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City of Fridley, Min�u..
BUILDING PERMIT
Date: �y 8 � 1969
p�,r. Elmer fl. Flowers B��r Same
Ad�re� 1400 Fireside Drive Ad� Same
���s�
N° 10222
LOCATION OF BUILDING
No, 1400 S�t Fir�side Drive p� of Lot
Lot 6 Block � Addii3on or Sub-Divis�ton .____ Gunderson Terrace
Corner Lot _ Inaide Lot —. Setback � Side�►ard
Sewer Elevation
Founda.tion IIevation
DESCRIPTION OF BUILDING
To be Used as:
Move Ga�ge , Put in S1a�nt 14' Depth 22 � Height 11' �. � 308 ��
Front Depth ITeight Sq. F't. Cu, Ft
Type of Conatruction Frame �� �_$200.00 To be Completed
�
In cons�tderation oP the issuance to me of a permft to construct the building described above, I agree to do
�►O���Pro� f� �� �� with the description above set forth and in campliance with all provisions of
��- �
In c�sfderation of the payment of a fee of $ 5• �� � permit ia hereby granted to Elmer H. Flowers
to constcuct the building or addition as described above. Thiape rmit is granted upon
the express condition that the person to whom ft ia granted and Iua agents, employees and worl�nen, in all work
done fn, around and upon said building, or any �art thereof, shaA conporm in all respects to the ordinance� of
FridleY, Minnesota regaraiag location, conatruction, alteration, anaintenance� repair and movtng of builaia�re
with�n the dtY 7�1mi'ts and thia permit may be revoked at any time upon violation of a�nyy of the provieiana oP sa�d
ordinancxe.
ence Belisle
�
� NOTIC�
'flds psemh d� nM eevsr the coesfrocHoe, iestaUatloe Po� wd3eA, plumbtae, ea headng, ssvn� or wNsr. B� wro to ae
the Buildieg Insp�etor for qparai� parmhs fo� t6as (tems,
�
4PPLICfl`�ION FOR BIIILDING PERMIT
CITY OF F�IDLEY, MINNESOTA .. �
,
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LOCATION OF BUII,DING
NO .�,� /'� O STREET � i 1���°lli� �� 1�� �� / I/.� ,�Y
� LOT BLOCK ADDITION OR SIIBDIVISION �r��d'�i�'I3.S�l�%
CORNER LOT INSIDE LOT � SETBACK ��� SIDEYARD�,
SEWER EIrEVATTON /�O�(%� TOP OF FOOTING ����Q� ,� ��1�Ap��
Applicant attach �to thia form Two Certificates of Survey of Lot and
p�opos��l build7Lng locatioz�. drawn on these Certificatea.
DF��CRIPTION OF BfTILDING
To Be IIeed ge:
_ �s�.r48 � AQI� Y j% G%/�� �'' e'r� , , �
� �l',¢ % �' . �'ront /d� Depth � a� Height l I
. . . Square feet Cubic Feet
� �px�� AQ�th Heigh� _ _ _
Sque�ea £��� �ubic Feet — - -
�yp� of Coa��truotion. y�1/���,,�'�,�� ���ima��d Co��t =�
^
To He Completed �,�� '—` � % ,,.._
The unde�ei�ed hereby makes application for a permit for the work
herein �speaified, a�r�eing to do all work in strict accordancQ with the
City of Fridley Ordinances and rulin.ge of the Department of Buildings,
and hereby deolaree that all the facts and rep�esentatioxi.s stated in
thie appliaatiort axe true and coxrecte
DgTE w; �°� " � / SiGNATURE � ��,.�� _
�Schedule of Fee Coate can be fourid on the Rever�e Side,)
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BUII,DING PEftli'�IT � �"EE SCHEDULE
SEGTION 2o The Inapecto� of Buildinge ahall, before is�uing permita
ior the erection of ax�.y building or �tructure 9 0� ior a.ny addition to any
�axi�ting structure or buildingfl or ,for a:n.y altera,tion or repa.irs to any
egieting builduag o� structus�e 9 upox� �,pplieation the�efore, require the
payment by the �,pplicantufo� �uch permit ,�f fee� to the amount herein
below �et forth and ua the ma.�er here�aa. provided to-wits
IIniform Build° Codeo Type 19 29 & 4 m$1075 for each one thousand
cubic feet, or fraction thereoi9 �s �ueh cubical c.�zatenta: Type 3& 5-
$10 50 ior each one thousax�.d eubic feet o
For the purpoae of computing fees for building p�rmits9 the cubical
cz�nt�nte of ��u�.%li�a3'�azizii�-��, ut�si'orm heigti`l.`�t�oug���'��r_^�
multiplying the $round area covered from a poirt six (6� inches below
the iloor line of the basement or the cellar to the average height of
the upper �urface or to the average height of the rooi surface of the .
