AF - 454771
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Gity of Fridley, Minn.
BUII.DING PERNIIT
nate: . . . �': . 4. � .'.� . . . . . .. . . . . . . . . . . . . . . .
Owaer .......................................
Addre�s ......................................
N° 3367
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Builder. . ....'....'.! ...........................
Address .............................................
LC3CATIOiV OF BUILDING
No. �O �/ '
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'3 � . BYock . . . . . . �. . . . . . . . dition or Sub-Dfv3sion �`.•��'� -�```"' -
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Lot ......... ....................... ..:... �
-, � ... Side .� �...... S s
Corner Lot ............ Inside Lot ....:�... Setback ..... yard .� 'Rm...........
DES�CRIPTION OF BUILDING
To be Used as: �
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.�^�. . . . . . Frout . e.:� . . Depth . �. :. . Height . . . �. . . Sq. Ft. . d: .'�? � Cu. Ft. � �'d•� �
.................... nt ........ Depth ........ H ght ..:..... Sq. Fk ........ G�. F't. ........
Zjrne of Construciion ��`'�j�:"�.�: �: �':-: : . . . �st. Cost. � : � . �� � . . . . . . �o be Caanpleted . � . J�'''t��°'� . . . . . . .
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In conaideral3on of 11�e is�ance to me o! a permit to con�truct the building desribed above. I agree to do
U� proposed work in acwrdance with the descrlption above set fo and ffi c�mpliance with all provisions oi
ordinence.s of the dty of Fridley.
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In consideration of the payment of a fe� oP $..��...--., permft is hereby granted to ............. ...
. . . .. .. .. .. .. .. .. . . . . . .. . to construct the building or addition as descrlbed above. This permit 3e granted upvn
the express condition that the person to wham it !s �anted and hia agents� employeea and worl�nen, in all work
done in, around and upon said building, or a�► part thei�eof, sliall conPorm in all r�pects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and mov3ng of bufldings with-
in the dty limits and this permit may be revoked at aay time upon viola.tion of a�+ of the provisfons of said
ordinances. '
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NOTICE:
This permlt does not cover the construollon, Instatlation o� alte�ation to� wiring, plumbing, gas heating,
sawar o� watar. Ba su�e to see the BulldlnO Inspeotor fo� separate permits ior th� Items.
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'"°"�"'"` C. E, C O U�. T E t�
eus�pess
CITYLOTB LAND SURVEYOR
TOPOORAPtitC MAPPINO �] REGISTERED UNDER LAWS OF BTATE OP MIWNESOTA
�/_ ' I I.ICENH6D BY OpDINANCE OF CITY OR MINNBAPOLIB
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3300 LYNDALE AHE. SO. MINNEAPOLIS 8. MINN.
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I hereby certify that the above is a true and correct plat of a survery of:.
Lot Thirty-seven t3?). Bloc� Two �(2), P�fiR9I�ii HEI�iTS ADDI�1'ION. Ataoka County. M�nnesota.
As surveyed by me thia lb�h de,'�r of September 19,rj8 A. D.
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Signed �. ` , , � � �.�, �
r""� Minnesota Ae�'�ration No. 2,584
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City of Fridley, Mi.nn.
BUILDING PERMIT
Da�: ..--� �_----_�._.�.._._� _..�._.__.._..---_....__
N° 4034
Owner: ........_.......-----_...---�•----._...---- •........_........._.........__......._........... Builder ��G�qv� �+�L6 _..
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Address...-----......_...---....._.._...._._...._....__...._..._..__._...�....._.._._.._..._....... Address -----------•------.--.._.----•—•_....._..___...._.__._.._.___.__._____..._..__
TION OF BUILDING
No. .��_ �/. Street _�._._. ...._..--------�-_:.._. ...... �G..�►.`..�-L....`—� Part of Lot _...._...--•--...-•---.....__.._..••----•---......._...._.....__..._.._
Lot....._ ..............--............... Block --------.....---.......----�--......._.....--- A�l6ition or Sub-Division ....._.................--��----..._......._...._._.......-•------_......_........-------__._...__...
