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SUBJECT PERM
City of Fridley 16 3 5 s
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
' � RECEIPT
� �L � COMMUNITY DEVELOPMENT DIV. ��'
r j � PROTECTIVE INSPECTION SEC. /
1
�
1
(---_ A ���� ;,� CITY HALL FRI�LE� 55432 NUMBER REV. OATE oAGE OF APPROVED BY
i �� 612-571-3450 910-F15
8/26/81 � �
JOB ADDRESS 149 Hari�tan Ciscle N.E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR.. ],3 2 Sandhurst Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Alice Nelson 149 Hari�oann Circle N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Chas. E. Johanson Inc. 424 Rice Creek Boulevard 571-8021
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MA�L ADOFESS ZIP PHONE LICENSE NO.
6 USE OF BUiLDING
Res identi.al
7 CLASS OF WORK
0 NEW ❑ ADDITION ❑ ALTERATION �O REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Structure
9 CHANGE OP USE FROM TO
STIPULATIONS
Roof can be the 2nd but not the 3rd roof. Install ridged galvanized
valleys.
SEPARATE PERMITS ARE REOUIflED FOR ELECTRICAL, PIUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANC`/ LOAD
VENTILATING OR AIR CONDITIONING. ��7�,Zt
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 FOA A PERI00 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 VAIUATION SURTAX
WI H WHETNER SPECIF ED EREINIOR NOTOTHE GRANT NG OF AO ERMIDT $1�200 $.6O
DOES NOT PRESUME TO GIVE AUTHORITY -T0 VIOIATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROViSIONS OF ANY OTHER STATE OR �OCAL LAW REGULATING CON-
STRUCTI N THE PERFOR CE OF CONSTRUCTION. $ZO. SO
PLAN CHECKFEE TOTALFEE
� �.�,,._ y��q $Z�.�o
SIGNATUREOFCONTf� ORAUTHOAIZEDAGENT �Dn7Ei WHEN PROPERLY ALIDATED THIS IS YOUR PEAMIT
�
SiGNATURE OF OWNER�IF OWNER BUI�DERI IOATEI BLDG iNSP � pF E
CITY OF FRIDLCY Effective Aug. 1, 1981
APPLIC/1TIO:J FO�t RESIDLi�TIR� [3UILDIi1G PEfL`�ITS
(�de►•r, Alter.�tions, Additions, or Repairs)
Ot�!(�ER: ��C/L°� /�L��S o�
ADDRESS: ��!J ��i�y /�1,�,� G�/�1?G.�C�
TEL N0:
t3UI lOER : C l���+� S, L� �!� ��;r�,a�ti- �
ADDRCSS: ��.�i 1�Q ��er�1z. ���.�C
TEL t��0: �7j— �°�J
Construction Location
,
STRITyT NO: � STREET: �/�ri�.,.� �, . _ _
r,or. : %3 si,oac : �
ADDITION : � 1�� ��•ZS T �6� �lJ •
Corner Lot: Insicie Lot: SetbacY.: Sideyards:
Ap�licant attach to tliis form two Certificates of S�rvey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOi� OF CO�JSTRUCTIOPJ
� dc� F Front: Depth: Height:
Square. �'eet: 4ibic Feet:
r'ront: Depth: Height:
Squar.e� Feet: Glzbic I'eet:
Rype of Construction : ��{1� �}L �
Zb Be Oor.�pleted:
Proposed Drive�aay Width if New Opening Is Desired:
• 00
EstimaL-ed Cost: $ ��p o �—
Alt. A Alt. B
$� $
SE� I�CVERSE SIDE OF SHEET
T'iie undersigned hereb�► make� application for a pezznit fcr the �:vrk herein specified,
agreeing to co ,all work iri strict accordance ��ith the City of I'ridley Ordit�ances and
ruling� of tlle De�-�rtment of IIuildings, and hereby declares that all ti�e facts and
representatiens stated in this application are true and �orrect.