ma.in gable of a pitched roo£. �
For repairs or alterationa to asb existing structure, the fee sha,ll.be
at the rate of $3.00 per eaeh iive hunclred: dollars (�500.00� or
frac�ion thereof in the cost of all proposed worka
In x�o case ahall the fee charged for a�.y permit as set forth in Section
2 be leas tha.:�. $5o00a �
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SUBJECT PE .
City of Fridley 2 0 3 3 5
, , AT THE TOP OF THE TWINS g � I L D I N G P E R M I T ECEIPT NO
r
� �
� � COMMUNITY DEVELOPMENT DIV.
, ; ,: ----- , 3� /a�
r � � PROTECTIVE INSPECTION SEC.
1 = i
� /'�'1 � CITY HALL FRIDLEr 55432 NUMBER REV DATE PAGE OF APPROVED BV
�""� � �'' 612-571-3450 9t0-F15 5/4/�0 / /
JOB ADDRESS 1400 Fireside Drive N,E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO
DESCR. � 2 Gundex�snn Terxace . SHEEr
2 PHOPERTY OWNER MAIL ADDRESS 21P PHONE
Morris B.enson 14Q,Q Fireside Dri�e N�E,
780-4097
3 CONTRACTOR MAILADDRESS ZIP PHONE UCENSENO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW �1 ADDITION ❑ ALTERATION ❑ REPAIR � MOVE O REMOVE
8 DESCRIBE WOHK
Cons.truct � a 22 t x 24 �& a 1Q'•' x 20 `•' Addition to tfis dwelli,n
9 CHANCiE OF USE FROM TO
STIPULATIONS g .__ ���� ����� �}.$��
�='- r---- -- ��" `�ttg'= 1�'i l�'g`�l'
�--C�'rL-�+��our�-�-. S'ee notations on pla,n� Variance ap�x'oved for side yard setback
from 10 £eet to 5�eet on April 23� 19�0 FX City Council,
SE �������'���' �
� .°.! .� a� i� �;°',�
r
�r� �� TF p�RM/�� �efore diggin� cail for
all utilit (ocations
. d�IF.�iTlt��. l���� �`;�?�-� �� y
454-0002
���� ��� �1� REE�1tR�D BY LAI�►
�s.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATINCi,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONINO SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTfiUCTION
OF WORK IS SUSPEWDED OR ABANDONEO FOR A PERIOD OF /20 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUHTAX
AND ORDINANCES GOVERNING THIS TYPE OF WOHK WILL BE COMPLIEO $36��rQ $15�48
WITH WHETHER SPECIFIEO HEREIN OH NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHAfiGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- $33QaOQ
STRUCTIO OR T ERFORMANCE OF CONSTRUCTION.
f PLAN CHECK FEE TOTAL FEE
� � � $348�48
SIGNAT oFCON�a CT AUThIOF12EDAGENT i W N PROPER V I T D IS IS YOUR PERMIT
�� ��� V
Si NATUREOF ERiI OWNERBUILDEHi IDATEI "� 8 INSP npTE
� [ ] EffeCtive 1/1/90
� [ j R-1 AND R-2�
�T� [ ] Buildirig Permit Application
constivction ��: _ l Li d 4 �" �� �� � s,-cf' �� �l � ��� , e���e / dL � Gf,�
Legal Description:
OF�Y' TTa10� bt �.a'a �(�'`( (r v� f e�iL� � �' 1'� �2 e . �/
� c�.=+: _ �J r.S f.� c? �-. s o G. S�/ /%/C�1 # 7 b v��n �i 7
CAT1t,Y'dCt.OY'L ,��I�° 'i�21. # ��� -�04 >
Addi�e�.S: ��/O �) �� %2 sic�P 6/� ft /�e' � ��. r����e y G�i �z
Attach to this application, a Certificate of S�vey of the
lot, with the proposed v�nstruction drawn on it to scale.
D�CitIPTI�T OF Il�9IIN�Tr
LlVII� AREA: i�ngth ���� / C/Width �� Height � Sq. Ft. �7 / O
C�iR�GE AREAs Iength Width Heic�t Sq. Ft.
