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AF - 42308o denole9 i�bn monumrnf 6earings shown arr ecsumed Scale: ! "'= So' 421 - 4100 �KEI TH �VI. GRAHAM . 2and `�urvcyor `Theatcr `Building. �Anoka. RVlinnesota. 55303 Certiilcate ol Survey for: LARRY VOG7 � Descriptlon: THE WEST 99 FEET OF THE EAST Z73 FEET OF LOT 'Ir�� AUDITOR�S SUBDIVISIAN 111�. 129 ���� Before digg'ing cali lotxl ut�liti�s TELEPHO(iE - EIECTRIC - GAS Etc, REC�UIRED �Y LA�M I � 0 _ , NORTH LINE OF LOT 14, AUD. SUB. N0. 129 m � ,..... ..._ 490f .... _.... ..... / 74.0/ ... .... N _ o . qo ' I � . � ��,,,� , a • � - � , ......27300..... 40 — •t ------- q0-- — — — --- — — --- -- -- � �� i .....99.00... ...:�' °•......... ..._l74.0� �.. "o��. o .. . , I fn�l h � � . � � I O N Q 3� N � � m � �� � � $ �F�' E �eb, : �y G�'' ; 13s 7 �' , � �'•. � i �3�7 � t. ....74.01 ._. ... ... ..... /74.0/ _.•- SOUTH �IIdE OF LOT 14, AUD. SUB. N0. 129 F/RES/DE OR/VE � �° nae c�nr o� �� �°�s NoT cu�w► �TMS�. ACCURACY OF ��� �� pNLY AND THIS DASA IS F4R pE�,pNS USING R ii?01J1� V� 'lii! �P�nt3A1 � TME s� j�ab no. �7 -4i bve�l�, �oi pa�'e 35 �. ra �. 3o Y. z4 � LL O I W Z J � � � a W � � �i ���;���- i�s � I hereby oertify that this survey. plan, or report was prepared by me or under my direct eupervieion and thai I am a duly RegisterQd Land Surveyor under the laws of the State o� Minnesota. ,,� � .�'��—s�� .a,ffi. I?ata J���lr__/T/. �g��_T4eg. �o. 1�i�3 �� � '�_�, sue�ecT PER . c�ty of Fr�aiey �y o i4216 , AT THE TOP OF THE TWINS g U I L D I N G P E R M�T r ; � i RECEIPT NO. � `y � _ COMMUNITY DEVELOPMENT DIV. 2 r � � PROTECTIVE INSPECTION SEC. �J �� 1 .1 i � 1 /'��{ � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �--"� � ,� 612-580-3450 910-F15 7/14/77 � � JOB ADDRESS 1357 Fireside Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. W. 99' o E. 273' o Lot 14, Auditor's 5ub. #129 SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Larry Vogt 536 Ironton Street N.E. 786-2624 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Bohman Custom Homes Route #2. Cambridge, Mn. 55008 689-4910 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS 21P PHONE LICENSENO. 8 USE OF BUILDING Residentia.l 7 CLASS OF WORK O� NEW 0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ VE 8 DESCRIBE WORK ��t� f�l�lil� q�i �9CEi' Utl�it�t Construct a 44' x 26' Dyvelling and a 30' x 26' Ga.rage - 9 CHANGE OF USE FRO HE/'1T1�� P`U�v1NG �D SWNS� STIPULATIONS provide City �fX with copy of truss design befor� capping. Provide 6'6" minimum headroom in stair area. Provide sod in the front and side yards. Provide veri,fying survey before capping. Provide a hard surface driveway. SEWER LOCATION: (Approx. 9.5' Deep) 60' West of Manhole (Inv. 885.36) WYE ELEV: 885.02 (WYE ONLY) TOP OF FOOTING: 888.02 Minimum WATER LOCATION: MUST BE TAPPED 6" CIP Watermain 15' South of South line of Lot 14. DRIVEWAY DEPRESSION COST: N/A Exi.sting Surmountable 'R�G : A1T 01� �tiDllR� DOES NOT GUA�lAN�.. TM! . ACC�IRACY O! � 1/II1i�Y IOGATiONS At� ,�E1"A'IIQrIS4. Tr';S bATA IS 1°OR UII�ORMATICtN r(ilPQ�ESF QMLY A�,j� �:�SONS tJ511��3 R p10�D 1�1�� TM� . DF�pRA�A110rt TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, W�d FY,d�e 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 R�. 12%9 + 632 31,900 Total ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 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 OHDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $39,340 $�-9.67 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- 127 . SO $375.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $ PLAN CHECK FEE TOTAL FEE $31.90 $554.07 �TUREOFCONTRACTORORAUTHORI2EDAGENT IDnTE� WHEN P OPERLY VALIDATED THIS IS YOUR PERMIT X ��� , t� •� - SIGNATU� OWNEFlIIF O E� 9UILDEAI IDATEI � r BLDG INSP DATE ;r . CITY OF FRIllLEY APPLIC�TIOtJ FOR RCSIDEtJTI/1L BUILDItJG PER��IITS. �a �'' (idEw, ALTERATIONS, ADDITIONS, OR REPAIRS) �a t ��-�- � � �' ' (-� owta�r�: ��R�'�' �} �� aviLn�x: �. � � � �..,,, � � �ddress:- d�e�6'����e�p,a� �� l�� �. Address: . �l�i �7^�PS�C��'�, ���.' e�� y"c�� ` (� 7�'�-'�f�'�1 Tel. No.: \ No.: �o��% Street: �a�r^e5`sc�P ��• LOT: � BIACK: ADDIT20N : q,u+ A � � �� �,� / �� �q � �' ` � ` �'! �9' CORPiER LOT: INSIDE IAT: SLTBI�CK.