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AF - 45242City of Fridley, M;� BUILDING PERMIT N° 5969 � �: - � � � � • , . , . � �/: _.,�t"_ .l _ 1 i � : � _ . � . �� ''� � �.� i Address _..._ Address ,� ,r L CATI F NG Na , 5ireet r 'r f P f Lot �- . Lot .__ Block �� Additioa or Sub-Divisi --,�G��c�.��,f�.�'i Coraer Lot __ Inside Lot ___�,�tback deyard __.__l._�G Sewer IIeval3on — F dation IIevation DESCRIPTION O� BUILDING To � �/f �' �� R � Front � Depth ��"— � Height �— Sq. Ft o Depth — ei Sq. Ft �ie of Construction _ Es� Cost �� j'��'� To be Completed _ � � ��'�� Cu. F't. In consideration oP the issuance to me oP a permit to construct the building descrlbed above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordfnances oP the dty of Fridley. t� �f In consideration of the payrnent of a fee oE $� , Aermit is hereby grant�ed to— to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and lus agents, employees and worl�nen, in all work done in, around and upon sa3d building, or any part thereof, shall conform in all respects to the ordinances oE Fridley, Minneaota regarcun8 location, construction, alteration, maintenance, repair and moving of buildings within the city limfts and this permit may be revoked at �� upqp,lvio�l�ava�f aay oE the provisions of satd or8inances. ,t,�f Inspector NOTICE: Thb psrmM doea not cover ths eonshveHon, installaHoe fo� wUing, plumbing, gas heaNng, sewe� or water. Be sun to see ths Buildiag In�pectar for aeparate parmits h� thas (tsms. ``, � � /"`\ < � __ _ — -- APPLICdATIO�T �OR SUII,.DING PERP�IT C%TX O�' FItIDLEY► NtIi�TESOTA 4Wrie�' S NdIriO �� Address �� ,�-�� !�..��' Addtess ��;`�6��:� �d ��'II�°�� LOCATSON OF BUIL.DING Noe Street Fart or Lot Lot � �1ock � Addition or Subdivis�.on ��/�' �� Co�ne�c Lot �" �nside Lot Setback � S3.c1e-Yard SEWE� ELEVATION FOUNDATION ELEVATYOI�T Applicant�a��tach to th�.s rorm Certi�icate of Survey of Lot and �ropose� builcling location. DESCRIPTION OF BU2LDTNG To be used asa � � � �; . �:��-� .�, �'ront � �� ` Depth �` Height � �� _ Sc,� . Ft . C:u . Ft . Front ep•�h Height Sg. Ft. Cua Ft. � ' �s� Type o� Construc�Cion �,.' �°�_� Est�.mated Cos•�� = 10 be Completed �.�r; �,�� , , The unclersigned hereToy makes appl3cat3on for a permit �or �he work herein speci�cied, agree�.ng to do all work 1n strict accorc�ance with fihe City og Fridley Ordinances and ruling o:� the Depar�ment.of Huild- ings, and hereby declares that all the facts and �epresenicat3ons s�cated in th3s ap�lication are true and corr�ct. Dt�,TE �.��.�:� d d f� � SIGNATURE ��.c.' i.-�� ,��°�:��2�,..�� i � / 6. �" (Schedule of Fee Costs ca� be �ound on the Reverse Side). _ . � � � .s_ � - - �UILD�NG PERP�ZT PEE �C13EDULE section 2. The TnsNector o� Suildim�s ehall, be�ore issuing any perm3�: for the e�ec�ion o� any building or structure, or �or any addition to any exis�ing bu3lding or st�cuc�ure, or for any alterations or repairs �to any oxis�iny builciing or s�ruc�ure, upon application �here�or, require �he pay�nent by the applicant for such permit oi fees to the amount here3,ri below set �orth and in �he �aantaer here�ln ,�rovided to wito 2.�.. For any su�h pe�mit �or the erection o� any �Eire-►p�oo� building, o�he�c than a garago, waJC�ous�, facto�y or grain elevato�, or �Eor the erec�lon of any r�re-p�oo� acld3tion, fog sim3lar occupancy, to any exis�i.ng bu�.ldinc� shall be �t the rate o� $1.40 £vr each ono thousarid cu3�ic feet, or fraction thereof, in such cubical contents. 