, alteration, mafntenance, repair aad moving of buildings wlthin the dty ]imfts and thia permit anay be revoked at any 13me upon violation oY aay of the provisions of said ordlnancea _ _ /°'1 Build�.� Ins�t� NOTICEs ilds pe�mtt does ee1 eevsr t6s eera�rncH�, t�talWten fer �rhla& P��+�9. 6n 6adeg, saru er vra�sr. B� ams �o s� !6o Boildine I�e ier ppual� p�rmits /or th� ft�nn. _� M y+.1 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINI�SOTA OWN��'S NAME ADDRESS � � mADDRESS � � ��'' " _ LOCATION OF BUILDING No. ,�� Street Part, of Zot LoC Block Addition or Subdivision � �° Corae� Lot Iaside Lot Setback_�� Side Yard -/Q ' SEWER ELEVATION �� %�%' ATION �� i, � � Applicant attach to this form Two Certifica bes � i� location drawn on these CertificaCea. To be used as; DESCRIPTION OF BLTS,DILdG of Lot and proposed build- Froat Depth Heighe Sq. Ft. �'�,� Cu. Ft. Frone � Depth ,� f'f Height"�'�` "�� Sq. Ft. Cu. Ft. Type of Construction ��, � Estimated Coet /, �C�� To be Completed The undersigned hereby makes application for a permit for the work herein spec�fied, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildiags, and heseby declares that a!1 the fac�s an� repreaentations stated in this application are true and correce. IDA�.'E ��a _ � SIGNAT[1ItE (Schedule of Fee CosCs can be found on the Reverse Side). ..; . _ _. r�i� � n _ �. ., BUILDSNG PEItMIT FEE SCHEDULE Sect3on 2. The Inspector of Suildings shall, before issuiag any permit fnr 4,he erect3on of any building or structure� or for any addition to anq exist- ing building or atrucCure, or for any alterationa or repairs to any e�i�eiag building or stcructure, u�on application therefor, require the payment by the applicant for such perm�t.t o£ fees tfl the amounC herein below set fosth and in the manner herein provided to-wir: 2.1. For any auch permit for the erection of any fire-proof building, other than.a garage' w�rehouse,-factory or g�aia elevator, or for the erectioa of any fire-proof addition, for aimilar occupancq� to anq existing building shall be at the rate of $i.40 fox each one thousand cubic feet, or fract�.on thereof, in such cubical conCenta. 2.2. Por any such permit for the erection o�f any fire-pro�f garage. warehouse, factory or gra3n elevator, or for the �rec.tion of any fire-proof ac�ditioa, �or s3milar accupancy,�to any existiag building ahall he aC the r�te o� $1.25 for each one thousand cubic feeC, classified as °1fireproof" by Sectfon 502 of the Minaeapolie �uilding Code. '�OUSES Z.3. For aay such permit for the erec�ion of any noa-fireproof building other than a garage, warehouse, £actory or grain elevator, or aaq non-fireproof additioa, for s3milar occupancy, to any existiag building - permit $1.00 for each one thousand cubic feet. GAEtAGES 2./�. For any such permit for the erection of any aon-f�repraof garage, w�rehouae, factory or graia elevator, or for Che erection of any non-fire�raaf addit�oss: for s_ianilar occupancy, to aay exiating buildiag or for each auch au�id3ag or addition - ninety cemta�($�.90) for each one Chousaad cubic feet or fraction thereof, in the cubical cantente thereof with a minimum of $4.Q0.. For the purpose of campu�3.ng fees for building perm3ts, the cubical contents of any buildiag or �dditioa to a unifosm he3ght throughout by m�ltiplying the ground area covered from a point six (6) 3nches below tlne floor line of �l�e basemeat or cellar to the average he3ght of the upper surface or to the aver�.ge height of the roof surface of ehe maia gable of a p9.tched roof. 2.5. For repairs or alterationB to an existing structure, the fee ahall be �t the rate of $3.00 per each Five Sunclred Dallars ($500_OOj or fr�ction thereof in the cost of all proposed work. 2.6. In no case shall the fQp.chargAd for anp pes�m�it ae set forth 3n Section 2 be lesA than $4.00. i�`\ K w R, ti �� r ��s i� � T708 Lakeland Aye. �Brooktpn �ark�, P. O. Oasea, Minw. , Phone HA. 5-s181 � �I��WELL ENCINEER1101� CO.