�r� SIDEYARDS: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: . �� �����' eC Front: '-} �/ Depth: oZ L Height: � �� Square Feet: �i Cubic Feet: p�,� �i� � �'� %�% �' Front: �G' Depth: � 2 �� Height: ��__ Square Feet: �,� Z Cubic Feet: Type of Construction: ��^� ^^ � Zb Be Completed: g� �' �� Proposed Driveway Width If New Opening Is Desi � � �� Estimated Cost: $ -' °- ��j ,1� �� ,:� � Alt. A Alt. B � $ $ REVERSE SIDE OF SHEET) The undersigned herel�y makes application for a permit for the work herei.n specified, agreeing to do all work in strict accordanee with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby ]�eclares that all the facts and representations stated in this application ��r are true and correct. See reverse side for additional infoxmation. � DATEt 7T ��'' SIGNATURE: C�- � G�-c Stipulations: � / Z �. �Q . � l /�i�� . � � ���''` . . � . �/7�/�.i�t d �G ��/�N�.�.i'w"h I�o �.G+rr+�` � �-a,�%+. a� 3. '� : .�.,. . � ,r, , , �� t � d��� • 3 /, p o �9t�� � � �- a � � ,�,�y, a � --_ __ �.:. � BUILDIhdG PCRI�IIT FC� SCHEDULE 5I.CTION 2. mhc Inspcctor. of I3uildings �hall., },ef�re issuing per.miL-s .for thc erecL-ion oL any bui.lcliiig or �•tructurc, or f��r any aQdi.t�,i�n to •auy ca:isting builciiny or. sL•r.ucturc, or for any altcraCion or repair.s to any er.isting buildi.ng or structure, upon apr�TicaCior► L•heref�re, require t}ie l�ayment by tt�e anplicant f.or such Perma.t of fces to the ameunt hcrein below se� forth and in the manner herein �.,°uvided L-o-wit: tJL•'W COP15T1tUCTIOP]: 5ingle Famil.y liomes and Ga'rages: $4.00/1,000 cubic feet.. PLIaIJ CIILCK: 25 percent of builc3ing permit fee. DRIV�WAY ll1:PIZ�S5IOt1: (Concretc Curb Streets Only) Al.i:ernate A: Removal and replacement of concrete curb and gutter only; Drivecaay width plus 6 feet x$11.75 Alternate B: Removal and replacement of concrete curb and guttc:r .and install a 3 foot wide approach with G inch depth; Driveway width plus 6 feet x$15.40 ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (G) inches below the floor line of the basement or th� cellar to the average heights of the upper surface or to the average height of the roof surface of �the nain gable of a pitched roof. For -repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 �er each five hundred d.ollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any peL-mit as set forth in Section 2 be less than $1.50 plus $.50 state surcharge. VERIFICATIO� OF FOUN�JATI01� NOTE: Permits for construction cvill be issued a minimum of 24 hours from the time of anplication to allow for proper review of t.he prop�sed structure and of the con�truction site. A Certificate of Suxtrey of the lot, showing the location of the foundation once it has been constructed will be required before proceedir.g with the frami.ng. C�RTIFICATE QF OCCUPANCY Application for a Certificate of Occupa�cy shall be made ten (1G) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. � � , o denofes i�bn monumenl 8earir►gs s/rown are essumed �EI TH �II. GRAHAM �cale: !'"= So' `Zand `�urveyor `Theater `Building �Anoka. �1Kinnesota. 55303 Certiflcate ol Survey for: LARRY VOGT Descriptlon: THE WEST 99 FEHT OF THE FAST 273 FEET OF LOT �Q.� 6un�rea�s Suwn���c�na H1n_ 17Q HIA�N�H� Before digging caN locel utititi�s TELEPHO(IE - E1.ECTRIC - G�.S Etc. REC�USRE� �Y ��►� O N � p �I i C / � � N O 2 NORTH LINE OF LOT 14, AUO. SU9. N0. 129 m � ...- 990! •... - ..... /74.0/ ..... ...,,` N � �P' ; 1 r � . ��e��� � 4�_.....:• .� ------- .. � ..... 49. �0 .... . ( : � � I o L. m I r �� i I $ �'� � � I0; �v G � ' � 13s� �' � , � ,�•.� G � ? Q e — — — — — — —�7�:00 �..r — — — — — — =:y � 9 .... ..... l74.00 °"' F- .,00 ' 0 �3�7 � � tr : ..... J74.0/ _... ..� 79. 01 .-. .. ... SOUT�fI titNE OF LaT t4, AUD. SUB. N0. 