2,.2. For any euch porm�� or the �rect3.on o� any �E�.re-proor garage, warehouse, �actory or gra3n elevator, or for the erection or ar,y �'ire- proof ad�iti.on, LoY s�mila� occupaxicy, �o a�y existing bu�lding sha11 be at the ra�ta or $�..25 for each or►e thousand cubic feet, classi�ied as '°��.reproo�" by Sect3oa 502 0� the Minneapolie Building Code. fiO�E� 2_ 3. For any such perm�.t for th� erect�.on o% any non-�ireproof build- i�g other than a ga�age, warehouse, �ac�ory or grain elevator, os any non-rixeprcoo� addi�� on, for similar occupancy, to any ex�.,sting bu�.ld3.ng o Perc�nit $1.00 for each one thousaiicl cubic feet. C,�RI�iG`ES 2= For any such �e�nt3.� for the er�ction o:� any non�fireproof garage, waxehouse, �actory or g�ain eleda�or, or ior the erection of any nor�-fireproof addition, �Eor siYnila� occupancy, to any existinq building o� �or �ach such building or addition. Ninoty Cen�s for each one �ousand cubic �aet o�c fraction �hereof, in the cubical contents ithereof wi�th a n�.nismum o� $4.00. For the purpose or conaputing �Eees for build3ng permit�s the cubical con- °ten�s o� any build�ng or addition to a unifcorm height throughou� by snultip�.yingr the ground area covered rxom a point six (6) inches laelow the �rloor line o� �the basement or �e11ax to the average height of th� uppetc sur�ace or �o �he average he�,g�� of the rooi surface of �he �in ga�le ofc a pitched roof. 2,.5_.r �'or repe,l=s or alterat�lon� to an existinq �structure, the �ee shall be at �he rate of $3.00 per each Five Hundred Dollara ($500.00) or �raction �hereor in the cost o�' alZ proposed wosk. 2_.6_.. 3a no case shall the ree charged tor any p�rmit a� �ot forth in 3ectiori � b� ,,1esa L-�i $4.00. ' � � � � _ � L � ti � n C J \� — -��___�__, _ .._.._`_..._. �� ` .__...�. .L� . . � '� �+l �� ^�� , ' � t� � ,� �,�� .- r , t City of Fridley, Minn.. BUILDING PERMIT ��6� N° '7230 � � Date: � `� �j� ��'� ��' E Owaer: �&'�� '��'_..'� �� °'� Bu9lder � �'�l�Z�E— Addr2sa Address � � j� � L�CATI , ,� OF �ILDING No. � � Street - ^, � , l� ,part of Lot Lot _._.. _ Slock Addition or Sub-Division Coraer Lot _`� Ins�de Lot � Setback � Sideyard 5ewer IIevatian Foundation IIevation DESCRIPTION OF BUILDING T � � � � =�' � � �� ° Front � Depth = � Height � Scl. F't. �� Cu. �s%/�� _,_,_.. Depth fTeight �— Sq. Ft. Cu. Ft Z�►pe of Construction�,�� F�t.�C'o�-��-�=.-�_=- To be Completed In conaideration of the issuance to me of a permit to conatruct the building described above, I agree to do th� ProPosed work ffi acc�rdance with the d+�scription above set forth and in cwmpliance with all Provlsions of ordinances oP the dty of Fridley. � � In com�fderation of the payment of a fee of $ , permft fa hereby granted to to construet the building or addition as desccYbed above. Thiape rmft is Sranted npon the express condition that the peraon to whom ft is granted and his agents, employees and worl�nen, fn all work done fn, around and upon safd huilding, or anypart thereo� shall conform fn all respecta to the ordinanceg oP Fridley, Minnesota lacation, conatruct�Ton, alteration, maintenaace, r+epair aad moviu8 of bufldfuge withiu the dty limits�� permit may be revoked at any time upon violation of aay of the Proviaions of eaid ordi�,anc�. �� -,, � � Bu91din8 Inapecto� NOTIC� '11ds � d� eet eovse ths �natrue�tee, Imtallalleo for whteA, plombte�. 6n 6adne, asw�r er wat��. B� sun h� dn Buildie8 ImpKtee !or aparaf� p�e�ifs fee thw itNns. � � �� . . API'bICATION FOR. BUI�DIFIG �PERMIT , CITY OF FRTDL�Y, MiNNESQTA f� � A A 1� I� I� OWI�R' S NAi►�II: , _ � ..