D.'�T� : S IGN7ITU Fir, :
Stipulations:
i' o�� • �
� ��
$ ��,lb
�
�_ -
BUILDING PE•RMIT FEE SCHEDULE
The Inspector of buildings shall, before issuing permits for the
erection of any building or structure, or for any addition to any
�xisting buildinq or structure, or for any alteration or repairs
to any existing building or structure, upon application therefore,
require the payment by the applicant for such permit of fees to the
amount herein below set forth and i.n the manner herein provided to-wit:
TOTAL VALUATION
$1.00 to $500.00
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
FEES
$10.00 Minimum 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 th.ereof, 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 thereaf, to
and including $100,000
$100,001 and up $443.00 for the first $100,000 plus $2.50 for
each additional $1,000 or fraction thereof
PLAN GHECK: 25 percent of building pertnit fee
DRIVEWAY DEPRESSION ESCROW: Concrete Curb Sts eets Only
Alternate "A": Removeal and replacement of curb and gutter only
Driveway width plus 6 feet x$13.50
Alternate "B": Renoval and replacement of curb and gutter and install a 3 foot
wide approach with 6 inch depth
Driveway width pl.us 6 feet x$I5.75
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimwn of 24 hours froaa the time of
application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of S�rvey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with.the framing.
"" -�;,.
r a SUBJECT
Clty O1 FPIUIey � PERM�T
AT THE TOP OF THE TWINS g U I L D I N G' P E R M I T -��� O
r
� �
� � RECEIPT N .
� �L � COMMUNITY DEVELOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC. �OD�
�
i '
l�-__- �����,,� CITV HALL FRIOLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV
i �� 612-571-3450 910-F�5
8/3/82 / /
JOB ADDRESS 149 Hartmann Circle N.E.
1 LEGAL �OT N0. 9LOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ].3 2 Sandhurst Addition SHEET
2 PHOPERTY OWNER MAIL ADDRESS ZIP PHONE
A. Nelson 149 Hartman Circle N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Chas. Johanson Inc. 424 Rioe Creek Boulevard N.E. 571-8021
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
R2 Sl$Eri t].31
7 CIASS OF WOFiK
❑ NEW �O ADDITION 0 ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 14' x 22' Gara e Addition
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide a hard surface driveway.
��i�' ��G �p�El�ATfi PERMlTS Rf QlJiRED Ft'�R �R
Befae �ijging ce!! loc�t utrlities HEATi�lG. Pf.UM6tlYG AND S1G�tS.
fiELEP�IQNE . ELECTRrC • GAS Etc.
REQUf�ED BY LAyy
SEPARATE PERMITS ARE REQUIREO FOR ELECTRICAI, PLUMBING, HEATING, TYPEOF C�NST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTIIATING OR AIR CONDITIONING. �fl�pp(� Fr�te
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 PERI00 OF 120 DAYS AT 3O8 3OSO
ANY TIME AFTER WORK IS COMMENCE0. " NO. OWIG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY TNAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �3��-72.40 $�..59
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER ST E OR LOCAL LAW REGULATING CON-
STRUCTI N THE PERFOR E OF CONSTRUCTION. �4�i. SO
� � PLAN CHECK FEE TOTAL F�E
$46. 09
SIGNATUREOfCON7a cT ORAU7MOR12EDAGENT �on7Ei WHEN PqOPE Y VALIDATED THIS IS YOUR PERMIT
,, . '
S�GNATURE OF OWNEf711F OWNER BUILDER� IDATEI BLDG iNSP aTE
CITY Of FRIDLCY Effective Aug. 1, 1981
APPLICIITI�J FOft RESIDChlTI/li. BU]LDIitG PCRilITS
(1��►�u, A1 terations � Addi Lions, or Rcpa i rs )
Ot�lNFR: _ _ �� N� dl..i bN [3UILDER: __�'ylA s- �` � G-, r�, ��l � Qr�( I << �
ADDRESS: 1�� 9/r���i-�Q„2 �� ADDRCSS: �� y�j"', �,,g.
TEL N0: � TEL t�0: _ 3��l- �o .Z/
Construction Location
• ST7tITT NO: STItEET: ,G�'� �'lm yj�z ���
IAT: �� BLOGK: i_� I�iDAITION: �R�JQ b�1tiC' 1
Corner Lot: Insiiie Lot: Sctback: _� Sideyards:
1►p�licant attach to this form two Certificates of SUzvey of lot and
pzoposed building location dr�wn on certificates to scale.
DESCRIPTIOi�! OF COFJSTRUCTIO��
�. �•J� Fmnt: 1�� Depth; o� � Height: ld (
Square Feetr �C�j �bic Feet: 3C�0
`� Front: Depth: Heiqht:
, .