129 �O F/RES/DE OR/VE �° n�e carr oF r�a� ooes NoT cu �'TMSe. ACGURACY �� �� �OG�� � THIS DATA IS FOR M �nOV�� ���� QN pERS�ONS USING R � , � tHe s�re. job no. �� -4i boolt, �oi page 35 �. ia r. 3o r' 2� � � � 1 �s , � ( LL 0 I W z J ( N a W � � 42_ I hereby oertify that this survey� plan� or report was prepared by me or under my direct eupervieion and that I am a duly Registered Land Surveyor under the lawe of the State o� Minnesota. .-�1"aG►�G�.6-==-2 - Date rTYlv //. l2�7 Reg. Ho. 117a3 � � � ,...�-.o � /' � � J � � /; ; �� � � „ d � / vC, � �.� !�/ �/ O �, �, � � . � �� . . . b� ��� � � .s� G� � � �� �. �-v. ��5, , ,� �---- � ° � , ; - � � �� ��� / �' c�� °�ooa����-�� ��D - � � ���J�►�,� - � � � ��-�'o� �7-�rz' �5 � �� �s�� / I � � L�r � �� �� �� ��/ ���� /� 1y . , � S , o � �, L,�,�;- ��� � � �� � �� � � � �� � � � � �'X �� TeN(r � t1 %�h�d OcJ1:1TiQ�L� � , � . � ,.,� . � � � y j , I ! I � � i i i I I , � � � � I � I ! I I I 'I I I i, I ! '�, I �, � ! � ! ' � �� � I, I I'� I ,' 'I � . � . . , , , � I � . �I i. �, I i � ' � j ' �' ! 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' � � ; , �.a=#� Ij ���' 1�Sd'k ��— . � � � �, I � ' ' 7.!� i� - � ' I ; ! ; , ,, ; , ;, , / % � � I j /� I /i �. � � ! � , ! � � , � i � �� �� i�i��� �', ! � � .� � � — ; ��: Z � i ! ; ' , I �i � "IL � X �j % � ,= I � G � � � ; � � I i j ' I � � 'L ' 'X i �i° , � , i ' � ! ; ', j , , , ' I i, '' � ; ! i i � �I i i I i' I,; i ' ! �/ �'� d ; � !����� �; ! , 1 , , I �' i , I � ', I'I � I i� ��� � '.�'�� � � '� �� ' �� � � ; ���, �� ��� � ���� . �� G� , , ; � �� � i� i � ' ' ', I , ! �' ' �I ,�•— j� r2. � 9� X �'1�''� j �� i� �7 ;, 3� I� �; i , i i � � i � � � i i � I I I � , ' � I I�� I�, 'i � ���! i �. i ; I I I I I, I I' I ' , II j �Q� � �, �'I , ! ' I I � �� � � � I ��3Z� �� ; c3� A4� : � , .�i ¢% � II J� � c►� /', 9 v ' ; ' ', !, �! , , ; � I i � � '�, , , ; � i � / "'° i �Z ,�9 k;L�,�`, �I �.2���� �';��� i , ' � ! ; , � � � ' ` �, ; � , i , , ! � ! , i � , ! '� , � *° i lii,� � �� �, .�, `i� , ��i �� • ;� j� ; i '; ! E � I � ' ', I' i�' � I���! i i , j I � � �; i 'i � �� � I I ' ! � � I� � � � �� � �� � � �I �i � ; � � � ' �� I I � �� I I ; � i I � � i! i' ; ; � � � 'li I ; , � ; I � i �� � ; � � ' � ; i � I , i � i li i i ; ; ; � , j I ��;G � � ', '�� I li ��� �/"� i� ��'I I � � �I �i ', I � �( i { i I � � i i � , I � � I � ', ' j � I �� � i I �, I � � , , , . i . I � � ' , � i , � ,. � ' ' � � � � � ! � �. j � j i i I ; � � i I � ( l � I � � � � � � � ; I � I ' I � � I � i i I i i I i I I ', � �, i i � ' ' , f '' ' i � ! i jl il �; ' i i � �G � ; � � � � �%�, �, ' I I �' I ' I ��I � , I i , i �. I I! I, i i, f. � I II � � , �� , � '� I II , j � � . ' � , I i � � ; � ; � � i I I,,I i i ',i ' ' ', �., � I I , I ` �� � �' i � ' ' I � ' � � � i � !, I I �I I I j i I i � ' � �I I � �I �� I I, i i � I � � � � � , ' i �' I; � �, I , � ; . ' i ' ' ! ' I �, , i i � �I ! I �i � � � i ., ', I � �I I I � I �I �� ' � j � !` � i � I i i I ' I ,�_� � i ; � i ,�� � I , . . � � j I i �. / �� . . �� I � , ! , ,. � � � � I � I � � I I � I i i , i I i I I I � � i , � � ( � � �, I � I � i 1 � � ! � � ; , � I � j ti 1! �', � ' i I � ' � � � i � I I 1 ; 'I ' I I �I ,! I I il ' I� � ' � � 1 i I �� �� j� � � I � i i � � i i i i � I ! �! i I i i I � i � � � i i � � � I i � � 'i � � � 'i � I l � i i i I I � � I ; ! � - � �� --i - _� �I ' i -- -� �I - �-- � � � - � i �I I I � I I I -�, ' 3 � % ' ; , ' � , l � ' , , ' ' ; , , � �� � , � � �� �� �� I_ I I ( - �_ I �__ I I �- -j� �� � � �� � � i � I � I � I ' ', , ; ' � , � , , i i i ; ' � �� �__� � ``° � �� ^�� EXTERIOR ENVEL�P� AVERAGE "U" COMPUTATION '-.,, ��.A4 �'� �`� s , . OWNER: . �il�� Y ���J / , SITE ADDRESS : / •�3 `�. % �r'�P�� � �� ,� � � CONTRIICTOR: � � ¢�� C �. � /�.,.�� DA� 7�— 7� i 7 PHONE : � �3� — �� C.� � e� Determine working square footage o£ each , 1. Total exposed wall area. . . . . . '� � `�o / / sq. f�. x .17 = f � � , 7 � 2. Toal roof/cei,ling area ...... /� �`%•�.�2 sq. ft. x .OS '_ �`%� 3 Total exposed wall area above floor = ?���� � a. Total wall window area. . . . . . . . . . .. . . . . ... . . . . . � p�., , � �. b. Tota1 door area e.......< .............................