•r a ,� � _ _ : � " ADDRESS � � " � -�� ADDRESS �;, �, ' � -- . ... . , . . ._ . ,` ..� . . � . � � LOCATION OF SUILDING � , . . . . �, - No. ru _ S�reeC��d� c��? _ $art ,:of �ot� , .. .Lot �� . Block � Addition or Subdivision __ Corner I,ot_�Inside �Lot __Setback � � S3.de-Yaxd SEWER ELEVATION FOUNDATION ELEVATION Applieant-attach to.tbis �orm Two Ce�ttiicates ot.Suryeq�of,Lot�aad proposed buiZd� "ing iocatioa drawri on these Ce;tif�ca�es."�. .. - DESCRIPTION OF �UII.DING . '� To be uaed as: � ," . �' � Fr�oat / (� ' . Depth � Height � � ' Sq. Ft., Cu.,Ft.; , . FronC De th � __�He,� , . � � p i�hC � , : Sq. Ft . ._ _ Cii•. Ft . ` : , . � " '� � .. . .. � y , Type of ConsCruction ' Eatimated� CoaC ��. ; To be Completed � The undersigned hereby makes ap�licatian for a permit for the work herein�_specified, agreeing to do all work in strict accordance with the Citp of Fridley Ordinances and rulings vf,the_D�partment af.Build3ag8, and.hereby,decl�res that a11:�he faate and representatione stated in Chis application are true and cor,rect. ;. , DATE � � SIGNATURE %��"��€, � �Schedule of Fee Coats caa be found oa the Severse Side). ^ . rv � � - '9r' ' . ' . R a BUILDI�IG PEItP�IIT FEE SCHEDULE ' .- , Section 2. The Inapector of Buildin�s shall, before isauing any permit for the erection of any building or atructure, or for any addition Co any �:xist- iag building or structure, ar for any alteraCions or repairs to any esistiag building or s�ructure, upon application therefor, require the payment by Che applicant for such permit of feea to the amount herein below set forth and in the manner herein provided Co-wit: 2.1. For any auch permit for the erectioa o.f any fire-proof building, other than a garage� warehouse; factory or grain elevator� or for the erect3on of a�ay fire-proof add3tion. for similar occupaacy, to any existing building ahall be at the rate of $1.40 for each one thousand cubic feet, or fraction thereof, in such cubical contenta. 2:2.� For any such permit for the eractioa of ang fire-proof garage, warehouse.,._ factory or graia elevator, or for tbe erection of say fire-prnof add3tioa, for.sim3lar accupancq, to any existiag buildiag shal! be'at the rate of $1.25 for each oae thousand cu6ic feet, classified as "fireproof" by Section 502 of the Minneapolis Building Code. HOUSES. 2.3. For �,q such permit for the erection of any non-fireproof build3ag athe= thaa a garage, warehouse. factory or grain elevator, or any aoa-fireproof additian, for similar occupancy, to any existia� building - permit $1.00 for each one thousand cubic feet. GARAGES 2� For any such permit for the erection of any aon-fireproof garage, warehouse, factory.or graia elevator, or for the erection of any non-�ireps�oo�f 8dd3xioa,�-€c�r-s-imilar occupancy, ta any exieting building or for each such _y^ _-buildiag or additioa = ainety cents ($0.90) for each one ehou�and cubic feet or fraetion thereof, in the cubical coatents thereof with a minimum of $4.04.- For the purpose of comput�tag feea for building germits, the c�abical coatents of any_building or additioa to a uniform height throu�hcut by muLMpZying the ground area covered from a poiat si� (6) iaches below the £loor line of i:he basement ar cellar to the average height of the upper aurface or to the average height of the rQOf surface of the mait� gable of a p3tched roof. 2; For regairs or alterations to an existiag struttuxe, the fee ahall be at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction thereof in the cost o£ all propoaed work. Z.b. In no caee shall the fee�_charged,,for..any_perm.