Corner I.ot ....._ ............................. Inside Lot
Sewer Elevation
To be Used as:
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Type of Construction
Setback ....._ .............-•--...._...._........ Sideyard
.._........ Foundation IIevation ..................
DESCitIPTiON OF BUILDING
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Front ...�.�_�'� Deptha..��e�..�....�:� Heigh����- Scl. Ft ...1.•••!•-•-� Cu. Ft�i�..�
Front....................... Depth ....._.....- ....._.. Height ........................ Sq. Ft. ....._................. Cu. F't.
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............................---..................--- Est. Cost..�...�...f�.�.........'l.-.-'To be Completed ....._...---......._.....
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance wfth all provisions of
ordinances of tize city of Fridley.
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In considera.tion of the payment of a fee of $...��.._..�.. �---_, Permit is hereby granted to...--- ............._..---------.---......-------......_..
••-••---•------...._...-•---.._.._------•--....------._........ to construct the building or addition es described above. This pernut is granted upon
the express condit3on that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revo�ed at any time upon violation of any of the prnvisions of said
ordinances. � / /.� „ �
Building Inspector
iVOTICE:
This permit does not eover fhe wnstruction, insfallation fo� wiring, plumbing, gaa healing, aewer or water. Be su►e to aee
the Building Inspector for sepewte permhs for ihese ilems.
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sue�ecT PERMIT NO.
City of Fridley 9 5 31
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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• COMMUNITY DEVELOPMENT DIV.
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r � � PROTECTIVE INSPECTION SEC. 9 fp �// �
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� /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�""� � ,�' 612-571-3450 910-F15 / /
7/3/79
JOB ADDRESS 1041 Hathawag Lane N.E.
1�' LEGAL LOT NO. BLOCK TRACT OR ADOITION SEE ATTACHED
DESCR. 3% 2 PdY'�CV].E.'W Heights SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Da.le Farber 1041 Hathawag Lane N.E. 574-0354
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
B USE OF BUILDING
R2S].CZP.fl't1.31.
7 CLASSOFWORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WOHK
Construct a 22' x 20' Gara e Addit'on
9 CHANGE OF USE FROM TO
�TIPULATIONS
Provide a ha.rd surface driveraay.
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liiREU �� �IRtN� TEt��ian� � ��'� +��i�;�
SEPEAp�E P��M�iS ��Q . , . �� �' � Et�
PI�t�M81NG A�� :5��' ��_ . '�. QUIRED B Y I,,ei VW
H�pT�NC�. . . , . .
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PEF;MITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOCZ
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ], STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT $3,683 y�`�-•84
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ��-7s rOO
PLAN CHECK FEE TOTAL FEE
�_ � 4� $19. 44
SiG � tvTR CTO RAUTNORIZEDAGENT IDATE) WHEN PROPERL VALIDATED THIS IS YOUR PERMIT
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SIGNATUREOFOWNER IFOWNERBUILDER� IDATEI BLOG INSP �AT
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CITY 0� FRIDLEY
ARPLICATION FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
OWNER: ��/-�'/��' �%�
ADDRESS: �v�� s'-0����G•�dy�i✓�
TEL �d0: ���� � � -� 7"
BUI LDER : -
ADDRESS: �
TEL N0: �
Construction Location
5TR�T NO: � `�G STREET: , � � Cci� � ��`-� �
LOT: � � BLOCK: � ADDITION: �.h /� !/�C'il/� -ti���� �
Corner Lot: Insicle Lot: ^_ Setback: Sideyards:
Applicant attach to this form two Certificates of S�rvey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOtJ OF CONSTRUCTION
�� c� �i ,�2 � Front: O��' Depth: ,o��� Height: �� .