• ��',�,s c. Total sliding glass door area ......................... ��• �9 d. Total fireplace wall area ...e ......................... � e. Total� wall framing area (average 10�)..e ............... ��,[� � f. Total rim joist area .. cy�-, �� � 9• r°����e7� wa11 area above.floor. . . . e e . . . . .. . . o .. . .. . . . ... �-�g• �� h. wall area above floor .......................... i. � wall area above iloor ........................:. j• wall area above floor...e ...................... Total exposed foundation area = hl�7< c4 3' k. Total faundation window area .............. .,......... /e,/ofS'�' 1. .Total net foundation area above grade . . . . .. . . .. . .. . . . . � ,� • �� �, 7-� t.�/ l�oe�� �4���r . a.�o Determine "U" value of each wall segment (e.g: window, door, each•separate wall sectian) a. 1 B�. C � �X. b. ��•a� X �. ����9 x oUu ��U�� aUn d. � $ njln e. 7� � (� 3 X ��U�� �•� -y/�o ��r` X nUn � � GF� � nU�� � Yv��s x .,U.� I 2 0 � � X ��U., , �. / X ��U„ e �% 7 J � eai = . � � 3 = � � . / � �/ _ � � 6 a2 = a i� �55' _ ,� � _ ° T� / ' � . �/ _ k. $ uUn = �1 � e y � • ��s /i•� � G �t��/3 . �O, g 3 �•�� �.� .5`�9� y. �l / l. X nUn � s ' � r y�� � 3 . ............................. To�al = a ti? ' � �, � � . � 0 If item #3 is the same as, or less than item ul, you have met the intent of ssc 6006 (c) 2. - �� : ,� -` ~ "'". Page 2 of 4 �� • Total exposed roof/ceiling area = /a�'�� -Z m. Tbtal skylight area ........, a � ........ n. Total roof/ceiling framing area .(average 10�) ... /.,z�. y,3 o. Total net insulated roof/ceiling area........... ✓/� �.p7 Determine "U" valtie for each roof/ceiling segment M. C°� }( nUn Q . � n. �� �o y' S' X��U�� o�a. �.1 = o. 11 �'� , � �7 X ����� , t���' � _ 4.........e ...............e. Total = � _ 3`� 5� a y� �� �7�� If total of #4 is the same as, or less than #�2, you have met the int�nt of SBC 6006 .(c) 1. Alternate Building Envelope Design � Zb 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. l. /� �- � + 20 � �� �.� . = a ����� 3. ��/a/ + 4. ��• 9% _ ? Z 9< /l ��, 0 f L � ' 0 �' i T�r �R� e�� Xte �,a � �,�1�. ���u�lP,� Q= ,yi.1 �C��' PAo�� ��=,06 aj00-Y � �EA���i�.�g R = iis � � e, I,'�� �'tis�LA�e,� R = �l`�`/ �l A poR Sa�-n;�2 � _ � �_ �.�� ct = �•� 7 u = ,6,66 c,t = � � 6 I r� _ , e a. a, �� _ c� �oo,F�ce;l�ny 9=rA��%�9 �r e 0! r AJ'2rAfe i��C' � � � z� = ,02�/ � _ � �. � ,�,�� � % R �;/r.-. (� _ , C� � �d = 1, �7 F��ose�P �eo��Ceil;� I��e.4 -r�-ta � — l� = E-t � < � � zd = , o � �.� ��.,f R,�� �; l,ri "�" � � vi �. R� i e �r (�� � ��. �.;1/ Pl,�. ��� ���� ���m � _ .�� �' _ / �,Q� � _ �� g9 � _ � `�Y � _ .17 U=l.�l7 �--� _ , � 7 7 Gl=o��9 u = ,rC (�( =��BFl / p_ �i,93 U=� p��, ,aE.�,a,i' p7/�� �r • -., /7 - F � �re�� — R = o L� = o, �����g li= i<Ig �1=-�� Q/J RG� �' � e Af%i n y i �=.G� �l; l.G� UJ �41� .In�suLa%'e.� �= l2.9: � = ,(.�z� � �r f. /-i %R �� � e..-. � = . � 7 G� _ .�� 851 1N� �,� �� I�., R=� 6� ca = �• y, IAi i}�� � t I�°`S �t �=� yJ �i =°�l•,3`�i. �� t u ; O U R j�cSR �RPnle I� � = � t An-�- %o�'A�W�� A �._�.�� a�,�3� �Xpo���P �� �� R6�Ue � � � + �.�..�� '� � = 1%,0� �°�`��6�. T� �t R;� �°I-Y, ���%�'-�- ,j�,� f ��R �; /-.-, �� rt�l � � z � , s- -� �_ �>> � _ l�.�3 � = e Lo � iR� _ �,1� �i. _ �- � � � `_ a / � Q.� _ ),'�% �I = -��1�� � .� �� �,� a7%`e� ��� � A���� ���� ROOF/CEILING . I. , , �/G:� : . _�;-�_� ; � �: � ''/ � /1=✓ � i ��� � �� ��► n ► ���C��� . /'�° � 4Y,��,Z;C� , ! r . .� , .��'�� �,� 1�� ; � • Z t.ItT � .,.. �"`_''—"'1` �"1 � • :.�. �� � . ? . . i � .. , Vented + . �eat flow � . u� . . . � � ' � i �IGa n5 � ' � � a in+T,f�°�� `tJ• `•:'le�_?1�_a.'^. �iy.Gre-r��4G'�rl�'Ct,t�T,eei — - - — — — =� Page 4 of 4 I Construa'tion R-Value 1. Interior air film 0.61 3. 4. Exterior air film (still) 0.61 � Total l. Interior air film 0.61 2. 3. • 4. Ex�erior air film (still) 0.61 Total, . -�v��� � . N.e�t flof� up � . �� ;•venLed _ ,FIG. #�6 �.. ... . . ` . : . 1 e Inside air tilm . . . . . _._ ------- -- - -- ._. ._ _ 0 . 61 . � 3 � � ' t� 3. .� . `�,3a�S w ;!�-_:.^� 4 . . � ,.�.y,,L0.i.�°,,�-,-.�, , . - �:�ao3's�-;' �""'' .�s 5. Outside air film 0.17 � . ` ' f �' �� . . . . ../ ��:� ' , � 'p� ','�' t�'�..�_ ',�� .� . �!