{�.� 9et forth in Sect3on 2 be less. thaa $4.p0, � `� ' �-- �. �, ° - ` ., � � City of Fridley, Minn- BUILDING PERMIT ��; June 6 1969 p�r; E�lward J. Kowalski g�� Same Ad�ress 1 R� rib al tor R ad Adaress �� /� N° 10268 LOCATION OF BUILDING No. 185 Street 6ibraltor Road part of Lot Lot 9 _ Block 2 Addition or Sub-Division Caxlson Summit Manor South Add.a. Corner Lot — Inside Lot —. Setback �_ Sideyard Sewer Elevatfon ___._ ...._ Foundatfon IIevation DESCRIPTION OF BUILDING To be Used as: Dormer Bedroom �t 30' Dep� 7%0' Height $� Sq. Ft, 300 �� 2400 , --- -- Front Depth Height Sq. Ft Cu. F't. Type of Construction Frame �� _$2500.00 __ To be Completed In consideratlon o4 the fssuance to me of a permit to construct the building described above I agree to do the propesed work in acc�rdance with the description above set Eorth and in com ce with afl provIaions of ordinances of the dty oP Fridley. e In consideration of the payment of a fee of � 10.9Q_, pernnit is hereby granted to Edward Rowalski to construct the buflding or addil3on as descr4bed above. This perrmit fs grante3 u�n the expresa condition that the person to whom it fe granted and h4a agent�, employees and worlflnen, 9n all work dane in, around and upon said building, or anypart thereof, slxall conPorm in all respects to the ordinance� of Fridley� Minnesota regarding local3on, conatruct��on, alteration, maintenance, repair and moving of bufldfngs wltbin the dty limits and this permit anay be revoked at any time upon violation of any of the provl�lons of ea4d ordinaa�. l��/lL��.��j�:�. �i � + � •� _ �_ ^ NOTICEs 76b psrm(t dea no� eovse t6s coes�rudiee, tnstaWHen to� �ririee, plambtee, ea h�aHeg, a�r�r or w�r. e� sun to � tiro Bnqdhre lespeeto� for aparat� parm6� foe thas Itum. �� _ n .APPLIC9TION FOR BUILDING PERMIT CITY OF FRIDI,EY, NlINNESOTA ... . . � DWNER'S N.AME �BIIILDER .. �� '� '� .�DDR.�S % �� l ��'�'t ��' 7� ADDRESS f LOC9TION' OF BiTILDING � / N0. � STREE�I' � / ✓� Y�'r �� LOT �I,OCI{ 9DDITION OR SIIBDIVTSION CORNER I,OT INSIDE LOT SETBACK SIDEYARD SEWER FLEt1'ATION TOP OF FOOTING Applican� at�aCh to this form Two Ce�tificatee of Survey� of Lot and propoaed build�g location clrawn on these Certificates. DESCRIPTION OF BUILDING To BQ iT�ed de s �. �o 'r fY1 ° � / � �/ ��p-�, Frqnt � d Depth � o Height �3 _ Square feet � 4 d Cubic Feet � 7�'`-�� Fro�.�t Depth � Height Sque,re feet Cubic Feet �- Type of Conc�truction� �Q' �'�°C � Eetimated Coat � � � � To Be Completed The unde�si�ned hereby makes application for a permit for the work herein s�eo�f3ec1, ag�reein� to do all work in atrict e,CCOPCZ8x1C0 w�,th the Gity of Fridley Ord;inances a.nd rulings of the Department of Buildings, and hereby dee�ares that all the facte and repreaentationa stated in thie app�.�.aation axe �rue and corxecte DATE � � �G� % SiGNgTURE 4 , (Schedule of Fee Coet.s can be fourid on the Reverse Sideo) 1 -�� ;� �'J� � -i� z � �� . � ��, �, � �. - �� .-� L I: I 1 '�I' ��1 il�il 1 � SECTTOIV Z o The I�a.spector of Buildinge �ha,ll 9 before isauing permits for the erection of any building or �t�ucturee o� ior any addit�.on to any �xi�tin� structure or buildua.gg9 or .ior as�.y alteration or repaixs to any ezieting buiZding or st�uctuze9 upor� application therefore, require the payment by the applieant fo� �uch perm.it Qi fee�.to the amount he�eiu below set forth and in the man.