DEQC AREA: Length Width Hgt/Graund Sq. Ft.
ORR�R:
� FT
Cornex Iot [] Inside Int �, Ft. Yd Setback G � Side Yard Setbacks � O "
Z�pe of Construction: __ �i!/oa - Estimatsd Cost: $ �
,
Approx. Ccenpletion Drate: T �-t � �C � v � b , � � � � �� ,�'L
Proposecl Driveway Width If New Opening Is Desir�d: Ft. $ $
„�. f' �� f Width + 6' See Back Page
DAZ'E: %i;-�i `�'� ` APPLICANT: ;�` ° z •� ��e � �.� Tel. # ��� _e��g �
Permit Fee $ ���,�
State Surrhazge , $ � i � , �Q
SAC Criazge $
Driveway F�crcyw $
Park Fee $
Sewer Main criarge $
CITY IISE �Y
Fee Scheclule on Reverse Side
$.50/$1,000 Valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Abave
Fee Determined bY �J��4
Agrepment Ne�ssaYy [ ) Not N�ssaty [ ]
� $ � �� �'�
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7he Chief Building Offici.al shall, before issuirig permits for the er�ec.�tio�► of ariy
building or structure, or for arry additian to atzy existirig b�ilding or structure, or
for ariy altexatio�n or repair to any existing building or structure, upon ap�lication
therefore, require the payment by the applicant for such permit of fe�es to the amount
hexein belcyw set forth and in the manner herein provided t.�wit:
TOTAL VAIIJE
$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
i,��
$15 (Minitmrm Fee is $b5 plus surd�arge)
$15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$252 for first $25,000 plus $6.50 for each aclditional $1,000
or fraction thereof, to and includirig $50, 000
$414.50 for fiYSt $500000 plus $4.50 for each additional
$1,000 or fraction thereof, to and including $100,000
$639.50 for first $100,000 plus $3.50 for each actiditional
$1,000 or fraction thereof, to arid including $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each ac�ditional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 azid up $3539.50 for the first $1,000,000 plus $2 for each additional
$l, 000 or fraction ther+eof
DRiVEi�iY DEPRES,SI�T �
(Concrete GUrb S�:reets On1Y)
Alternate "A" : Removal arid replacement of curb ar�cl gutter only - Drive�ray width plus
6 feet t�mes $13.50.
Alternate "B": Re�noval arid replac�nt of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
� �,•ii- �� ., . i . u �.,� .;
P�eYmits for construction will be issued a mininnnn of 24 ho�urs frcan the time of
application to allow for praper review of the praposed structure and of the
oonstruction site.
A Certificate of S�YVey of the lot, shawing the location of the foundation onc� it has
it has beexi construct.ed will be required before prooeedirig with the fYaming.
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c�ty of Fridley S�B,E`T P� o�,
AT THE TOP OF TME TWINS g � I L D I N G P E R M I T
r
; �`���o�� RECEIPT NO.
ITY DEVELOPMENT DIV. /�
r � y � PqOTECTIVE INSPECTION SEC. �(/ ��
� 1
1 . ,
� _ �"'1 � CITY NALL fRIOLEV ��J2 NUYBEp pEV D�TE v�GE OF �vonOVED Br
�----� ' �•' 612-571-34b0 910-F15
8/5/99 / /
JOB ADORESS 1400 Fireside Drive NE
1 IEGAL �07 NO. BLOCK TfiACT OR ADOITION SEE ATTACMED
DESCR. ( 2 Gunderson Terrace SMEET
2 PROPERTY pWNEq MAIL ADDRES$ 21P PNONE
Alex Theobald 784-7626
3 CONTRACTOR MAIL ADDRESS 21P PMONE LICENSE NO
Owner
d ApCHITECT OR DESIGNER MAtL ADORESS 21P PHONE LICENSE NO.
S ENGINEER MAIL ADORESS 21P PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION O ALTERATION x� REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house 20 S Tear-off
9 CHANQE Of USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TVPE OF CONST. OCCUPANCY GROUP OCCUPANCY LpAD
SEPAfiATE PERMITS ARE REOUIRED FOR ELECTfiICAL, PLUM8ING, FIEATING.