� , � Total �';��%�'''_..G' . . � �� � - , �----^�i • . � Note : Use additional sheets if more space is �� 1� z • / needed for details and ca].culations i�/,�� . � � ,' � �.=� • , . . . . ` '" • � 2:0."--VI'.Z.:T"r„U � . ' � , : . , . •.. . • . � . ' Hent • �• ' , � . , ,• • £low up • ., • ' � . . � • r o � . . . . �. .. , .�. •• • - � F. Tr,. :�7 , . . . . ; � ��°_ � � 0� CITY OF F'RIDLEY �- �-�'% PUBLIC WORKS DEPARTMENT TAPPING APPLICATION AND PERNIIT FOR INSTALLATION OF WATER & SEWER SIILVICE I) This form to be completed before a tap is made to any existing water or sewer line. � , � `%�° 1 � �,3 ddifion �� ��� Address � � Owner Plumber ' CHARGES TO BE PAID BEFORE TAP IS E— WHERE ASSESSMENT HAS NOT BEEN LEVIED AGAINST PROPERTY II) Water & sewer connection permit must be registered before this Tapping Permit can be issued. City supplies all material and labor for 1" or under water tap. Con- tractor supplies all material and labor for water tap over 1", and all sewer taps. WATER TAP: Materials Used: $ / �t� Street Patch: ���: $ 1.�� � � TOTAL: $ �,�� o D � SEWER TAP: Street Patch: _x : $ III) If this property has not paid a full Lateral Charge for its share of the water and sewer system, additional charges will be placed against it. This will be in addition to the normal connection and tappiag permits, meter deposits, etc. Water ASSESSMENTS TO BE LEVIID: Lateral: $ Sewer Lateral: $ . TOTAL ASSESSMENT: $ �_ Clerks Supt. c M/P 3/76 W _ � � 'ro i ' � �O z ,, M [q H tn t" � m [�1 C � n a W m trt � r r� '� � N b � W N V� N- N a a W� Z C z C fi N �' rt (G E f� r� � F N N � tt �' ''"' i-� ^; r� r� r r� i �-' {. a rr j. �; rr w .�. r+ G, M 1- n � '*1 K ry �^• V1 N• y tf M r, F„ �p ly � p. •f, rn C.. 1� ,ii '� r.. �-3 ��� G G: � t� ! � C. �, �� r, � n % <^. w r �� n r�-• i� X �r�t Y �r G � W r, U. :7 N r+ r* ti � o y o M rt Y m � � my� ti� >• o ry � � N hy M 5 n C I O� y� C O � O 2 y W G. p � �'O ... o � M p o�' � m �� � j � D M (n H F; �� r• W �-1 � W C � � C^ —i � w o o w �; ,,.., t�-* ,q o � • • r o �y � � y � � a . ...� rn Cn c") _ I I rn I� I � I I ( �1 �� o m � I I x x x ee x x x x x x x x y � ' N Vi !+ N N N N fA F+ Vi N N L! N N t!� O F-� W ' V7 ll� �l O Ut 11� N N W � 0 0 0 0 0 0 o a o 0 0 0 0 0 ►� 0 0 0 0 0 0 0 0 0 0 0 0 0 o hy . N (A N Vl fA fA N Vl fil ip IA N fA N N f/! "'i T', �► �y � � �� � �' � r � H z H � � 0 �A � � z c� � � H N N N v w 0 ro c. N � � 0 y b � y C � tb � �y t� O z L+! � � � H - .� z H ro � CJ�1 �' C1� � � y ro � w o ~ � � � �' � K I G £ c H�+ H z c� � � 0 ro M � � H 0 '° '"' " Stari-rs �t, n � m s �f J W� GL [t � 11 fl 1 �S�r•'F Y � Cl�i�ef � i �� „� ,�-y [itinals H iU c o Bath ZUbs 't h � — ry �� Basins a o � � Sinks 'G O � '� Wash Trays � ti �� r• L,rinkinq `Q w Fountains Showers n Floor Urai 0 5 Catch n Basins m Automatic p' Washer s 7 Gas Appl. Misc. Fixt E y Gas Range a m ct E n K Other m m a � K� n � O (r'p N � .? `wJ h7 fyD W f�D O t�J z w p. � H r rr rWC tr � � C G � M K w f�D � ;kt 7 t+f O � M �rt w(D � J M c�p n g Oo ,7 0. W F� M d (D d `tl C W (D 1�i rt N � � � a o n ►�'�- 'u'+ °�' r°n � y o' z K"' m� °� � � M �w' a' `�w � � �ro °'�' w � � r �no� `� � � � ���� � s �+ � ��"�ro m W w � ►�'. \ � :� wam a � �� w rr rt ^` � R �C M� C � � N w � M w � � n �n a o . n �`w+� Wro n rr a �o w �c m � o � � a t a n r�r o M r 5r h � � � R � � a � � � . . N ]'µ� (' �0 7 t�t `�G x � 8 r a � � � K m � � r► � a � � r �i A "'+ O z � O � � � � .--. 3 � � � o T a z e � � c� �-- a a v, r- m T -< --1 Z � '� m � z � � O � � y z c� M � H H N N � N 0 i'� N N N 0 N � . t�7 N � � �i c� � t" � � � � o ro ro ?0 � �y n� � � H � r � � � 6 � �h � � � A � F � i m � H N � ~ � b � o a � � � � d 0a ('P. � �.j l% ` ' � � r, � � � (� � tri► y �' ro o � O � O H z � � � � �n� � C'� M� N Y� � OH H Z�� t/� V� t' YC"hx90 H < C C w N• o�oro ro � H a i+ Z �-3 M?� ,zp ~ r~o � w a w 0��� �b�''' �n fD t''� �� a� 25 �w �N w� Z<.ZH m aa.n % �70 0:� � o �¢� H a n fn L7 Li H F�• L7 �O I y' 1 p' p a' 7� Q+ fD 5' M �""'�"'�z w°MrM �o a° ps'roap'� �" ��oa� A ln (n z cu w x� trf � w [r1 �-3 H G� �' � y y r W W u� o�n'6 K n n G o��gy ►9-�i �j (q F+ iC t�a N O �W ~ � r� O [� 7 7 W O R 'N (•OK W O ~ID O�O F• .. .N W W O� om roo �o n o o �Oro w„ �.