�ser hereix�. provided to-wits IIniform Build' Codeo Type 1y 2y & 4-$1075 ior each one thouaand cubic feet, or fraction thereoi, ir auch cubical c.�ra.tents: Type 3& 5— $10 50 for each one thousa:n.d cubic feet o For the purpose oi computin:g fees for building.permits, the c�.bioal cZ�sitents oi� �:ny`�rxi.3�i��;d.�li��a, u'�i'form her�trt'-t�otrgpron`t'i�y____ multiplying the gxound area covered from a point six (6) inches below the iloor line of the basement or the cellar to the avera,ge height_of the upper surface or to the avera.ge height of the roof aurfaoe of the ma.in gable of a pitched roof. For repairs or alterations to an. existing structure, the fee sha,11 be at the �ate of $3.00 per each fiee hundred dollara ($500.00� or �fraction thereof i.xa. t�.e cost of all �roposed worke �In x�a cas� shall the fee charged �°or a�y per�it aa� set �orth in Section 2 be less thaxs $50000 NSSSD Corin.ection Charges based or� location - Area 1 or 2. ' �J 1 I / 1 t� � � � .�-�i°g,1"� � . -��ort�f.��:a .�s�oci�t�s Inc . Or. 1999 Ed . J. Kor�rAlski _ � ,,.14I,-?S ' � � � � / � � � � � � � . •Y • . LAl�ID SURV�1fOR _ � . . „ ' • •� - • � REGISTHR6D UND¢R LAWS OF BTATB OF M(NN4;BOTA ' ' LICEKEED BY ORDINANCL° OF CITY OF MINNHAPOLIC � 3616 EAST 83TH STREET PA. 4-4661 � � �atbepor'g �crt{�jt� � , � ' : 3 , �� 3g � � ' � . � ° �' ' " � o ��`� ya� p �� , ' �. " ./ � ~ n � ' � • , Z�-'Z' . ' � e .,t . . �r • . ' 1, . , , S . `� . ' �1 � 3z-� � � . _ � � /% �, �._. �. B . � �`�� d� W � . �. LS � ��, � C �, � ir�, , - . � �ca%': / - �.� L . _. � �� - �i � .y� � ,��, v � — - ..�i 9 9 - .� °..�___s ..�� . . -\. _ , , �f�-a��r �da� I HER�BY CERTIFY TNAT TM� ABOYE 18 A TRUE AND COFIRECT PLAT �F A SURVE1f OF F z, I�t 9�lock 2 Carlson�Sumriiit i,�,anor South. Ad.c�ition. � Anoka Count;�, �+��.nn . - As SURYEYED BY tAE THIS �t�h OAY OF—JP' t• A.o. 1961 ;�� - tr�-�r . �:�'--,�.��----- ' SIGNE . � F. C. S GKSON. MINNESO�A� .ffGIBTRATIONl. No. 3600 . �_. . _ + �� 1 � � � , �i . –R", ��-. z.a. � � t� � � � �� c� a � � p � � m � � � x ��0 � w x 8� �� e n o � �� o � �� , � p �F� �, � � A � � � m � � � � � � � O. � eD � � : O v � � � � Q � � p '�1 °' 0 w ,�r • �� a� �� : : � � : m � �. �- � : � ''� � a � : » �'+ . °•° � ' o � � : bd . �: � • � � � . . 1-+ : . • v . • � : : ; W : � ' � : � : � � � � O o a� �a oa " x �e �e x x �e � � N ,c�v � ;� � �: �' !� �0 $ � 8 �8 � 8 � $ � 8 � �N► N v► in tA &► tn tn O� N O I O S g � j �, I I r � � 1 � � O OM W R � � � � D � m � � m C r m ,�� ,� � � a � °1 x �9 �• � �i � � a , �� ' �� o� � o a � � z� �. � � � � a � � ib ('� `� y � a v. A �' � �" w �, ro o g � � � � � 0 � w m � a � �� M WAT[R � ua�w�t �►rH � U1fIN4 51N16 w,� �� DRINK. wuNr. sr+w�. FLOOR DAAINS �►ta+ �ASINS AUTo wws� � �. � � � OPENINOS ,. i • � � �. a Ri . � S� � a. �� P p O �. g � � � ��. � � � �'R w � �^'�� '�� m b � � �; � �� mo � UZ (� �. M � A ti � � � � �4 � � � �� g � f�R ti �� o �� .. eo � x I 3�� ,!`�, � ;. � �� O � � � p � �� w � � ` : � 0 °�q � � � � K o � � M O � � � �l'l � b � � � �w � � � � � �1't W 1 � � h-� � � SUBJECT City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r i � � � � • COMMUNITY DEVELOPMENT DIV. � � -------� r � v � PROTECTIVE INSPECTION SEC. � � � . � � � ��"1 � CITY HALL FRIDLE� 55432 NUMBER aev �""� � �'' 612-571-3450 910-Ft5 JOB ADDRESS 185 Gibraltar Road NE 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION DESCR. 