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AF - 45483� r � City of Fridley, Min.n.. BUII.DING PERMIT �� . / . A Date: . r .. ./. S. ..:. �"-� .... .. .. ..... . Owaer ..� .................................. Addre�s ...................................... �`j N° 3fi46 �,% / Bu3lder . ��Zvw`f . . � . . . . . . . . . . . . . .��: �!."'�i �`'�-% Address ..................................... LO�CATIO�V OF BUILDING ,. � ` . ��'`�,� Part oP Lot No. ..��J... Street . . ................... ........... ............. .............. .� /� Lot . �. �. . . BYock . . . . . P.�. . . . . . . . . . on or Sub-Division / : . . . . � e� . . . . . . . . . . . . . . Coraer Lot ............ Inside Lot ...�........ Setback �►�. ��. 5ideyard �:�: fl,�..� ............... DESCRIPTION OF BUILDING To Us : @ � �, . � .. . . ...: ..... r�orn .'�Q'r� ne�, �.�: � x��t .�.t ::.° sq. Ft. .y'� �. cn. Ft.1�.� %v ................. Front ........ Depth ........ Height ........ Sq. Fk ........ Cu. F't. ........ Type of Construction .�ile��Lk,.�,,,.. . 3�t Cost. ��j �/..� �.�� To be Completed In cronsideration of Yhe 9ssuance to me o! a pertnit to construct the building desribed above, I agree to do the proposed work in accordance witli the descripl3on above set Porth and in compliance with all prov3sicns of ordinances of the dty of Fridley. � . . . . . ��ie�(��! `��r. '�. . . . . . . C�� In conslderation of the payment of a fee of $. �/. . . . . . , permit is hereby granied to . . . . . . . . . . . . . . . . . . . . .. .. . . .. . . .. . . . . . . . . . . . . to construct the building or addition as described above. This pernnit is graated upon the express oondition that the person to whom it is granted and hia agents, employe� and worl�en, fn all work done in, around and upon said bw7ding, or any part t'hereof, shall conform in all respects to the ordi.ne,nces of Fridley, Minnesota regarding location, constructlon, alteration, mafntena.nce, repair and moving of buildings with- in the dty l�its and th3s permit may be revoked at any time upon violation of any of the prov3sfans oP said ordinances. , , : �°Y ��% S,� � ... Building Inspector e, ��N/.�. .. 7 �/�/A. � . •/.. .. NOTICE: Thta permlt does not cove� the cone�E�uatlon, Installatlon or_�teration fo� wl�ing, plumbing, gaa heaUng, sewer o� watar. Be su�e to see the Bullding Inspecto� f�R�aepa�ate permita for thoso Itema I INDUBTRIAL eusuaese CITY LOTB TOPOORAPHIC 67APPtN6 � �� . , -.-, � L � „ � � c �_ �LDC� 2, PARKb/�1N' �/�;�%6h°TS �%D�j7/o�Y (-1 ( � C. E. COULTER LAND SURVEYOR REaISTERED UNDER LAWS OF STATE OF MINNESOTA LICENBBD BY ORDINANCE OP C{TY OF b11NN6APOLtB 3300 LYNDALE AdE. 50. MINlVEAPOLIS 8, MINN. TAYLOR�4•0370 SUR VEY F�►,P .�,� 1//r� �`. ��'�Sa�Y te� So�✓ levc: �wrargui a Ulrrti�tp _ __ 7�� . PLATTIN• FAR6�1 6UfiV6Y6 U1K68MORH �uo�cu�. " N � SG,9C�- �c 0 \ � ,� � � i � J � V� r' =t�'� � — — • — — ��,,y-°�/' h',� �`�;F� �:�'qY L�1�zt ' � hereby certiPy that the above is a true and correct plat oi a survQy of: �� L.ot T'hirty�eigilt (38)� Block Two (2), ?'AF�CVIL�+i .HEIGHTS ADDITIQDI, Aaoka �aunty� 1�SinnE9ote. As sr.trveyec3 by me this 16th day o� September 195� �• �• �� . .� � , ,% .,. Si�ed t� i:^,�.s� _r_ _ ,_.�, �-. j� i�iinnesote Regis�tioa ilo. 2581� s � � � � EL � p � : � : � : � . � : � � � � : � • ►+ r 3 N � � r7 F+ � � � � � � �, � � � � � . o . O • b�7j . . `'j : . z � � � O pb7 F�+ �J O O O �' � � �� Ca" � � � m � � � � �� :�� : � `� � �� 0 0 : ,� . � � � . a N ; ; trJ o : °4 : � Q . � . . Q . . . . : � ' : : : a3I O � � � � �c � W N GO r+ f+ N �. � O � O O O � t!� {fl � °� � "y� � � t" 7� Q 1 � 1�9 � p v b t �. �1 e+ � Q � : � ; �Q� �� A � � : � � � � �� > � I'D' � '� m � T� i m � r m � • �• w � � � � � R� m �8 � � � s 0 � p : �� s �� 8 �+ M WATER c�osFrs URINALS @ATH �� BASINS SINKS WASH ra�rs DRINK. FOUNT. sHwes. FLOOR DRAINS CATCH BASINS AUTO WASFIER GAS APPL. GAS RANGE GAS OPENINGS 'n 6 2 � � � � � � � � � �'d. � � p' a � � w � �r � �n oi..�, ry � � ro � � � ry �� . � w � � � � �� \� � � �Q�q•� F � \��$�' � ' � � ,� ,� � � � O y � -.