� Registered Professional Engineers and Land Surveyors � � �ERTIFICATE- OF SURVEY For � ATIQN I�L �"UNi �►S , � NC. - - Lo� 1, �\a c.� 1 �. P.R�� a � `''` ��r� . -r � o �.�a CJCdI@ ''' SO ��'l0 K� �..0 �.i►N't�� ` `\NN . - - -.. �.:��1?�T2S ��ron e 0 ' _ " • qV a'C,. �—¢.ce+r�a\a.—� �v¢. � 0 � �9�oG.0 9�04� y'7 r ��.o �1 � o k �� O,. . ,�s q E � 9GB.a t� m E��.-, ro�° o� s �/3 � �orirdn �'a 0 qt n 9 os. � n f^ a 5 � 9ri,s s' �o l?.�i�:�� co.�.no.o�a �asdr�.mn t 9l04.5 I hereby eertify that this is a true and correct representation of e survey of the boundaries of the land described obove. 7t does not po�r/port to show improvements or encroochments, if any. As surveyed by me this ¢'�� daY Qf /% rG�i -i � 9��. ' ; :� �i ...,.......� �.a�..----°•-- --- � . , _—. _ _—._ __ a}L� � y . by • ! 4.. �- ,.a� - -- , -- - � File No. � 4_°� ��__Book � Page Minnesota R�,ration No. =-�939 -- � a �, sue�ecr P MIT N City of Fridley � 16 4 71 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � RECEI O. � `L ____ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � � � � � . , � � /"'1 � CITY HALL FRIDLE� � 55432 NUMBER iiEV. DATE PAGE OF APPROVED BY !"""�� ,�� 612-571-3450 g10-F15 / / Z2/�/81 JOB ADDRESS 1522 Ferndale Avenue N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ], 1 Larry's First Addition SHEET 2 PROPERTY OWI�ER MAIL ADDRESS ZIP PHONE Andy Rickert 1522 Fernc7ale Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Vinewood Builders; 1508 Ferndale Avenue N.E. 571-0311 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO. 6 USE OF BUILDING Resi.denti.al 7 CLASS OF WORK ❑ NEW � ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Rsplace t�nro exteri.or doors, 1 hay windor,�r 9 CHANGE QF USE FROM TO 'STI PU LATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. 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 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 I 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 $2��00 �`I:.4S WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $38.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE �/� �� _ j-�% $39.95 Si NATUREOFCONiRACTOR RAUTHORIZEDAGENT �DATE� WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT r' � _ �, IO�- / p G SIGNATUREOFOWNERIIFOWNERBUILDERI IDATEI BLDG INSP �AT CITY QF FRIDLEY Effective Aug. 1, 1981 A('PLIG/1TI�"J FOf; RCSIDEi�TI/li_ I3U1LDIiiG PEFti�fITS (tJc�r, Alter��tions, Additions, or Repairs) 0�lNER: ��%�� + �_� 6 � � �- C��(xsAD�/ � ADDRESS: /'S� � ��i�� TEL N0: � �,��'� , /,�/�/- aUI LOER : ��}�.��-�-�=�.-�0 �/�,o � �_..__ IIODRCSS: ��'lJ� ��a��o_ J%- � . TEL ��0: � '�// —D �// Construction Location • ST]ZI�T NO: STItEET: � � � LOT: BLOQC : � ADAITION : '1C?�'t,' �x ,, � ti � .c �� .� e �? , J Corner Lot: Insic3e Lot: Setback: Sideyards: Ap�licant attach to tliis form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. u�� DESCRIPTIOfs OF C0�•JSTP.UCTIOPJ � • �P� : Height: Squane. Feet: C�ibic Feet: �_a� Front: Depth: Height: Squar.e� FePt: Qibic Teet: �►pe of Constructien : Estimated Cost: $ d3 �%�G- 4� Zb Be Cbr,�pleted: Alt. A Alt. B Proposed Drive��ay Width If New Opening Is Desired: $� $ SE� R�VER;E SIDE OF SHEET T'iie undersigned hereby mal:e� application for a permit for the �:vrk� herein specified, agreeing to �,all work is, strict accordance with the City of I'ridle�► Ordii�ances and rulings of tlle DeZhzrtment of Buildings, and hereby declares that all tl�e facts and represrntations stated in this application are true and correct. D.'�T�: % Q �°% SIGNATUFE : �-•�� c�� Stipulations: r� L; �' �, . � y_ � �� a_ . %- �� -�-- ` i� � e : �� :•��, BiTILDING PE•RMIT FEE SCHEDULE The Inspector of buildinqs shall, before issuing permits for the erection of any building or structure, or for any addition to any bxisting buildinq or structure, or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the applicant f or such permit of fees to the amount herein below set forth and i.n the manner herein provided to-wit: TOTAL VALUATION $1.00 tc $500.00 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100, 001 aibd up FEES $10.00 Mi.nimum Fee $15.00 plus surcharge $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 $�,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 $283. 