Squar.e Feet: Wbic �eet:
Rype of Cor,struction : (�� A-�
Rb B� Wr.�pleted:
. �� �'�ao
Estimated Cost: $ ��
Alt. A Alt. B
Propose8 Dzivc�►,�ay kidth If New Openinq Is Desired: $� �
, . . SE� J�VER;E SIDE OF SHEET
Tiie urider�igned hereby make� application for a permit for the work herein specified,
agreeinq to do,all work ir, strict accorda,nce with the City of Fridley Ordinances and
rulings of the Delklrtrnc�� of Duildings, and hereby declares thnt all the facts and
repr�s�t�tiens stated in this �pplication are true and eorrec�c
DC1TE: �Z SIGNATUIZ^c :
Stipulntions:
�� �d
/��
� �� � 9
n � a W
�
BUILDING PE�RMIT FEE SCHEDULE
The Inspector of buildings shall, before issuinq permits for the
erection of any buildinq or structure, or for any addition to any
•xistinq building or structuze, oz for any alteratfon or"repairs
to any •xistfnq buildfnq oz �tructuze, upon application therefore,
requize the payment by the applicant f or such permit of iees to the
amount hezein below set forth and in the manner herein provided to-wit:
'POTAL Vl�i�ATION
�1.00 i� 5500.00
SSOI ba $2,000
S2,OQ1 to $25,000
525,001 to $50,000
S50,001 to $100,000
PEES
S10.00 Minimum Fee $15.00 Plus surcharge
520.00 for the first $500 plus $1.50 for each
additional $100 or fraction thereof, to and
includinq S2,000
$32.50 for the first 52,000 plus 56.00 for each
a8ditional $�,000 or fraction thereof� to and
including $25,000
5170.50 for the first $25,000 plus S4.50 for
each additional $1,000 or fraction thereof, to
ar�d includinq S50, 000
$283. 00 for the first $50, 000 plus $3. 00 for
each additional $1,000 or fraction thereof, to
ar�d including $100, 000
5100,001 ar�d up 5443.00 for the first $100,000 plus $2.50 for
each additional $I,000 or fraction thereof
PLAN CHECK: 25 percent of building pezmit fee
DRIVF�e1AY DEPRESSION ESQtOW: Concrete G1irb Streets Only
Alternate "A": Removeal and replac�oent of curb and gutter only
Driveway width plus 6 feet x 513.50
Alternate "B": Rr3noval ar�� replaceinent of cvrb arid gutter and install a 3 foot
wide approach with 6 inch depth
Driveway width plus 6 f eet x S15. 75
VERIFICATION OF FOUNDATION
Pexmits for construction will be issued a minimian of 24 hours froca the time of
appiication to allow for proper revisw of the proposed structure and of the
constzu ction site.
A Certifica te of Survey of the lot, shawing the location of the foundation once it
has been constructed wi11 be required before proceedinq with the framinq.
'' •
:� • - e
� ' Su��Eti � . . . � . . .
City of Fridley 2 2 �
AT THE TOP OF TME TWINS g� � L D I N G P E R M I T
r
; � RECEIPT NO.
� ; y ����� COMMUNITY DEVELOPMENT DIV. /,
f � � PROTECTIVE INSPECTION SEC. Li�O
� i . (
� �"'1 � CITY MALI FRIOLE� SS1�2 NUY�ER �EV O�TE ��GE Oc ��nOVED Br
�""�" ,'' 612-571-3450 9t0-Ft5 / /
7/19/00
�os �ooaess 149 Hartman Circle
t LEGAL ��T NO. BLOCK TRACT OR AODITION SEE ATTACHED
oescR. 1 Sandhurs t SNEET
� PpOPERTY OWNEfi MAIL AODiiES$ ZIO PMONE
Alice I. Nelson 149 Hartman Circle 7 1- 0
J CONTRACTOR MAIL ADORESS ZIP PHONE IICENSE NO
St. Anthon Builders 4013 Fordham Drive St Anthon MN 55421-4336 612-788-8404
� ARCMITECT OR OESiGNER MAIL ADORESS ZIP PMONE LICENSE NO.
2857
5 ENGINEER MAII AOURESS ZIP PMONE LICENSE NO
6 USE Of BUIIOING
Residential
7 CIASS OF WOpK
O NEW O ADDITION O ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Tear Off and Reroof House and Garage 29 sq
9 CHANGEOfUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV IOAD
SEPARATE PERMITS ARE REOUIRED fOR ELECTRICAL, P�UMBING. MEATING.