�,,. J �� O � � `�- � � � ��' b � �` ,� �� m�� _ .� � �� .� p� � � �� p �. � o 0 �� I �. � � y � ��a�� a�� ! � �� '' @ fA � y �„,`�'! '� � � � �+ `Q � � � m m � � I I � �� T-�° � � � d �� ro a� �x � i� � w� Q � � � �� i � � � � � � � O � � � � d � � � � � M � � �i a%' � � � �� V �, � 0 s� � �jr.a i' � � � � � t ��, � G� �� City of Fridley, Minn_ N° 877'2 BUILDIl\TG PERMIT Da�; APRIL 15, 1966 Oveaer: •�ames F. Mi11er B�� 3USSEL LUMI3ER CON.�ANY Addr�s . 105]. Hatha.way I�ane N. E. A� ],85o eomo venue Fridley, Minnesota 55421 St. Paul, Minnesota LOCATION OF BUILDING No. 1051 s�t Hathaway La.ne 1Q. E. Part oP Lot Lot 38 _ Slock 2 Addition or Sub-Div�sion Parkview Hei�hts Coraer I�t _ Inslde Lot Setback � Sideyard 3ewer IIevatiam — Foimdat4on IIevation DESCRIPTION OF BUILDING To be Used es: Det. Ga.rage �t 24 �� 22 g��t ],0 �. � 528 �, �_ 5, 280 Front Depth ITei�ht Sq. F't. Cu. F't. Type of Construction � F�t, Cost —. $1,450.00 To be Completed Ia c�sideratton of the 9esueace to me of a permit to conatruct the buflding des�il�d above I agree to do tha proposed work 9n accordance wlth the d�s�iptfon above se Porth aad in complianc+e with a�l provisions oP ordinaaces of the dty of Frlaley. � Ia camaideratton of the Pa3►meat of a Pee oP � 5• 00 ��t fe hereby graated to SIISS�L COMPANY to construct the build9ag or adaftfon es desc�lbed abave. Thfap�rm� t ia granted up� the express c�ndition that thepe�on to whom it fs granted and hia ageuts, employees anc� worl�nen� fn all work done in, arouad and upon eaid build9ng, or anypart ther�oP, ahall conPorm fn all respecta to the ordinancee of FridleY. Minnescta rsgeniii�g lacatton, conatruction, alteration, maintenaace, repafr and moving oP bufldin�s within the dty ]imfts and thia permft msy be revoked at any time upon vio]ation of a�y of the provisions of sa�d ord9naacea A�LEN G. JENSEN ��,�� NOflCEs tld� p�neh doa eof eewr t6s comhuaH�, le�aqdlen tor �. pinmbteg, on 6�adeg, a�ra� oe water. B� suro to a� �s &rUdteg los�ter h� apnah p�rmNs tor dua ti�t. APP'I..ICATION FOR BOILDiNG PERMIT CiTB OF FRID�LEY, MI�Il�TESOTA OWNER' S . NAME -�a1.�n � S � . �`%/ %%� �- BUILDER �t� � �S � � � ADDRESS_�� f .�� i�� ADDRESS %�'.�� f �i,� LOCATIOAT.OF.BIIILDING N0. STREET LOT � BLOCR �2� ADDITION OR LOT , � _ .. �c�=t..�c.�'`� , CORNER LOT INSIDE L_____SE�BACR SIDE-YARD � SEWER EI,EVATION " � FOUNDATIQR ELEVATIQft � Applicant attach to this form Two Certificates �of Survey of Lot and proposed building location drawa on these Certificates. DESCRIPTION OF BDILDIIQG To be used as; _D� ta-� �a� Front_ ,� � Depth� eight � . . Sq. Ft._�J�� Cu. Ft. � � �� Froat Depth ,� Height Sq. Ft. Cu. Ft. Tqpe of Conetruction_ �+� a�� Eatimated Coat �� `� To be completed_ �� '� � � The undereigned hereby makes application for a permit for the work herein specified, agreeing to do e.11 work in strict accordance with the City of Fridl.ey Ordinancea and ruZings of the Degartmeat of Buildiaga, and hereby declares that sil the facts and representationa stated in this application are true and correct. DATE_ �� , �`� I �f ° I � f� � � �s (Schedule of Fee Caste can be found on the Reverse Side). � �y �i _ ' - '� �i � � � � p �,y�� BUILDING PERMIT FEE SCHEDDLE SECTI014, 2. The Inspector of Buildings shal]., before iseuing an.y permit for the erection of any building or structure, or for gny addition to any existin� building or structure, or for any alterationa or repairs,t�o any existing building or atructure, upon application therefore, require the payment b� the applicant for such permit of fees to the amount hereia below set forCh and in the manner herein provided to•wit; 2.1. For any such permit for th�"erection of any fire-proof building, othei tha a garage, warehouae, factory or grain elevator, or for the erection of any fire-proof addition, for similar occupancy, to any esisting building, shall be at the rate of $1.40 for each oae thousand cubic feet, or fraction thereof, in such cubical contents. ... 