00 for the first $50, 000 plus $3. 00 for each additional $1,000 or fraction thereof, to and including $100,000 $443.00 for the first $100, 000 plus S2. 50 for each additional $1,000 or fraction thereof PLAN CE�CR: 25 percent of building pezmit fee DRIVEWAY DEPRESSION ESCROW: Concrete Gtirb Streets Only Alternate "A"s Removeal and replacement of curb and gutter only Driveway width plus 6 feet x$13.50 Alternate "B": Renoval and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth Driveway width plus 6 feet x$15.75 VERIFICATION OF FOUNDATION Permits for construction will be issued a minimwn of 24 hours froan 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 founda tion once it has been canstructed will be required before proceeding with.the framing. SUBJECT PE . c�ty of Fridley o � so3 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � R EIPT N . � `L ___„_ COMMUNITY DEVELOPMENT DIV. r j � PROTECTIVE INSPECTION SEC. �/ 9� y 1 .1 i (� ' 1 /"'1 � CITY HALL FRIDIEY $5432 NUMBER REV. DATE PAGE Oi APPROVEU BV �----� • •�� 612-571-3450 910-F15 6/5/85 � � JOB ADDRESS 1522 Ferndale Avenue N. E. t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCF. ]. ]. LdYTY�5 lst Addition SNEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Andrew Rickert 1522 Ferndale Avenue N.E. 574-1728 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Vinewood Builders Inc. 1508 Ferndale Avenue N.E. 571-0311 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENOINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUIIDING Residential 7 CLASS Of WORK O NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 12' x 24' Addi.ta,on 8 CHANdE OF USE FROM TO STIPULATIONS SEPARATE PERMiTS R�QUIRED FOR WIRIIVG, HEATIhIG, PLUMBING AND SIGY�S. SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PIUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OH IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO 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 �- STAILS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES CiOVERNING THIS TYPE OF WORK WILI BE COMPLIEb $15, 550 y�% .7S WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE ROVISIO ANY OTHER STATE OR LOCAL LAW REGULATING CON- �S`116. SO None S RU T N OR THE PERFORMANCE OF T CTION. P AN CHECK FEE TOTAL FEE � s �� $ 29.13 $153.41 GNATUREOFCONTRACTO O AUTHO:�IZEDAGENT iDarE� WHEN PROPERL VALIDATED THIS IS VOUR PERMIT Q h : "a / r�i �° S O S.� SiGNATUFiEOFOWNERIIFOWNERBUILDERI IOATEI BLDG INSP fJAT N�l [] City of Fridley EPfective �/1/8� ADDN. [t� R-i �1D a-2 AL,TER. [ ] Building Permit Appliaatioa Construction Addresa: _ i.��"' Legal Deacription:� Owner Name i A ess :, Coatraator: ` Addreaa: /.5'''?� a LI9II�G AREA: GARAGE AREA: DEC� AREA: OTHER: � ,/V �� _ Attach to t�is application� a Certificate of Survey of the lot� �ritb tl�e praposed construction draWn on it to acale. Tel . � S � �l�-/ ? �-� Tel . i ��A � � � DESCRIPTI01 OF �IPFOYBI+�NT � Length / L iiidth � 8eight _� Sq. Ft. �'� �� Lengtb Yidth Height Sq. Ft. � Lerigth Yidth Hgt/Grouad Sq. Ft. � � J �'�'�� a ��', � � Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setback Type of Construction: � Estimated Cost: � p,�� - 9 Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: a � See Back Page for Explanation DATE: APPLICANT: Tel. f CITY OSE OI�1LY Permit Fee �� Fee Schedule on Reverse Side Plan Check a��1' �� 25x of Building Permit Fee State Surcharge = � �� , a.50/a1,000 Valuation 3AC Cbarge = =425 per SAC Unit �'uk Fee = Fee Determined by Engineeriag Se�ver Main Charge = Ilgreement Necessary [ ] I�oy Neceasary [ ] lOT�I. � . STIPULATIONS: � . , , BOILDIAG PBRNIT FEE SCHBDIILE The Chief Building Official ahall, Detore ia9uing permita for the erection.of any Duilding or atructure, or for any addition to any existing building or atructure, or for any alteration or repair to any existing l�uilding or atructure� upon applicatio n therefore� require tbe payment Dy the applicar.t for auch permit ot fees to the amount Derein Delo� set forth and in tbe manner berein provided to-Wit: ?otal �aluation =1.00 !o �500.00 =501.00 to =2�000.00 =2,001.00 to a25�000.00 =25�001.00 to =50�000.00 Feea =10.00 (Minimum Fee is =15.00) =10.00 for the tirat =500 plus �1.50 for each additioaal �t00 or !'raction thereof� to and including =2�000. i32•50 for t�e first �2,000 plus �6.00 for each additional =1�000 or fraction thereof, to and including �Z5,000. =170.50 for the first a25�000 plus �4.50 for each additional 81,000 or fraction thereof� to and including =50,000. �50�001.00 to a100,000.00 i283.00 for the firat �50�000 plus �3.00 for each additional =1�000 or fraction thereof� to and including =100�000. �100,001.00 and up ��33.00 for the fir�t �100,000 plus �2.50 for each additional �1,000 or fraction thereof. DRIV�iiAY DEPRESSION ESCROY (Concrete Curb Streets Only) . Alternate "A": Removal and replacement of cuu�b and gutter only - Drive�ay Width plus 6 feet times a13•50 ATte�nate "B": Removal and replacement of cwrD and gutter and install a 3 foot vide approach vith 6 inch depth - Driveway width plus 6 feet times �15•75 VERIFICA?ION OF FOONDATIOp Permits for constructioa Will be issued a mirnimum of 24 hours from the time of application to a11oW for proper review of the proposed atructure and of the constructioa site. A Certificate of Survey ot tbe lot, ahoving tbe loeation of the foundation onee it haa been oonstructed �►ill be required before proceeding vith the framing. f � � � �� .�� *.°t �� - �� ,.. . X � � O a � , �� p ` s� � s � � . � � � i, � ` 7s N . �� ? �+ � � � � �-� � � -�- -= ( � ; , i � �� / � ` \ \ \ N \ � � � �.t � �t � ! � .y r � � � � � � � � ' �I V � � LY � � F � � 0 0 \ � � 0 � � � � � � ' �� n (� �R �J r i � � t� , , ti �� i �- � _ � — ; � re w � � � � � K �� SUBJHCT City of Fridley 2961 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T f � � CE � `v �_�� COMMUNITV OEVELOPMENT DIV. r j � PROTECTIVE INSPECTION SEC. �� 1 . � i---.�� '�'�•� CITY NALL FRIOLE� 531�2 NuMBER nEV O�TE v�GE Or �PVnovED Br t 612—s�t-3a5o s�aF�s 6/3/99 / / JOB ApDRESS 1522 Ferndale Avenue NE t LEGAI �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ], 1 Larry' s Fi rst Addi ti on SNEET 2 PROPERTY OWNER MAII ADORES$ ZIP PHONE Bonnie Prokosch� 574-1728 3 CONTRACTOIi MAIL ADORESS ZIP PFIONE LICENSE NO North Central Builders Inc. 7401 42nd Ave N New Ho e 55427 533-6168 3763 e ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO. 5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION L1x REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reside home - Steel 9 CNANGE OF USE FROM TO STIPULATIONS Call for building wrap inspection before covering. SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBINCa, MEATIN(i, TYPE OF CONST OCCUPANCY GROUP OCCUPANCV LOAD VENTILATtNG OR AIH CONDITIONING TMIS PERMIT BECOMES NULL AND VOIO IF WORK OF CONSTRUCTION 20NING SO. fT CU FT AUTMORIZEO IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDEO Oli ABANOONED FOR A PERIOD OF 120 OAYS AT ANY 71ME AFTEF WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING 1 HEpEBY CERTIFV 7HAT I MAVE READ ANO EXAMINEO THIS APPLICATION STALL$ GARAGES AND KNOW TNE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUR7AX AND ORDINANCES GOVERNING TNIS TYPE OF WORK WILI BE COMP�IED �[I,OOO WITH WHE7MER SPECIFIED MEREIN Oii NOT. TNE GRANTING OF A PERMIT �Z.00 DOES NOt PRESUME TO GiVE AUTMOiiITY TO VIOLATE OR CANCEL TME pEqMIT FEE SAC CHARGE PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON• STRUCTION OR THE PERFORMANCE OF CONSTFiUC710k �87. Z'Jr Fi re SC $4.00 PLAN CHECK FEE TOTA� F Lice $5.00 $9 5 S�GNATUNE 0� CON'i1ACTOp Op AUTHOA�2E0 AGENT IDAiE� EN OP ALIDA7 IS IS V R P 1.