VENTI�A7ING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL AND VOtD If WORK OR CONSTRUCTION ZONING SO. FT CU FT
AUTMORI2ED IS NOT COMMENCEO VyITHIN 60 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR A9ANOONEO fOR A PER100 OF 12p OAVS AT
ANY TIME AF7ER WOfiK IS COMMENCED. , NO DWLG. UNITS OFFSTREET VARNING
I MEREBY CEFTiFY TMAT I NAVE REAO AND EXAMINEO TMIS APP�ICA710N 1 STA�LS GAiiAGES
ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAWS VALUATION SUfi7A%
ANO ORDINANCES GOVEflNING TMIS TVPE OF WOiiK WIIL BE COMPLIEO
WITH WHETMER SPECIFIEO MEREIN OR NOT. TME GRANTING OF A PERMIT �2,535.00 �1 .27
DOES N07 PRESUME TO GIVE AUT RIT TO VIOIATE OR CANCEL TME PEqM11 fEE SAC CNARGE
FROVISI OF ANV OTME TAT O OCAL LAW RECUTATING CON-
STqU OR THE PERF N CONSTRUC N �H3 . ZS Fl SC �Z . S�F
P PLAN GNEGK f TOTA FEE
� q�d Lice S $5 92.06
S�G TUaE OF CON'A AU1MOp�LEO �GENT iD�iE� EN q P V ALIO E THIS I UR IT
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$�GNaruAE O� OWNEp��� OWNEp8U�L0Epi i�ATE� ' 8l �NSo : ricrE
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Construction Address:
Legal Description:
Owner Name & A�
Contractor:
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
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Effective 1/1/2000
(763) 572-3604 Bldg Insp
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�aa � S�U
' ' Tel.# �(9�-,� �-�Q 1
� MN LICENSE # ��,'� � _
� �'- -e ` l�t1u 7�M., Tel. # _% � Z - i � E� O � d �
SS�/��- � S6 -- 3 s��
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length V�idth Height Sq. Ft
Length Width Hgt/Ground Sq. Ft
� �
Construction Type: � ��'L stimated Cost: $ �
�� ��3�-
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ = g
DATE: APPLICANT: Tel. #
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Call (763) 572-3604 for Pennit Fees if mailing in application
$ � 3•�� Fee Schedule on Reverse Side
$ _ � `-{ .001 of Permit Valuation (1/10th%)
$ 1 - 2� 7 $.50/$1,000 Valuation
� $1100 per SAC Unit
$ S� 00 $5.00 (State Licensed Residential Contractors)
$ Alt. ,�A�� or Alt. ��8�� Above
$
$450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary [ J
TOTAL
STIPULATIONS:
$ 4a- 0 6
: S i r
BUII�DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
addition to any existing building or structure, or for any alteration or repair to any existing building or struct�
upon application therefore, require the payment by the applicant for such permit of fees to the amount he:
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
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fracdon 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 $7.00 for each addirional
$1,000 or fraction thereof, 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 $1,000,000 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
Altemate "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 $23.25.
VERIFICATION OF FOUNDATION
Pernuts for construction will be issued a minimum of 24 hours from the time of application to allow for pr�
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been con�truct�d
be required before proceeding with the framing. New Houses Onlv
��
SuB�ECi
c�ty of Fr�a�ey
AT TNE TOP OF 7ME TWINS g� I L D i N G P E� M I T
;,
� �
; ; V __��_ COMMUNITY DEvEIOPMENT DIV.
f � � PROTECTIVE INSPECTION SEC.
i . ,
� � �"'1 � CITY MALL FRIOLE� 55�32 NUMOER NEV O�TE
�.---� • •', 612-57t-3450 s�aF�s 8/18/00
JOB ADDRESS 149 Hartman Circle
1 LEGAL �OT NO. BIOCK TRACT OR AODITION
oescR. 13 2 Sandhurst
2 PROPERTY OWNER MAII ADDRESS 21P
Alice Nelson 14S ..Hartman Circle
J CONTRACTOR MAIL ADDRESS ZIP
St. Anthony Builders, 4013 Fordham Dr, Mpls., NA1 55421
s ARCHITECT OR OESIGNER MAIL AODRESS ZIP
5 ENGINEER MAIL AOOpE55 ZIP
6 USE OF BUIIDING
Residential
7 CLASS OF WORK
O NEW ❑ ADOITION O ALTERATION [� REPAIR
8 OESCRIBE WOfiK
Install new soffit and facia
8 CHANGE Of USE FROM
STIPULATIONS
TO
Install soffit ventillation to meet the State Code.