2.2 For any such permit for the erection of any fire-proof garage, warehouse, factory or grain elevator,. or for the erection of�any fire»proof addition, for eimilar occupancq, to any existing building shall be at the rate of $1.25 for each one thousaad cubic feet, classified as "fireproof0/ by Section 502 of the Minneapolis Buildiag Code. HOIISES 2.3. For any such permit for the erection of any non�fireproof building, other than a garage, ware&ouse, factorq or grain e�.evator, or any nou-fireproof addition, for similar occupancy, to any e�isting building - permit $1.00 for each one Chousand cubic feet. GARAGES. 2.4. For any such permit for the erection of any non-fireproof garage, warehouae, factorq or grain elevator, or for the erection. of any aon-fire-proof addit�.on, for aimiiar occupancy, to aay esisting building or for each such building or addition - ninety cents ($0.90) for each one thousand cubic feet or fraction thereof, in the cubical contenta thereof with the minimum of $4.00. For the purpose of computing feea for building permits, the cubical contenta of any building or addition to a uniform height throughout by multip2yin,g the ground area covered fram a point six (6) inches below the floor line of the basement or cellar to the average h2ight of the upper surface or to the average height of the roof surface of the main gable of a pitched roc�f. 2_Ss, For repaira or alterations to an existing sCructure, the fee shall be at the rate of $3.00 per each Five flundred Dollazs ($500.00) or fractivn thereof in the eost of a11 propoeed work. 2.6. . In no case shall the fee charged £or any permit as aet forth in Section 2 be less than $4.00. STORM REPAIR DAMAGE EEES: Residential: Co�ercia2; , a,, Estimated Cost of work up to $SOO,Q� -�'S,!;=0. Estimated Cost of work over $S��"'.. �:-�� ,.:, ; ��0 Estimatec�'—'`ost of work �� : _y ':`; ',. , ;.s•:; •, Y? "r"'�,j . Estimated .,ost of wor': u;��r ;��i:°ouL� - Y�i,�...0 "�`" - 4. a ,. 3 a4' � 7� . �� M �sr� `� e o.� o�,�� , � 1� poo2 s.D, 2' 0. t� 2 r� r.t • - c1 � �� i�� 130�.'�5 .� f_�.. -� � i � �_�n � Q S c�.�e��E (.R.1 �-�- �-t N Ovs E O (�ES l� �+ �U�U t T 3O =u ST IL L.L.. O�Z ��J E.4.� Ay !� S Sc�ow �► t,i.%�-�H �ESH �ES� �x�ST � �p vSE , � M�s H Co►,, c � u - � � RA� .p. . •°� `� � � c�.� < _ I�SF�H ALT � �UtT�IZ S'rIZEET r'�'', �':~ � ' sue�ECT PER' 0. c�ty of Fridley � � �6�7 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r i � RECEIPT NO. � `v __�___ COMMUNITY DEVELOPMENT DIV. P r � � PROTECTIVE INSPECTION SEC. �, �� 7f � ' U 1 = i � /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED 8Y �"'""� • •`� 612-571-3450 910-F15 8/22/84 � � JOB ADDRESS 1051 Iiathaway Lane N.E. LOT NO. BLOCK TRACT OR ADDITION 1 LEGAL SEE ATTACHED DESCR. 3S 2 Parkview Heights SHEET 2 PROPERTYOWNER � MAILADDRESS ZIP PHONE Stephen Hansen 1051 Hathaway Lane N.E. 572-0437 3 CONTRACTOR MAIL ADDRESS Z�P PHOIVE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USEOF BUILDING Residenti,al 7 CLASS OF WORK ❑ NEW ❑ ADDITION C3X ALTERATION 0 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling 9 CHANGE QF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. St�l THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 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 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 WIIL BE COMPLIED l.ld WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 2 ZOO $ 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- $3S. SO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECKFEE TOTALFEE $39. 60 SIGN tTURE � CONT ACTORO AUTHORIZEDAGENT (DATEI �'WHEN PROPERL VALIDAT THIS IS YOUR PERMIT � �� -�� a � SIGN UREOFOWNERtIFOWNERBUIIDERi IDATEI ' BLDG iNSP n E NEW L J ADDN. [ ] �,TEx. I ] Constructioa Address Legal Description City of Fridley �R-1 AHD R-2 . Building Permit Application /.� � Y" /� (�' wCc � /i/ .