�Y �— ' o m � �u .ao o m o o ro oo n x �oy- � �x m� `�c �'� o n �c°o a� � �o � o �t � a' o 0 p' o 0 y ry' � � t0 � O O O �y. y �p O O � a I I I` � � � 0 � � �C xxx � v' a' N r N N O 1-' W O O O O� J�P tv O O O O O O O O O O N iANL/ N N NNin N � . � o �o d � c r°+ �o � ��r' � � ~ w m z - � � � � � � - y fC M � � ro N� W �. � z a � a+ � ro �_ a � � y L � ,n , I N " n � � � � �p� � p H � � ti °x til � K �i � e, e � ry� �. " � �p µ µ fND £ \ � � w x � c � o O M y i'� 'A c � � � O r 0 �O `C�i O � � � o �. N tA Ll N fA iA N{q 0 �3 �� O �i H M v 0 C y � M � � H Q o � 'n tro+l � H z 0 b7 [9 M�t y N C H � 1 � r V v N �p�1�lAN O O O O O O O O O O N i/! f/� N fA .� 1� m � � a �°o��°o� ►-{+ x rorob � � �'' wwa w r���°m 9 P� Q+ � � � � ��`�� a 9 � n rr o r y a a � � �•° -p � O O 7 � � � � a �r --1 W N (IN F. D � ro �, r �rt 0 aN m �°o n O O = O � O C o I-' rTl N �r �pJVN � 0000 CTJ O O O O fAN�N1A a a r t��J z � O W f% H h' � b o d � �n h{ w � � H{t UI � � � D' � vMN m A' �a °' m i� ►'�s � ~ � ry� W N A p. O pd �-` n r°n "o � o m"' � A � x' ��i° a �r � owa�°s � ,� �V C �n�{o�e � '� m fD F' W � � � m� o o f° Y °'roxro � :� � W� w � �sa�.w m W w w �t rr .� � �� w0 ���� �r a m o W 7 n K � m w �o � o � '° a��� � Q K O � a � KR � c�D 7 7 � m m m p �� inC ' ' � a �� IiO �~�� ' � �° 5 m ,. O a a� K � � W � �� � � � � A. � �% � R a, , v v '� r A D -� O Z � O ."D O � m e�% a �.'O Z C� -�1 O N Z r� a -� d O S z mn c�i � z � � � � --1 C"� rr1 O N � Z G� b .� d C � � f7 ►+ m � N � ' 0 z � m T � � m � D -�1 0 z a z e c� � 0 T 'Yl � d m '-C _�-�_ _ rCj �� J "� �CA�� I ��s� ��'% t➢ s�/l�ao i�r " � , WS6 .•_'. _,az ��t�0 � � �� !4',ri� 1� C�° �� � HEAT LOSS CALCULATI I�f� DEPARTMENT OF BUILDINGS FRIDLEY, MINN. Weatherstrips A.S.H.V.E. Construction No. Insulation Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof F7oor Kind How Applied Yes—No Yes—No 19_ Fl.� .1.; ✓ Room � Length �. O Width d� Height � Fl.� � �� Room Length D� Width � Height � Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area �Vidth Helght Na. ot Llneal [t. Area •• Wldth Helght No. ot Llneal [G Area No. ot pane ot Dene liBhte of crack eq. tt. No. ot Dane ot Dane Ilghte of crack ep. tt. , (0 2� �� B �e ��>� ) z� me � A�.� �.� � � �� � �s � � �e� �� � � � �@ � G� � e � � o � Coef. Btu Coef. Btu ln6ltration `�' �� � � � � � � � lnfiltration � F�° �� � � � �� Glass J �. � , �'� .� � F� � Glasa D � m �, � � 1� � ��° Eap. wall ��� Eap. wail P�� Net exp. wall A�°� � J� /���`' Net eap. wall 1?8.3 %� B��� Int. wall Inw wall Ceiling � �� �� � ��� Ceiling P �� � � �' ��� Floor Floor 7'otal Btu. ! � � � � Total Btu. �` 9 � Required sq. ft. E.D.R. or aq. ins. W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.� � p Room ( Length ! 9 Width � 2'�'DHeight �, �,� ���" ��� Room I 1.en8th `� Width d Height � Windows and Doors—Crackage aad Area Windows and Doors—Crackage and Area Wldih Helght No. ot Llneal tt. Area Wldth Aelght No. ot L1nea1 !t. Ares No. ot Dane ot DBne Ifghte o[ crack ep. ft. No. of pane of Dane Ilghte of crack eq. [L � `� `7' � � � � �" � O e O D l � A � � /�. � � � Coef. Btu In6ltration d �A� ��' � D � �BSb �e � ��i, � � :� Exp. wall � � Net exp. wall �/o � 1 � � � � Int. wall Ceiling 6 3� e D 4��� II Floor Total Btu. � � � � Required sq. ft. E.D.R. or aq. ins. W.A. Leadsr area F7. � � . Room � Length e �'�' °pWidth � � Height � Windows and Doora—Crackage and Area Wldth Relght No. ot Llneal tt. Area No. of pane o[ Dgne Ilghts ot crack eq. it. 9 ��' /� z r�, s �� � � / @� � 4 � e �i �'� p � Coef. Btu lnfiltration � tic� � � � � ��° � Glass ! 3 , � SO '� �� Exp. wall � %�o � Net eap. wall ► rd �• �� D� �� Int. wall Ceiling /� L D� i 9�� �loor �; Total Btu. � � � / iRequired sq. ft. 6.D.R. or aq. ins. W.A. Leader area In6ltration �A• � 6 �' °`� 3 � �85s �e � �: ,� fiZ� Z �o .� E7Cp. WSI� � �'� Net eap. wall �:� F> 4�! l� �� � c' Int. wall Ceiling �' � / � �`'� !'a Floor Total Btu. Z' D � � Required aq. fw E.D.R. or aq. ins. W.A. L.eader area Fl.