Squa.�e Feet; _ Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet: _
..�� ,F� �.�
Type of Construction : ��� �� � �'d /`a' � Estimated Cost: $
Zb Be O�mpleted: � � a --� �
Alt. A A1t. B
Proposed Driveway Width If New Opening Is Desired: __ S $
SEE REVERSE SIDE OF SHEET ,
The undersigned hereby makes applicati.on for a permit for the w�ork herein specified,
agreeing to ck� all work in strict accordance with the City of �'ridley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correc
DATE: SIGNATiJRE :
�_?��' �i � G�'' "'`''J
Stipulations:
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BUILDING PER��IIT FEt SCNEDULE�
SEGTION 2. The Inspector of Buildings shall, before issuing permits for the erection
of any building or structure, or tor any addition to any existing building 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 in the manner herein provided to-wit: •
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic L-eet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete,Curb Streets Only) ��
' Alternate A: Removal and replacement of concrete curb and
qutter only; Driveway width plus 6 feet x$15.75
Alternate B: Removal and replacement of concrete curb and
•� gutter and install a 3 foot wide approach with ��
� 6 inch depth; Driveway width plus 6 feet x$17.85
:11 1 1_ ► �• � �l
For the purpose of computing fees for building permits, the cubical contents ot any
building or addition, is determined by multiplying the ground area covered from a
point six (6) 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 main gable of a pitched roof. �
For repairs or alterations to an existing structure, the fee shall be at the rate
of $3.00 per each five hundred dollars�($500.00j or fraction thereof in the cost
of all proposed �aork. �
In�no case shall the fee charged for any permit as set forth in SecL-ion 2 be less
than $7.50 plus $.50 state surcharge. •
' : � � 1 �11 ��
AIOTE: Permits for cons:kruction will be issued a minimima 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 been constructed will be required before proceeding with the framing.
,
. : � ''►
- - �
Application for a Certificate of_Oceupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building pernmit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
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sue�ecr T N O.
City of Fridley � o � g 2 2 � `
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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� • COMMUNITY DEVELOPMENT DIV. / ;.�
r� � L i PROTECTIVE INSPECTION SEC. �(o Sl �
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� /"�1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE VAGE OF APPROVED BY
1"'"'� � ,�� 612-571-3450 910-F15 10/6/87 � �
108 ADORESS 1041 Hathaway Lane N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 37 2 Parkview Heights SHEET
2 PROPERTY OWNER MAIL ADORESS ZIP PHONE
Dale Farber 1041 Hathaway La�e 574-0354
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP pHONE LICENSE NO.
8 USE OF BUILDING
Rasidential
7 CLASS OF WORK
❑ NEW ❑ ADDITION C� ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Raise existing garage maximiun of 12"
8 CHANGE OF USE FROM TO
STIPULATIONS
SEPARA�'� p�'R�ITS R�QUI{�ED FOR
b'�9�Ii�G, ���T6fVG, PLl1Bi�Bl6�� Ay�� �9�;�g
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDIT�ONING.
THIS PEHMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OH IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEFEBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALIS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVI310NS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED
WITH WHETHER SPECIFIED HEHEIN OR NOT. THE GRANTING OF A PERMIT $700 $.5O
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $ZS.00
P�AN CNECK FEE TOTAL FEE
� $15.50
SIQNATURE�NTRACTQRORA�AGENT IDATEI WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
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SIGNATUREOFOWNER�IFOWNERBUILDERI IDATEI BLDG iNSP nq
NEW [ l City of Fridley Effeetive 4/1/86
ADDN. [ ] R-1 AND R-2
ALTER. � Building Permit Applieation
Construet3on Address: �o S�� f��1T ��d�-��%�e-% °C-�7"N
Legal Description:
Owner Name & Address: ��GE �' �� �E�- jo`�� ��"!���'� Tel. � � 7�-1 3S %
Contraetor: ���'e- Tel. 4
Address•
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTIOA OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECR AREA: Length Width Hgt/Ground Sq. Ft.