- � �` . � � f �U! F_e.e, r,r��l �ti /� y�� r l �` %�6ti S Effective 4/1/84 ' T 1 � S 7 Z—��,�/ Ownez Name & Address: J/ � � 0 T-' e' i Contractor: S� �"'' � • Tel . # Address: LI9II�G AREA: QARAGE AREA: DECH AitEA : OTHER: Attach to this application, a Certificate of Survey of the lot, vith the proposed construction draWn on it to scale. DESCRIPTIOP OF �iPROYEMENT Length Length _ S�r�� Yidth Nidth Width Seight Beight Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [] Inside Lot [� Ft. Yd. Setback Side Yard Setbaek Type of Construction: ��— Estimated Cost: ��d � Approx. Completion Date: /G � 3 0-� 5! � i � Alt. A Alt B Proposed Drivexay Width If NeW Opening Is Desired: E a See Back Page for Explanation DATE: �� Z z � � APPLICANT: s �' Tel . # `�� Z -° �`� ( CITY IISE ONLY Permit Fee � �o �� Fee Schedule on Reverse Side Plan Check � 25i of Building Permit Fee State Surcharge � �� / a �•50/�1.000 Valuation 3AC Charge a �425 per SAC Uait ' Park Fee � Fee Determined by Engineering SExer Main Charge � -- -- Agreement Necessary [ ] Not Necessary [ ] To�rai. � � l. � O STIPULATIONS: BIIII.DIAG PSRMIT FEE SCHBDIILE The Cbief Building OfPicial ahall, before issuing permits for the erection of any building or structure, or for any addition Lo any euisting 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 permit of fees to the amount herein belou► set forth and in the manaer herein provided to-wit: ?otal Yaluatioa =1.00 to =500.00 Feea ' � �10.00 (Minimum Fee is �15.00) �' �501.00 to �2,000.00 �10.00 for the first �500 plus �1.50 for each additional �100 or fraction thereof� to and including �2,000. �2,001.00 to �25r000.00 �25,001.00 to a50�000.00 �32•50 for the first a2,000 plus a6.00 for each additional �1,000 or fraction thereof, to and including a25,000. �170.50 for the first �25, 000 plus ��1.50 for each additional �1,000 or fraction thereof, to and ineluding �50�000. �50,001.00 to �100,000.00 �283.00 for the firat �50,000 plus �3.00 for each additional �1,000 or fraction thereof, to and including �100,000. �100,001.00 and up �433.00 for the first a100,000 plus �2.50 for each additional a1,000 or fraction thereof. DRI9�.1iAY DEPRBSSION BSCRW (Concrete CurD Streets Only) Alternate "A": Removal and replacement of curb and gutter only - DriveKay width plus 6 feet times �13.50 Alternate "B": Removal and replacement of �urb and gutter and install a 3 foot wide approach xith 6 inch depth - Drive�ay Width plus 6 feet times �15.75 VERIFICATIOp OF FOIINDATION Permits for construction Will be issued a minimum of 24 hours from the time of application to al1oW for proper reviex of the proposed structure and of the coastruction site. A Certificate of Survey oP the lot, shoWing the location of the foundation onee it has been oonstructed Will be required before proceeding With the framing. 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 � � � IPT NO. � �y ______ COMMUNITY DEVELOPMENT OIV. �� r � � PROTECTIVE INSPECTION SEC. 1 . � 1 ( ��1 ' CITY HALL FRIDLE� 55432 NUMBER REV DATE PAGE Of APPqOVEU B� �'""'�'� �'' 612-571-3450 gt0-Ft5 7/20/95 / / JOB ADDRESS 1051 Hathaway Lane NE 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO DESCR. 3$ 2 Parkview Heights Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIIADDHESS ZIP PHONE LICENSE NO. Ron's Roofing & Remodeling 1567 Ferndale Ave NE, Fridle 55432 572-8092 EXEMPT a ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK � NEW ❑ ADDITION O ALTERATION C� REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof House (23 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. TH�S PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S0. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WOHK 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 1 HAVE fiEAD AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WOFiK WILI BE COMPLIED @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT � 1� 7LS �p . SE) DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CHARGE PROVISI OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- @ STRUCT R THE RMANCE OF CONSTRUCTION. ��{].. QQ Fire .S�', .p Z.