� ��' ^� Room I L.ength 9 b°' Width i� Heighc �►, Windowa and Doors—Crackage and Aiea Wtdth Helght No. o! Llneal [t. Ares No. o[ Dane ot pane Ilghts ot crack ea. iG o �� �� � � 9• � �� Coef. Btu Infiltration � � • � � � � � °f Glass �� ��� �Df3'D Eap. wa11 � C� Net eap. wall ��� D t� ��� Int. wall _ Ceiling / ��° .�'� / �'p�D Floor � Total Btu. � ��? � Required aq. k. E.D.R. or sq. ins. WA. Leader arra I �� L� ,elz � � B,"� ��6� f������ �`��F`�� �� d�����if�.�ie�t��o. D�J6 _.'` a z _ a HEAT LOSS CALCULATIONS ° DEPARTMENT OP BUILDINGS FRIDLEY, Nb1NN. , Weatherstrips A.S.H.V.E, Construction No. Insulation Guide Windows Doors Reference Out. WaU Int. Wall Cxiling Roof F1oor K;nd How Applied Yes—No I : Yes—No 19_ Fl.� ; � Room � Length J/ '3 ``Width e 3' Height �° FI.� Room Leagth Width Height Windows and Doors—Crackage and Area ' Windows and Doora—Crackage and Area , �Vidth Helght No. ot Llneal tt. Area Wldth Helght No. ot Llneal tt Area No. o[ Dgne ot Dane Ifghte ot crack eq. ft. No. of Dane ot Dane 1166te ot crack sQ. tt. 1 / 3� � 0��2 8�� Coef. Btu Infiltration /�� � � � (80 � Glass � 7 �'� y.?S' Eap. wall � 9 O Nec exp. wall � �. � � � � � „� Int. wall Ceiling � �i / � �� Floor Tota! Btu. � 3.� � Required sq. ft. E.D.R. or aq. ins. W.A. Leader area F7.� �'+� r Room � Length 0?,� Width �' Height � Windows and Doors—Crackage aad Area W(di.h Helght No. ot Llaeal ft. Area No. of Dane ot pane Ilahts ot crack eq. tt. � � � �'� / � � r� d� �� Coef. Btu In6ltration ,� � � e ;' `� � B Glass �.:��('a �`;�� D �' � � Exp. wall 2 v�� _ Net eap. wall z 2��/ / O 2�� Int. wall Ceiling / Z 4�87 i 2�0� Floor ' I �g / � ! �, �0 Total Btu. 7�'� � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI. l3qs�MC�,�oom � Length �' � Width � ra Height � Windows and Doors—Crackage and Area Wldth Hefght No. ot Llneal [t. Area No. ot pane ot Dane Ilghts ot crack sp. [t. � 3 � !6 / �6� � s�A� � �� �C� f A�e � ��• I lnfiltration Glaaa Exp. wall Net eap. wall lnt. wall Ceiling Floor Tbtai Btu. �S. Coef. Btu �� Z,� � 3�� � 6��'� ►/�O eo�3 A� s���b ll �a�� � ,� 7Z� ����� ft. E.D.R. or sq. ins. W.A. L.eader area � Infiltration Glasa Eap. wall Nec eap. wall Int. wall Ceiling Floor Total Btu. Required sq. k. E.D.R. or aq. ins. W.A. Leader area FI.� Room � Leagth Width Windows and Doora—Crackage and Area Wldth He16bt No. of Lineal tt. Area . ot uane o[ vane ItBhte ot crack ea. tt. Infiltracion Glaas Eap. wall Net eap. wall Int. wall Ceiling Floor 'fotal Bta. Required aq. ft. E.D.R. or aq. ins. W.A. l.eader area F7.� Room I Length Vf/idth Windowa aad Doors—Crackage and Area Width Helght No. of Llneal tt. Ares No. of uaoe of oane Ilg6ts ot crack ea. tC In6ltratioa Glaas Esp. wali Net eap. wall io�. Wau Ceiling Floor Total Btu. Required aq. k. E.D.R or aq. ins. WA. l.eader area Btu �� Bcu c�ty of Fridley S�B�E`T P? �� AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ����� r � � PT NO. � �y _ _ COMMUNITY DEVEIOPMENT DIV. ; r , r � � PROTECTIVE INSPECTION SEC. L �C'' �� � %t-Z � . � � � - i ' � /'��1 � CITY HALL FRIDLE� 55432 NUMBER REV OATE PAGE Of APPROVED B'I �----�: �.� 612-571-3450 970-F15 / / 11/27/95 JOB ADDRESS 1357 Fireside Drive NE 1 LEGAL LOT NO. BLOCK TRACT OFi ADOITION SEE ATTACHED DESCR. Pt 14 Auditor's Subdivision ��129 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Larr Vo t 1357 Fireside Drive NE 786-2624 3 CONTRACTOR MAIL ADDRESS Z�P PHONE �ICENSE NO Panelcraft of MN 3118 Snellin Ave S M ls MN 5406 721-8628 2179 4 ARCHITECT OR DESIGNER MAII ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIIADDRESS ZIP PHONE , UCENSENO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW �7 ADDITION O ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 OESCRIBE WORK Construct a 19'6" x 10'6" Three Season Room 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. �� cail �ot Befote d�gg� jocations SEPARATE PERI�i ITS REQUIi�ED FrJR all ut454-0002 � •„ n � �I�E� �Y l°`R�V� l�J�,�,:��, F��AT19V�o PLUN7�1�lG A,��� ;;o�;;�d REQ SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV 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 SUSPEN�ED OR ABANDONED FOR A PERIOD OF 120 OAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STAL�S GARAGES AND KNOW THE SAME TO 8E TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WOFK WIIL BE COMPLIED WITH WHETHEH SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �S� LO8 �L.SS DOES NOT PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �I1L. ZS Fire SC �S. IO PLAN CHECK FEE TOTAI FEE License SC $5.00 $124.91 S�GNATUFIEOFCON'RACTOAOAAUTNORIZEDAGENT ioarEi WHEN PfiOPE� Y VALDATED THIS IS VOUFi PERMIT _ ��+ G��� /(�� �'%�� SiGNaTUREOFOWNEAUFOWNEABUILDER� IDI�TE� !" 