VENTILATING OR AIH CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK Oi; CONSTRUCTION IONING SO. FT CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANOONEO FOR A PERIOD Of 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED NO DW4G. UN17S OFFSTREET PARKING
I HEREBY CERTIFV 7HAT I HAVE FiEAO AND EXAMINEO THIS APPLICATION STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF �AWS yq�UATION SURTAX
ANO ORDINANCES GOVERNING THIS TYPE Of WORK WILL BE COMPLIED ¢
WITM WMETMER SPECIFIED HEREIN Ofi NOT. TME GRANTING OF A PERMIT `P174'8 �,g7
DOES NOT PRESUME TO GIVE AUTMOIiITY TO VIOLATE OF CANCEL THE pEFMIT FEE SAC CMARGE
PROVISIONS OF ANY 07HER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR TME PEFiFORMANCE OF CONSTRUCTION .�63. �.rJ Fire aSC .��.. %rJ
PLAN CNECK FEE TO AL FEE
65.77
S� 4TUAE OF CONCRA TOAOA AUTNOp12E0 AGENT iDATE� ME P Y VALI D TMIS IS . R PERMIT
� � r
�GNOTUA O�OWNEA��FpyVNEABWLOE:�� �DATE� B �NSp p6tE
���..
ADDN
ALTER
Effective 5/10/99
[ ] CITY OF FRIDLEY
[] SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2 � ��
BUII.DING PERMIT APPLICATION � �� (}�
_ �
Construction Address: � �(� �112� �O� ��L �lJ� ��/01.�i' �iL�/ `�.3L
Lega1 Description: _ RC� 1 p�C'� D1 c. ld�m.E
Owner Name & Address: ,
Q(-�X `���VI o 5� q s q�v✓�= Tel. #(, I 2` Z 8S�- ?6 Z 6
Contractor: ��n� oWalt�2. MN LICENSE #
Address: /�c;� �,2t�5r/�� J�/� ��s r F2�d��`1 m,J ,STfS�- Tel. #�/2- 7Bt%' 762�
Attach to this application, a:Certificate of Survey of the
lot, with the _progosed construction drawn on it to sca�e.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
DESCRIPTION 4F IlVIPItO�ElVIENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
Sq. Ft.
Sq. _ Ft.
Sq. Ft.
'/�n/6e.� _ �c;
- i v
��� C_
EStIiri1�C� COSt: $ � L �
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$
_$
DATE: Sf APPLICANT: Tel. # ��Z - % � �-% ?�2 �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ �.� �s�
$ ! ,�Sd
$
$
$.
$
$
$
$
$ �pS.�
CITY USE ONLY
Fee Schedule on Reverse Side
.�1 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.00 (Sta.te L,icensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review.
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
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 structure, or for any alteration 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,�
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $10(l,QOQ
$100,001 to $500,000
$500,001 to $1,000,0�
$1,000,001 and up
FEES
$23.50
$23.50 for first $SQO plus $3.05 foreach �dditional $1(l0 .or
fraction thereof, to and including:$2,00�...• �-:
$69.25 for first $2,000 plus $14.00 for each additianal $1,000
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 $50,000
$643.75 for first $50,000 plus $7.Q0 for each additional
$1,000 or fraction tliereof, 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 $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,0(}0,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Aiternate �"B": Removal and replacement of curb and gut�e� and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction s�te.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before proceeding with the framing.
�,�_ �
sue�eC1
City of Fridley
AT THE TOP OF TNE TWINS g U I L D I N G P E R M I T
i �
� �
� `v __��� COMMUNITY OEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
i ; �
� �"'1 � CITY HALL FRIOLEv S5132 NUMBEf1
�'""'� � �'' 612-571-3450
910-F15
JOB ADDRESS
1400 Fireside Drive NE
t LEGAL �OT NO. BLOCK TfiACT OR AODITION
OESCR. (� 2 Gtmderson T�
2 PROPERTY OWNER MAIL ADDRES$
Alex Theobald
3 CONTRACTOR MAILADDRESS
Cornerstone Const. 222 N Con�
4 ARCNITECT OR DESIGNER MAIL AODRESS
5 ENGINEER MAII AODRE3S
8 USE OF BUILDING
Residential
7 CIASS OF WORK
O NEW O ADDITION � ALTERATION O REPAIR O MOVE ❑ REMOVE
B DESCRIBE WORK
DATE
9/20/99
21P
� /
PHONE
•450_
PMONE
PFIONE
�''ERMIT NO.
3 0�
RECEIPT NO.