%.3 PLAN CHECK FEE TOTAL FEE � �'�� Cit $43.59 SIGNATUFEOF oN�pACTOAOR ORiZEDAGENT iDnrE� �. WHEN PflOPER ALIDATED THIS IS OUR PERMIT �/� , 0 (�+ �/ SiGNaTURE OF OWNEA d� OWNER BU�LOERi iDATE� g�p �psp pa E tg ' NEW ADDN ALTER [l Il �l Effective 1 / 1 /95 C[TY OF FR[DLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: �� Legal Description: Owner Name b�. Address: 0 Contractor: ''',. � �� I:IVING AREA: � GARAGE AREA: DECK AREA: OTHER: �.wa� � � . Tel. � O �� , . ► � � �,�^ MN LICENSE � /��`7 ` `y/ �� - "`P Tel. # �� ` � �-� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawa on it to scale. DESCRIPTION OF IMPROVEMENT Length � Width Length Width Width Height Height HgtlGround Sq. Ft. Sq. Ft. Sq. Ft. Comer Lot [] Inside Lot [ j F�Setback Side Yard Setba ks Type of Construction:�Q�� —��Estimated Cost: $ � ��S— Approx. Completion Date: � —' � � � (Cost on Back) Driveway Curb Cut Width Ne�ed: F b Ft — Ft x$ _$ DATE: ��D� APPLICANT: �� Tel. # s ��"� � Permit Fee Fire Surcharge Sta.te Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE UNLY $ �/. �� Fee Schedule on Reverse Side $ % , �� .�1 of Permit Valuation (1I lOth%) $ , c�� $.50/$1,000 Valuation $ $850 per SAC Unit $ ' �,, -Z� �" $5.(� (State Licensed Residential Contractors) d $ Alt. "A" or Alt. "B" Above $ $450.� Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ ��- �� 0 i;ui�.l)ING }>i:KMI"(' FEE SCIiEnU(_r_ "I�hc Clii;:t t3t�ilciir�}� Ul�ticial shall, tx:lorc issuing permits for thc crc;ciion of- any building or stn�cturc, <�r ti�r any :tcl<litic�n tu :�ny cxistin�; buildinf; c�r struclurc, or for any altcraiion or rc��air to <�ny cxistin}; I�uiliii��g <�r stn�cture, u�n aPplicetion lherefore, require the payment by d�e a��licant for such rermit c�f t�c;t tc� ttu; a��iount hcrcin t�cli��v sct to�ili and in thc mannen c�rcia �ravidui to-�vii: "1'O"1'I�1_ V�(,[Jk: � I to $500 $501 to $2,000 $2,001 t4 �25,000 $25;001 w �SO,OOU - $50,001 to $100,000 $100,001 to �500,000 $500,001 to $1,000,000 . $1,000,001 and up r-r_��s $!5 (Minimum Fec is $15 plus surcharge) $15 for first $SQO pius $2 for each additional $ i00 or fraction thereof, to and including $2,000 $45 for ficst $2,000 plus $9 for each additional $1;000 or fraction thercof, to and including $25,000 � $252 %r first $25,000 pt�s $6.50 far each addirional $1;000 or fraction thereof, t,o. and inclading �50,000 $414_SO for first $50,000 plus $4S0 for each additional $1,000 or fracbion th�reof, to and including $100,000 $63950 far fa�st -$100,000 plus- $3_50 for each additional� $1,000 or fradion the��o� to and inciuding -$500,000 $2039.50 for die first $�0,000 plus $3 for each addition,al $1,000 or fraction thereof, to .and includ"ung $1,000,000 $3539_SO for the fust $1,OU0,000 plus $2 for each additional $1,000 or fraction thereof • DRIVEWAY DEPRESSION ESCROW (Concrete Curb S�ceets Only) Alternate "A": Removal and re�lacement of curb and gubter only - Driveway widtfi plus 6 feet times S13_SO_ Alternate °E3°: Removal and replacement of curb and gubter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15_75_ VCR[FICA"CION Or FOUNDAT[O[Y Permits for const�uction will bc issued a minimum of 24 hou�s from the time of application to allow for proper rcview of the proposul structure and of the consiruction site_ A Certilic;;�te oC Sucvey of dte lot, showing the iocaUon of the founclation once it h�s it has t�een consWeteci wiU tx; re:yuicul t�ef�re proceedi�g with lhe framing. sua�ecT P c�ty of Fridley � � � �9 AT THE TOP OF TME TWINS g U I L D I N G P E R M I T r � � RECEIPT NO. � • COMMUtJITY DEVELOPMENT DIV. �� ' �ti _"'�' r � � PROTECTIVE INSPECTION SEC. ' ' �'��1 � CITY HALL FRIDLE� 55d32 NUMBER AEV DATE PAGE OF APPROVED BV �----�: �., 612-571-3450 910-F15 6/17/96 / / JOB ADDRESS 1051 Hathaway Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3$ 2 Parkview Heights Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Carol Hansen 1051 Hathaway Lane NE 572-0437 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION l� ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 8 OESCRIBE WORK Install basement egress window 9 CHANGE OF USE FROM TO STIPULATIONS Window must meet the State Egress Code SEPARATE PERMITS ARE FEOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. " THIS PERMIT BECOMES NUI.L AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU. FT. AUTHORI2E0 