8 DG �NSP �1aTE hai�l.!—:='i-1'��� 1.�� -�'� PHhdEL��R�FT �1'.=' +�1 �1�E� F.E11:�'b�1 ,tix:rr L ti ;� ; 1 � '� " T CtIC�GIV�+ $/)/�$ A�►�N �] C1't'Y t�F �1tf i)L,�Y �� � � AI;Y`I:1� � j ,�IN{C'L� 1��lMIL.Y ANl) i9Ul'L�X�.fi �t-y A1V� R-2 �ufldlrig PCrmit Ap�+liCa,ho�n C���ctiun Addr�sss: � '�=. �►�-�-�.1� � �t �— . �.. _ L�ga! Descsi�iticrn: ---- -- . �_ ---- • - .. . — . �_...,,�.. — C�wI1�r �idlt�C �G AddY'�5: t°°�.g--"y V Q,� .._ , X`@�. �l_���p= �(v�� �e._ C.+�ni��!=�r� ��,.�,��--� �--� �,�`�_ ,.. . __ MN I�iGh:�1SE �` ._ �l i' �l . — Addr�.c�:�.....--�-��.-. �.L�. �� �-�-��.�ao!�� � � .► .. . _ _Tc�. � _ � I - ��'�- $ . A41,�eh W thi�5 s��lic�ttfon�, a C:ertificat,� of Surve,� o� rhe l�t, wiih i� �►,r��se�d c�nst.ru�tian drawn On at t0 scale. 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Pt 14 Auditor's Subdivision �i�129 2 PROPERTY OWNEFi MAIL ADDRE$$ ZIP Kristi Rroona 1357 Fireside Drive NE 3 CONTRACTOR MAIL ADORESS ZIP Panelcraft of MN Inc 3118 Snelling Ave S, Mpls., MN 55406 d ARCHITECT OR DESIGNER MAIL AODRESS ZIP 5 ENGINEER 8 USE OF BUILDING Residential 7 CLASS QF WORK ❑ NEW MAII ADDFiESS ZIP PAGE OF � � 0636 ��� PPROVED 8Y SEE ATTACMED SMEET NONE 425-1333 MONE LICENSE NO 721-6628 2179 MONE LICENSE NO. PHONE LICENSE NO � ADDITION O ALTERATION �] REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WOHK Reside House & Garage; Fascia, Trim 9 CHANGE OF USE fROM TO STIPULATIONS Call for building wrap inspection before covering. TYPE OF GO SEPARATE PERMITS ARE FiEQUIRED FOR ELECTRICAL, PLUMBING, MEATIN(i, VENTI�ATING OR AIR CONDITIONING THIS PEFMIT BECOMES NULL ANO VOID If WOiiK Oii CpNSTRUCTION ZONING AUTHORIZED IS NOT COMMENCED V�IITMIN 80 OAYS. OR IF CONSTRUCTION OR WORK IS SUSPENOEO OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AF7EF WORK IS COMMENCED NO DWLG. 1 HEREBY CERTIFY THAT I HAVE READ ANO �XAMINED TMIS APPLICA710N 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VALUATION ANO ORDINANCES GOVERNING TMIS TYPE OF WORK WILL 9E COMP�IED WITM WNETMER SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT $3,654 DOES NOT PRESUME TO GIVE AUTMORI7V TO VIOIATE OR CANCEL TNE pEqMIT fEE PqOVISIONS OF ANY OTNER STATE OR �OCAL LAW REGULATING CON- STRUCTION OR 7NE PERFORMANCE OF CONSTRUCTION �97.ZS S�GN4TUNE OF CON'AACTOA OR AUTHpq12E0 AGENT IOAfE� � NG iD�iE� SQ. STA��S S� $8.0� P �OCCUPANCVLOAD CU. FT. OfFSTREET PARKING GARAGES SUR7AX r .�1.03 SAC CMARGE Fire SC �� TOTAI.FEE $107.73 ATED TNIS IS VOUR PER IT � ` � •Z� Db qciE rrEw ADDN ALTER [] [] �Vl� i''\ : - �. c:onstructionAddress: Effective 1/1/99 CITY OF FRIDLEY . SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2 ,��'�� � G�' f/ 3,�� BUILDING PERMIT APPLICATION '-� 5 � �� �� �," �.� �� � �v � �3 �� ��� `� Legal Description: � � � ' � � � ` � �- Owner Name & Address: f(r� st' Kroo n q /,3aS7 �res, �/e `, cl/e Tel. # �f a�- �3 �3 Contractor: �/7C�L'�Q�j� p� /Lri(f . �j7� MN LICENSE # �/%g Address: 3//d �h¢l�:an r�i�cur ���� �,tl 5��, Tel. ���ia) 7a/-�Ge�.� LIVING 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. DESCRI�TiON �DF IIi�i�RO�iTE1VIENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. �5'd � �, Construction Type: r i h� �q S�i �/r � r>-� Estimated Cost: $✓� �v �� e� r ` (Fee Schedule on Back) Drrveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: —� -�� APPLICANT: � Tel. #(��2�70'�1�li�o'� X/3/ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Fscrow Erosion Control Park Fee Sewer Main Charge �-.? oT�. STIPULATIONS: $. � � �. a.� $ .�, � � $ /� �.3 $ $ 5� � D $ $ $ $ � /D 7. �.3 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 Deterimined by Engineering Agreement Necessary [ ] Not Necessary [ ] 0