����
APVROVED B�
SEE ATTACNEO
SFIEET
LICENSE NO
200742E
LICENSE NO
LICENSE NO
' sec
& repair 8" hole in foundation
9 CHANdE Of USE FROM TO
STIPULATIONS
See stipulations on plan
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. HEATIN(i, "rc vr VVry.I� vG�.ur�
VENTILATING OR AIR CONOITIONING.
THIS PERMIT 9ECOMES NULL ANO VOIO IF WORK OF CONSTRUCTION 20NING S�. fT
AUTMOR12E0 IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOO OF 120 DAYS AT
ANY TIME AFTER WOqK IS COMMENCED. NO OWLG. UNITS
I HEREBY CERTIFV THAT I MAVE READ AND EXAMINEO TMIS APPLICATION STA�L$
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VALUATION
AND ORDINANCES GOVERNING 7NIS TYPE OF WORK WIIL BE COMPLIEO
WITN WHETMER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .�23],O
DOES NOT pRESUME TO GIVE AUTMORITY Tp VIOLATE OR CANCEL THE pEqMl7 fEE
PR VISIONS OF ANV OTNER STATE OR LOCAL lAW REGUTATING CON-
ST CTIO OR 7HE PERFO ANCE OF CONSTRUCTION 83. ZS
PIAN GMECK FEE
� Licen S S. 0
GN U�7E O� CONCiiACTOA OA AUTMOA�2E0 AGEN1 IOATE� FN A[1PP e
v
CU FT.
OFFSTREET PARKIN(
IGARAGES
E
1
PERMIT
LOAD
��_r �
ADDN
ALTER
Effective 5/10/99
[ ] CITY OF FRIDLEY
[] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUII..DING PERMIT APPLICATION
Construction Address: �; D O ,�r,.��y, ��,e ,� �- . � �',
Legal Description: _
�Y
6�
�
Owner Name & Address: /� ,� �'"�� ea�� ���� Tel. # % g/— 7� .2�
Contractor: �'a�� �� �. ��,,, � �'o h .� � > MN LICENSE # � o c� � ,��� �
Address : ,� � �U C�o �-� � �� �'x� So 5 ?' /�� �.� %r �i u✓ .s�`s-,� �-Tel. # � s/ Y.�-o s�
Attach to this application, a Certificate of Survey.of the
lot, with the proposed construction drawn on it to: scale, -
DESCRIPTI�ON OF IMPROV�11v1ENT ` `
LIVING �REA: Length Width Height Sq. Ft.
GARAGE AREA: I.ength Width �ieight Sq. Ft.
DECB AREA: Length Width Hgt/Ground Sq. Ft.
OTI�R: /
Construction Type:���` �,�-ov� //' `s«,l.o� Estimated Cost: $ ���� • B 6
,
Driveway C�rb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ .
DATE: % —�4 ` 9Q' APPLICANT: � �e ��i-a-v Tel. # �s/- �so =sr��'
,
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� c�.��.�
$ -�/
$ /, /S^
$
$ .SD�
$
$
$ .
$
$ �� 7�
CITY USE ONLY
Fee Schedule on Reverse Side
.�1 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.00 (State Licenseci.Residendal Contractors) . _
Alt. "A" or Alt. "B" Above
$450.00 Conservarion Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
_ _- �
BUII.DING PERNIIT 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 structure, or for any alteration or repair to any existing building or structure,
ugon applicadon therefore, require the payment by the applicant for such permit of fees to the amount herein
helow set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,�
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,(�?0,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $1(� or
fraction thereof, to and including $2,000. _
$69.25 for first $2,000 plus $14.00 for each additional $1,U00
or fraction thereof, to and including $25,0�
$391.25 for first $25,000 plus $10.10 for each additional $1,(�0
or fraction thereof, to and including $50,000
$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,(�0 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,(�0 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,�0 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "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 ph�s 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed 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 consmacted will
be required before proceeding with the framing.
CCM
Cornerstone
Construction
& Management
Alex Theobald
1400 Fireside Dr. N.E.
Fridley Mn.
P#784-7626
Bid to include the following.
F#540-1364
222 N. Concord Ecxh.
South St. Paul, MN 55075
Phone:651-450-5668
Fax: 651-450-8991
License# 20074263
Proposal Number 99-214
Date: 8/24/99
'' Excavate side approximately 11'-15' across and down to foofing level
'' Patch hole at bottom of block
'' Instali Bituthane waterproofing membrane to exposed block
"` BackFill and compact to create positive pitch away from foundation
" No steps included at this time
*'TOTAL LABOR AND MATERIAL $2310.00 DOLLARS