IS NOT COMMENCED WITHIN 60 DAYS, OH IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTEq WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CEFTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS yALUATION SUHTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED WITH WHETHER SPECIFIED HEREIN OFi NOT. THE GRANTING Of A PERMIT �SOO �.SO DOES NOT PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEL THE pEiiMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @21.00 Fire SC �.SO S7RUCT OR THE PEFiFO NCE OF CONSTRUCTION. W �� I,^. G�j� PLANCHECKF T A FEE � � 22.0� S ATUREOFCON' CTOjipRAU MORIZEDAGENT IDATEI N PF VAL A D HIS IS Y UR PERMIT Jr _ v ��'�. 6��7� 9� � -�7•�� SiGNATURE OF pWNEA iiF OWN R BUILDEAi �DATEi ' G�NS ��FTE �— NEW ADDN ALTER Il [l [l ConstructionAddress: Lega1 Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application � J � G-- /U Effective 3/1/96 �� Owner Name & Address: � � ��1 -- � D�j � �{'� �,�j�'}�,t,� Tel. # 5 % � — Q � � Contractor: �, �� (� �,�(' c,� l� �o c� MN LICENSE # /, Address: LIVING AREA: GARAGE AREA: DECB AREA: OTHER: Tel. # �' Attach to this application, a Certificate of Survey of the lot, with the proposed consiruction drawn on it to scale. DESCRIPTION OF IlVIPROVEMENT Length Width Height Sq. Ft. Length Widih Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. �--� s _ _ _ � s� _ , . � , f? �, . _ _ Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ `F ,� Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Pazk Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ o� �� Fe,e Schedule on Reverse Side $ -,S'U .001 of Permit Valuation ( i/ l Oth %) $ , � $.50/$1,� Valuation $ $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 Chief Building Official shall; before issuing permits for the er�tion 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 structtue, 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 $SOa,000 $500,001 to $1,000,0� $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge). $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,(?00 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fracrion thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,0� $574.75 for first $50,�0 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,D� or fraction thereof, to and including $500,�0 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the fust $1,000,(�00 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete G�rb Streets bnly) 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 approach 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 structure and of the construction site. A Certificate of Survey of the lot, showing the location of the founda.tion once it has it has been constructed will be required before proceeding with the framing. . - c�ty of Fridley AT THE TOP OF THE TWINS i � � � � ' COMMUNITY DEVELOPMENT DIV � j V �'�__', r � � PROTECTIVE INSPECTION SEC i----� ��"' �.� CITY HALL FRIDLE� 55432 i 612-571-3450 SuBJECT BU ILDING PERMIT� NUMBER REV �A�E PAGE OF 910-F15 8/26/96 / / JOB ADDRESS 1051 Sathaway Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION oescR. 38 2 Parkview Hei 2 PROPERTV OWNER MAIL ADDRESS Carol � Hansen 1051 Hathaway Lane NE 3 CONTRACTOR MAILADDRESS Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MAIL ADDRESS s Addition ZIP ZIP ?4�Go � RECEIPT NO. �� APPHOVEO BY SEE ATTACHED SHEET PHONE 572-0437 PHONE LICENSE NO. PHONE LICENSE NO. PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION q� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Install interior walls in basement for living room and bath 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in each sleeping room and on every level of the home. Provide treated sill plates. Submit sketch to City of proposed layout with material detail. SEPARA't'E PERMtTS REQUIRED FOR WIRIIVG, HEATiNG, PLUMBING 14ND SIG�iS. SEPARATE PERMITS ARE REQUIRED FOR EIECTRICAL. PLUMBING, HEATING, '"` v' vv•�. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING AUTHORIZED IS NOT COMMENCED WITHIN 60 DAVS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOF; A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS I HEREBY CERTIFV THAT I HAVE READ ANO EXAMINED THIS APPLICATION 1 AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF �AWS VALUATION AND OROINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIED @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTiNG OF A PERMIT y�2�000 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON- STRUCT OR THE PE R ANCE OF CONST6iUCTION. �C)L.ZS PLAN CHECK F SIGNATURE fCONTPACTORORAUTHORI2EDAGENT IDATEI . � ve• S�GNATURE OF OWNEA iif OWNEA BU�LDERi IDATEI �A PANCY GROUP IOCCUPANCVLOAD SQ. STALLS CU.FT OFFSTREET PARKING IGARAGES SURTAX $1.00 SAC CHARGE F �e SC $2.00 TO A FEE 65.Z5 HISISY RP I '� � s �/ NEW ADDN ALTER il [l Ll CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: o� f Legal Description: Owner Name & Address: Contractor: ' S� � Address: � LIVING AREA: GARAGE AREA: DECB AREA: OTHER: Effective 3/1/96 r, � � � �� )�p �� Tel. # �j � Z � ,3 % ILMN CENSE # � Attach to this applicaxion, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Leagth Length Length DESCRIPTION OF IlVIPROVEMENT Width Height Width Height Width Hat/Gi Tel. # �� Sq. Ft. Sq. Ft. �,. �. Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks Type of Construction: . �p�Q Estimated Cost: $ �, �� Approx. Completion Date: � . � Driveway Curb Cut Width Needed: _ DATE: APPLICANT: Permit Fee Fire Surcharge State Surcharge 5AC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge (Cost on Back) Ft. + 6 Ft = Ft x$ CITY USE ONLY _� Tel. # $��.� Fee Sch�ule on Reverse Side $ o�. O� .001 of Permit Valuation (l/lUth%) $ / D� $.50/$1,000 Valuation $ $9Q0 per SAC Unit $ ' $5.00 (Sta.te Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary j] Not Necessary [] TOTAL $ ��' a ��T� �CL �,4� STII'ULATIONS: �� v/�� y� �'.�� _ ��7��T��Z� i� �.�C'f�1 �°�� /� �?i �d�'_ y .,��✓�� vF ?'�C i�� / � �7� LE'Ed�� BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing germits for the ere�tion 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 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 $1,0�,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,� $52.25 for fust $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.� for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.� for ea.ch additional $1,i�0 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,0OO,OQO $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,OD0 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete C�rb 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 approach 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 tune 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 constructed will be required before proceeding with the framing. �- ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 l+'AX: : 1051 HATHAWAY LN NE : 243024310032 : PARKVIEW HGHTS ADD : LOT 38 BLOCK 2 : ELECTRICAL : RESIDENTIAL : ADDITION/ALTERATION 571-1287 PERMIT NO.: 2004-00903 DATE ISSLTED: 06/15/2004 VALUATION . NOTE: ELECTRICAL PERNIIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. REPLACE AIR CONDITIONER. # INSPECTIONS 1 APPLICANT SUBURBAN ELECTRIC 109814 ST HANOVER, MN 55341 OWNER LORRIE TOMLINSON 1051 HATHAWAY LN NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This pernut becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and lrnow the same to be true and correct. All provisions of laws and ordinances goveming this type of wor� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERNIIT FEE - MIN (RESI) STATE SURCHARGE, ELEC FLAT TOTAL PAID WITH CHECK # 13440 �r,Y[�icH 1� Yr.tuVll 1 � ic�11U11C�1J r VK W VKK V 1 tir:K 1 t1AN llr;�C:Klli�ll Al3U V�. 20.00 0.50 20.50 U1 � � � a v n o Q. � =*: � o d4 � m oy v � m � �� o� � a � � m � �� a o � Ci `� � � � a � � -- �-- � � � rn � � � $ < � 'a � < a � -'� y `� � � � �;:� � +� � �� . ��`;��' 5 � � '�� m �'�D17 � � O �� r� �, � > > v � v � m V � � m z � -D n � O Z -� rn m � � 0 O \ x O � � X � � F' �� CNn � o c � � rn � N � rn � °� n °oa o� O � � o �° oi � � r O � a ,,N.