9 2 Carlson� s Summit 2 PROPERTY OWNER MAIL ADORESS Edward/Joyce Rowalski 185 Gibral�tar Road NE 3 CONTRACTOR MAILADDRESS Same 4 AFiCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MAIL ADDRESS 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION O ALTERATION 8 DESCRIBE WORK 9 CHANGE OF USE FROM TO DATE PAGE OF 3/21/96 / / PE �� °� 5 �-.�. .� RECEIPT N� �/ � APPROVED BY SEE ATTACHED [lOr South SHEET ZIP PHONE 572-8238 ZIP PHONE UCENSE NO ZIp PHONE LICENSE NO. ZIP PHONE LICENSE NO. REPAIR ❑ MOVE O REMOVE STIPULATIONS Underlayment must comply witt�.the State Building Code. TYPE OF CONST. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTiiUCTION ZONING AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OH ABANDONED FOH A PERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 AND KNOW THE SAME TO 8E TRUE AND CORRECT. ALl PROVISIONS OF IAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED NEREIN OF± NOT. THE GRANTING OF A PERMIT �880 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 32.00 STRUCTION OR T.HE PERFORMANCE OF CONSTRUCTION � pR TMOAIZED AGENT IDATEi � aFGRlllf]FR� iDATE� m.` OCCUPANCY GROUP SO.FT OFFS STALLS B OCCUPANCVLOAD CU. FT. ' PARKING GARAGES $.50 iAC CHARGE Fire SC $.88 'OTAL FEE $33.38 ) THIS IS VOUR PERMIT �s A � � NEw ADDN ALTER [] [l [l CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R 1 AND R-2 Building Permit Application Effective 3/1/96 ConstructionAddress: _ � lS s �, �i� �i � � Tn i ��' �% � Legal Description: Owner Name & Address: Tel. � v��- �� 3� Contractor: /'h� se � � MN LICENSE # Address:��q n�-•.2_ i4 S �1 � � � �--� Tel. # .S � � Attach to this applica.tion, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LiVING AREA: GARAGE AREA: DECg AREA: OTHER: DESCRII'TION OF IlViPROVEMENT Length � � Length Width � � � Height Width Height Vj�idth Hgt/Ground _ � �� I / ��-iZ °C��t� Sq. Ft. �� S='� Sq. Ft. Sq. Ft. Corner Lot � Inside Lot [] Ft. Yd Setback Side Yard Setbacks _ Type of Construction: n% `.� �� Estimated Cost: $ �°°`��— �� Approx. Completion Date: �� (Cost on Back) Driveway C�ub Cut Width Needed: Ft. + 6 F— Ft x$ _$ DATE: �- �/�- % 6 APPLICANT: � Tel. # 5 7 2��.� 3� CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: � $ $ $. $, $ $ $ $ �3� �� , � . �� . �� Fee Schedule on Reverse Side .001 of Permit Valuaxion (1/lOkh%) $.50/$1,�0 Valua.tion " $900 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] �- ,� � - BUII.DING PERMIT FEE SCHEDULE The Cluef Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or strucuue, or for any alterarion or repair 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: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,Ot�0,001 and up �� $21 (Minimum F� is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 ,1.,;,,. '�.�- . $62.25 for first $2,OQ0 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,� $349.75 for first $25,000 plus $9.00 for each additional $1,�0 or fraction thereof, to and including $50,�0 $574.75 for first $50,�0 plus $6.25 for each additional $1,�30 or fraction thereof, to and including $1a0,00U $887.25 for first $100,000 plus $5.00 for each additional $1,D00 or fra.ction tliereof, to and including $500, 000 $2887.25 for the fust $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,0� plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Conerete C�irb Streets Only) Alterna.te "A°: Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alterna.te "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VEIZIFICATION 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 constructiom site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. _ �_ � }