TYPE OF CONST
SEPARA7E PERMITS ARE REOUIREO FOR EIECTRtCA�, P�UM6ING. MEATING,
VENTILATING OR AIR CONOITIONING
TMIS PEFMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING
AUTHORIZEO IS NOT COMMENCED WITHIN 60 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PER100 OF 120 DAYS AT
ANV 71ME Af7ER WORK IS COMMENCED NO OWLG. UNI7$
1 HEREBY CEHTIfV THAT I HAVE FlEAO AND EXAMINED THIS APPLICATtON 1
AND KNOW TME SAME TO 8E TRUE AND CORRECi. ALL PROVISIONS OF LAWS yq�UATION
AND ORpINANCES GOVERNING THIS TVPE OF WOfiK WILL BE COMP�IED
WITH WMETMER SPECIFIEO HEREIN fi NOT. THE GRAN7ING OF A PEIiMIT %OO.00
OOES NO ESUME TO GtVE AU O Y TO VIOLATE OR CANCEI THE pEqM1T FEE
PFiOV15 OF ANY O STA E LOCA� L REGULATING CON- �29�60
STRU N OF THE P FO A E F CONSTR ION
1 PLAN CMECK F
, Licen S
S�G RE O CO • AA . Op UT�Op�2E0 �GEHT �O�TE� ,�,�.. �.
PAGE OF
/ /
31324
RECEI T NO.
�53�9
►hnnOVEO Br
SEE ATTACNEO
SHEET
PHONE IICENSE NO
788-8404 2857
PMONE LICENSE NO.
PMONE LICENSE NO
� MOVE O REMOVE
OCCUPANCv G
CU FT
OFFSTREET PARKING
STA�LS GARAGES
SURTAX
$.50
SAC CHA E
Fir SC $.70
TOi FEE
�5. 5.80
E A�10 HIS IS�UR P.EBMIT
� ~ Ir �•r41\�Y/l�//ii'��i� L �� ��,���
��:pWNEQBURDEAi iO�TE� B�D �NS� Oc
LOAO
NE1N [ ]
ADDN [j
ALTER [ j
Construction Address:
Legal Description:
Owner Name
Contractor.
LMNG AREA:
GARAGE AREA:
DECK AREA:
V OTHER:
l`
CITY OF FRIDLEY
SINGLE FAMtLY AND DUPtEXES R 1 AND R-2
BUILDtNG PERMIT APPLICATtON
�
Effective 1/1/2000
(763) 572-3604 Bldg, Insp
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�'/.% /r'�'tZ'I,i�I��! ���/ -
f
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�/ �/�.L� ��,� . , I �
''�1../�� �� _ � - � , . � "`�i_
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Attach to this application, a Certificate of Sunrey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length � Width Height Sq. Ft
Le�gth _ Vj6dth Hgt/Ground Sq. Ft
Construction Type: Estimated Cost: $ � i�� �(� �J
Driveway Curb Cut Width Needed: Ft + = Ft $ =$
� �
DATE: ' 0 � � APPLICANT• Tel. # � �
CITY USE ONLY - Catl (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ � J- � d Fee Schedule on Reverse Side
Fire Surcharge $ .`%C� .001 of Permit Valuation (1/10th%)
State Surcharge $ , S� $.50/$1,000 Valuation
SAC Charge $ $1100 per SAC Unit
License Surcharge $ �- U(� $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Att. "A" or Aft. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [) Not IVecessary []
TOTAL
STIPULATIONS:
� �sr $o
_ `
., r
BUILDING PERNIIT FEE SCHEDULE
The Chief Building Off'icial shall, before issuing permits far tfie erectiori of any buiiding or structure, or for
addition to any existing building or structure, or for any alteration or repai� to any existing building or struct�
upon application therefore, require the payment by the applicant for such permit of fees tu the amount he:
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
$10(},001 to $SOQ,QOQ
$500, 001 to $1, 000,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to :and i.ncluding $2,000
$69.25 for first $2,000 plus $14.00 for each addidonal $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 $7.00 for each additional
$1, 000 or fraction thereof, to and including $ lIX?,OOQ
$993.75 for first $100,000 plus $5.60 for each additional
$1,OOO�or fraction thereof, to and including $SQ0,000
$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
$5,608.7'S for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION FSCROW
(Concrete C�rb Streets ��h`ly)
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 plus 6 feet times $23.25.
VERIFICATION QE FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of applicadon to allow for pro
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the lacation of the foundation once it has it has been consmxcted �
be required before proceeding with the framing. New Houses Onlv
a _ �
� , . ._i