/eQ. �`5 � L�X /' S/i N G C,� 7%'1-�'--� m-if /� ,�
OTHER: --
Corner Lot [] Inside Lot [] Ft. Yd. Setbaek Side Yard Setbaek
Type of Construction: ��� �`'�� 'N`�� Estimated Cost: $ � �
Approx. Completion Date: t9�-���5 ����� v
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: /�Y b�' � I APPLICANT: Tel. �
Permit Fee
Plan Cheek
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY IISE ONLY
� l�i �C�(� Fee Schedule on Reverse Side
$ °'—' 25� of Building Permit Fee
$ A� $.50/$1,000 Yaluation
$ $ 525 Per SAC Unit
$ Fee Determined by Engineering
�
J�� Agreement Necessary [] Not Neeessary []
$
r_ � _ t
BIIILDING PERMIT FEE SCAEDIILE
The Chief Building Official shall, before issuing permits for the erection of any
buildin� 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 applicatio n
thereFore, require the payment by the applicant for sueh permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
Total 9aluation
$1.00 to $500.00
$501.00 to $2,000.00
Fees
$10.00 (Minimum Fee is $15.00)
$10.00 for the first $500 plus $1.50 for eaeh
additional $100 or fraction thereof, to and including
$2,000.
$2,001.00 to $25,000.00 $32•50 for the first $2,000 plus $6.00 for eaeh
additional $1,000 or fraetion thereof,. to and
including $25,000.
$25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for eaeh
additional $1,000 or fraction thereof, to and
ineluding $50,000.
$50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for eaeh
additional $1,000 or fraetion thereof, to and
ineluding $100,000.
$100,001.00 and up
$433.00 for the first $100,000 plus $2.50 for each
additional $1,000 or fraction thereof. �
DRIVEI�TAY DEPRESSION ESCRW
(Conerete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus
6 feet times $13•50
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approaeh with 6 inch depth - Driveway width plus 6 feet times $15.75
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 strueture and of the
construction site.
A CertiPicate of Survey of the lot, showing the location of the foundation onee it
has been eonstructed will be required before proceeding with the Framing.
,.. � _ °
SUBJECT P
City of Fridley ,� ,� � � 1
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
f
� �
, � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV
� Ly ����� , �� �
r � � PROTECTIVE INSPECTION SEC.
� �
� � �"": � CITY HALL FRIDLE� 55432 NUMBER AEV On7E pAGE oF qPPROVEO BY
�'""'� � ��� 612-571-3450 910-Fi 5 � �
5/15/95
JOB ADDRESS 1041 Hathaway Lane NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 3] 2 Parkview Hei hts SHEET
2 PROPERTV OWNER MAIL ADDRESS ZIP PHONE
Ellen Farber 1041 Hathawa Lane NE 574-0354
3 CONTRACTOR MAILADDRESS ZIP PHONE UCENSENO
Builders & Remodelers Inc 3517 Henne in Ave S M Is. MN 55408 827-5 1 110
4 ARCHITECT OR DESIGNEH MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION O ALTERATION g REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WOHK
Soffit/Fascia
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REQUIRED FOH ELECTRICAL, PLUMBING, HEATING.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAWS VALUATION SUHTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIED
WITH WHETHEfi SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �I�HOO .9O
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW FEGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �FI..00 Fire SC I.SO
PLAN CHECKFEE TOTALFEE
License SC $5.00 $48.70
SIGNATUAE OF CON � RACTOQ OR AUTHORIZED AGENT IDATEi WHEN PNOPERL ALIDATED THIS IS YO R PERMIT
/
7
S�GNATURE OF OWNEA �iF OWNEA BUILDEAi IDATEi BLD �NSP ���T
..e
� a �
NEW [ j Et�ective 3/1/92
ADDN [ ] CIT� OF FItIDLLY
ALTER[ ] S1riiGL� pA�i�,'lf' AIVb b���.�XLS R-1 Af�iD R-2 �i 7� �
�bilding Permit Appllcation
ConSttllC�lOri AddteSS: 1041 Hataway Lane NE
Legal Descriptian:
Owner Name & AddT�SS: Elien Farber
Tel. # 574-0354
Contrdctot: Builders & Remodelers Inc MN LICENSE �{ 0001100
AddTeSS: 3517 Hennepin Ave S Mpls MlV 55408 Tel. i� 827-5481
Atta�li to tltis s�ilit;�tiori� ��diic�te of Survey of the
lot, +wit1� the ��sed cor�sh�ucti��i +dt��vn on it to scale.