� r � � � � � m c� °' o 3 �� -- -� o _ � . � � e'^� a �, o p � N C � � N'�'I C�D N h m o � ��a� � ��°—° �°n�a `��°�� OA � � o cu N. `z � � Q � N � � N m r' 0 o � 1 � � O � 0 0 � °� m � � v � � a � '± 0 7 5 � D � N � v � � � � m � v N _v, a � ua Z � c v � N -n m '� v � 5 N � � o� -n � O � (�A � � . � �p tD � � � m �. m m � � d �. Q � ° -. _ �� C �c O � W � � m R� � � � � � -- - - - cNn o 0 0 ,cwi� "^ 0 o g o o � � � � � � � � � � �� p � . m 4�., � . a� � � S � Z � a a rn � �_ N c �i � a � Q � N N � N � r3+ �+ �- N � r�+, 3 � � � � Uol �- N � � � � � O � �. � � � O � � <_. o CD 3 N. � U N "�a �, _ � � � ' n�i �`*o rr �p n � � � a- Q o �Q�� '� A C=i N (p 1 ��'�� rt � Q3,?o o °* � � � � n � �. � �' o �D o � a Q' � y � � W W C � N � d Q tD Z � � � I -o � � o c W � � rn � p_ �, , �_ Z CD v v N04 � � A O (p ?= o o �° � � 7 � N m r, � � � � � � O � _ Q o � m N � � v o ' � v � � 3 � -_I D m 0 O � �p, �� m � � � Z O a� _';� --. ,� �a W C Q 3 oa N N -et � � � M1� � � � � �D F� � =` c � ►V � � � a W z � -t1" � � N � � � N � v � � m� � � C �a W cn � r= '' v � z � � VTI V m � - - - — °z o � � O W � � �a rn � � �'" �D m � � z Zo n� Z -� vo a� � rn � n � vz '�'� � � � Z z �v _ � � �"� Z m � � C7 Z O vz v� �c m z �� O Z �! � � m � N O .�A ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 iJNIVERSITY AVENUE NE FRIDLEY, MN 55432 s�z-36u4 r��: : 1051 HATHAWAY LN NE : 243024310032 : PARKVIEW HGHTS ADD : LOT 38 BLOCK 2 : HEATING : RESIDENTIAL : ADDITION/ALTERATION 571-12if7 � PERMIT .: 2004-00933 - � DATE ISSUED: 06/17/2004 , VALUATION . NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL A LENNOX, 2 TON, AIR CONDITIONER. # A/C LJNITS # GAS DRYERS APPLICANT SEDGWICK HEATING & AIR COND LLC 8910 WENTWORTH AVE S MINNEAPOLIS, MN 55420-2853 (952)881-9000 OWNER LORRIE TOMLINSON 1051 HATHAWAY LN NE FRIDLEY, MN 55432 ] #FURNACES 0 # GAS RANGES AGREEMENT AND SWORN STATEMENT 'fhis pemut becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and lrnow the same to be true and correct. All provisions of laws and ordinances governing this type of wor� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law re,gulat�g c�struction or the performance of constructi¢n. Bldg HEATING PERMIT bIINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONII�TG FEE STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 70133 SEPARATE PERMITS REQUIRED FOR VJORK OTI-IER THAN DESCRIBED ABOVE. 0 0 0.00 0.00 0.00 0.00 25.00 0.50 25.50 NE1N [ j CI7Y OF FKIDLEY Effecdve 4/1/2004 ADDN () 6431 Universily Ave NE, Fridley, MN 55432 (?63) 572-3604 Bldg Insp ALTER [ j SINGI�� FAMILY AND DUPLEXES R-4 AND R-2 (763) 571-1287 FaOxo � I BUILDlNG PERMIT APPLICATION o � , O"" ConstruCtlon Address: Legal Description: Owner Name & A� Contractor: / �r �. �� ' f r — CIa �' ;��= f�� .� Yrio��r:�-� �j � �,%�- f�r�� c� ° MN /� � �,� �<� �`' � j�'� � Attach to this application, a Certlficate of Survey of the bt, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT ,_�� ''�� c��- � � # `` �# �� "� �`.�� #. 'C'l �7 7�- �':S=�� LNlNG AREA: Length Width Height Sq. Ft. GARAGE AREA: Lehgth Width ,.� Height Sq. Ft DECK AREA: Lengih Width NgUGround Sq. Ft OTHER: Construction Type: �f" i�IC�L� i f�`��G�� Estimated Cost: �� I �. _ DrIveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ =$ � � � � � "� %G° .�� DATE: � � � �-�' � APPl..ICANT: � � Tel. � �c S Ca[! (763j 57z�3604 for Pemilt Fees if mailing in application. Fa�x to 763-579-�287 if using credit card and we wiil cail you fvr card numher. C1TY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surc�iarge SAC Charge License Surcharge Curb Cut Escrow �rosion Control Park Fee Sewer Main Charge TOTAL �e�za•d $ ,�5 Fee Schedule on Revers� Side $ 65% of Permft Fee $ � / � .001 of Permit Valuation (1/'i Oth%) $ � $.50/$9,000 Valuation $ $1350 per SAC Unit .$ $5.00 (State Ucensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ � $450.00 Conservation Pian Review $ � Fee Determinec! by Engineering $ Agreement Necessary j J Not Necessary [] $ o STIPULATIONS: o p� y� Jl3�Q I a� �0 Jll I� bS:z� b00z-L0-�3Q