� � / S�GNATUAE O� OWNEA �� OWNEA BUROEN� iDAiE� BLO �NSp qptE N�w o C ] �►DDN I J ,� AL�'F,R C a1 /t'�5!°% ; Cotl�trtictio�Addre§s: '� Legal Descriptioa _ CITY OF FRIDLEY $IltiTG�.E Ft�MILY AND bUPLEXES R-1 AND R 2 $UILDING PERMTT APPLICATIO�i + �� Effective 1/1/99 0�� b 1 � �� , 3 ,�G o Owner Name & ddress: �i7'!l?�L ��d1i�f/-.S � 'J ^ `Te�.. � .�,%'�-/%a� Contractor: D ,� . N[111 LIC�.NSE # ✓�%'6 .� Address:�'�lD/- �o�'/lo%a� ./� _ a11L v� ,/Yi� ✓�Sf�a�% � Tel. 3 3� 6/6� Attach t� this applicatiod, a Certificate of Survey of the �%a lot, vvith the proposec� construction drawn on it to sc�le. LYVING t�REA: GARAG� A�tEA: DECS AREA: OT�ER: DESCRIPTION OF IlVIPROVEMENT Length Width Height Length Width Height . Length Width �IgtlGround Sq. Ft. sq. �c. Sq. Ft. Construction Type°/p�� ,¢�j� .,��8,` Estimated Cost: $': � B D• � �� -��- :+ (Fee Schedul e on Balc�� ' brivew�y Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ I)ATE: � 'o� " APPLICANf: f. %%% �e Tel. # � ✓�✓?' �/�� Permit Fee Fire Surcharge 5ta.te Sdrehatge SAC Ch�tge License Surch�rge �rive�vay Escrow $rosion Control �'�rk �'ee Sewer 1Vlaiti Chazge TO�AL STIPULATIONS: $ �7 a5' $ �-B� $ �. �a $ $ 5:00 $� $ � $. 16 �: � $._. ..�0�.1 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuatio� (1/lOtUii%) $.501$1,000 i�'�luation , � -� , ., , � $1050 per SAC Unit - $5.00 (State Lic�nsed Residential �ontra�tots) A1t. "�" or Alt. "S" Abo�+e $450.00 Conservatioti Plan Review Fee Detetmined by Engineering Agreemenf Necessaty [ � NotllVecessary [ ] . .. . ... ... y , , � s_ � a BUII,DING �'�R11�IT FEE SCHEDULE ' ` The Cluef Building Official shall, before is5uing pertnits for the erection of any building or structure, or for an� addition to aay existiing bnilding or structute, or for �ny alteration or tepair to �ny e�cisting building or struchlre, ttpon application therefore, require the payment by the applicant �or such permit Of fess to the amvuht herein below $et forth gnd in th� m�nner herein provided to-wits � ' � 1t . I; ',,.,)',. . . ��. C':i�s1.` ' �a , o TOTAL VALUE FEES � . '�. :�.�rib;i ��'�� =::��% . . . . , ` . �v�� . r $1 t0 �5�0 $501 to $2,0� �2,aoi co $2s,o� $25,(�1 to $50,000 $50,001 to $100,0(� $100,001 to $SOO,Q00 $500,�1 to $1,000,000 $1,000,001 and up $21 (Minimum Fee is $21 plus surch�rgt) $21 for first $500 plus $2.75 �or each addidonal $100 or fraction thereof, �o and including $2f000 � $62.25 for first $2,�U plus $12.50 �or eac1� additional $1,0� vr frac.tian - tt�x€of, -�ci a� }nclu�g $2�,�80 - _ $349.75 for first $25,000 plus $9.00 for each additionai $1,000 - or fraction thereof, to and includiag $50,� $574.75 for first $50,000 plus $6.25 for e�ch additional $1,000 or fraction thereof, to and inclu�ing $100,000 $887.25 for first $100,000 plus $5.00 for each �dditional $1,000 or fractiom thereof, to and including $500,�0 $2887.25 for the fust $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and iticluding $1,0�,000 $5012.25 for the first �1,000,0� plus $2.75 for each additional $1,000 or fraction thereof DRIVEWA� DEPItESSION ESCROW — - - - (Concrete �b Streeis 4�1y� , , ; . ,._ � , Altet�nate "A": Removal and replacement of c1u�b atid gutter oiily = Driveway width plus 6 feet times $13:50. Alteraate "B": Rtmov�l and replacemerlt o� curb and gutter and install a 3 foot wide . � approach vvith 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION �F FOtJN�t�'1'ION Permits for cofist�ucfion will be issued a minimum of 2� hours �rom tt�e time d� application to allow for proper review of the pro�b�ed �cEure and of the Construction site. s A Certific�te of Survey of the lot, showing the location of the fowidation once it 1�1 it i�s been co�Gted will be required before proceeding with the framing. ' �. �_..