��5C1ttPTIO�i UF. �l��tbVi�MENT
LIVIN(� �A: L�ttgth � i�Vidth .. Height
GAI�AGE �A: L,�i►gkh i�Vidtl� Height
DECK A1tEA:. L+et�gth �Vidth �Igt/Ground
OTHER: Soffit & Fascia
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner L.ot [ � Inside I.ot C] �t. �d �etback Side Yard Setbacks
Type of Cot�strir�bd: SOffit & Fascia F.SNtri�t� COSt: $ 1800.00
Approx. Completioti 1�t�:
(Cost on Back)
Driveway Cutb Cut �Vidth Needed: �t. + b Ft = �� � $ _ �
DATE: 5/9/95 AppLICAIVT: . Tel. # 82�'5481
Permit Fee $��
Fite Slurcharge $ . ,
State Surchatge $ , iU
SAC Charge $
License Surchatg� $ `fm �
Driveway Escrow $
Park F� - $
Sev�+er �V[�In Ch�tg� �
TOTAL $ �� �� �
�TIPULAT[ONS:
. ��
�� Schedule �ot� �tev�irs� Side
:00, �►f Pettriit V�1tl�titi� (1 / l Oth 9� )
S.Sti/$1,000 'V�ldation
5700 �er SAC Uttit
�5.� (State Llcehsed �e�sidendal Cdntractors�
Alt. "A" or �lt. "B" Above
�ee Determined by �rtgideering
Agre+eti��ttt N�c� C j 1Vot Nece.fisacy [)
�
�'�
�
y���� �f
BUILDIN(i PER�IIT �EE SCHEDULE
The Chief Building Official shall, before issuiag permits for the erection of any building or structure,
or for any addition to aay �xisting buiiding or sttucture, or for any alteration or repair to any existing
building or structure, upon �pplication therefore, require the payment by the applicant for such permit
of fees to the amount hereiri►► below set forth and in the manner herein provided to-wit:
$1
TOTAL VALUE
to $500
$501 td $2,000
$2,001 to $25,0�
$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
$15 (Minimum Fee is � 15 plus surcharge)
$1 S fot first $500 plu� $2 for e�ch additional $100 or
ft�ctio�i thereo% to �trd iticluding $2,OQ0
$45 �ot first $2,000 plus $9 for each additional $1,OQ0
�f �ctian theteof, to and including $25,000
�252 for first $25,000 plus $6.50 for each addidonai $1,000
or fraction ther�f, to atid including $50,000
$d�14.50 for first $50,(?00 plus $4.50 for each addidonal
$1,000 or fraction thereof, to and including $100,000
$639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction thereo% to and °u►cluding $500,000
$2039.50 for the fu�st $500,0� plus $3 for each addikianal
$1,000 or fi�ction thereof, to and including $1,OD0,000
$3539.50 for the fust $1,000,000 plus $2 for each additional
$1,000 or fraction �thereof
DRIVEW�IY DEP1tESSIOIY �SCROW
(Concr� C'� �ire�is C7-iily)
Alternate "A": Removal and replacement of curb atid gutter only - Driveway width plus 6 feet times
$13.50.
Alternate "B": Removal and replacement of curb �tid guttter and install a 3 faot wide
approach with 6 inch depth - Driveway width plus 6 feet dmes $15.75.
VEltl�fC/�TION dF �Oi1�TDATION
Permits for conshvction will be issuecl � minimum of 24 �ours ftom the time of application to allow
for proper review of the proposed struciwe and of t6e construction site.
A Certificate of Survey of the lot, shovt+ing the locadon of the founciation once it has it has been
constructed will be required before proceeding with the framing.