AF - 47092., �
04-Nov-04
City of Fridley
6431 University Ave. NE
Fridley, MN 55432-4383
763-571-3450
Special Assessment Search And Statement of Charges
TO:
On all that tract or parcel of land lying and being in Aaoka County, Minnesota described as follows to wit:
Parcel No: 13-30-24-43-0105 6209 HEATHER PL Lot: SA, Block: 1, HEATHER HILLS NORTH PLAT
LEVIED SPECIAL ASSESSMENTS
This is to certify t6at I have examined the records in the office of the Clerk, City of Fridley, Anoka County, Minnesota, and
for such search, certify that the following special assessments appear unpaid with respect to the above described tract or
parcel of land:
Term Certitied Initial Interest Remaining Current Current
Proiect Number Project Deccrintion TYPe (Yrs) Date Amount Rate Balance Princival Interest
9100-0000-00 00 REG SA(Water/Sewer 3120 15 12/31/1960
5000-0058-01 00 W/S/SS 2230 20 10/O1/1963
6000-1962-00 OOST 6400 10 06/02/1964
92Q0-1982-00 OOTREES 9200 5 10(04/1982
$257.41 5.00%
$228.70 6.00%
$29.07 6.00%
$65.49 10.50%
Amount Certified to Anoka County Auditor for Current Year Taxes Is: $0.00
PENDING SPECIAL ASSESSMENTS
$0.00 $0.00 $0.00
$0.00 $0.00 $0.00
$0.00 $0.00 $0.00
$0.00 $0.00 $0.00
For the purposes of this document, the City of Fridley has determined that an assessment is considered pending after the City
Councii passes a resolution ordering the improvement, the approval of plans and the advertising for bids. This is prior to the �
City Council adopting the final assessment roll. If you seek further information, you should do so upon your own
independent inquiry. Any amount given as to pending assessments is informational only and may or may not be the amount
ultimately assessed.
Term Initial Interest Estimated
Proiect Number Proiect Descriation (Yrs) Year Rate Pendin� Amt.
NONE
MISCELLANEOUSFEES
Descrintion Status Date Fee Amt.
Pazk Fees Unpaid g/19/2001 $1,500.00
UTILITY CHARGES
You shall be responsible to verify the status of any outstanding utility charges. To check utility charges
( water and sewer) contact Fridley Utility Billing Department at 763-572-3529.
The records referred to above are public and may be inspected by anyone during regular business hours. The search of these
records was made by the undersigned as a public service on request. The undersigned certifies that the above indicated
searches were made and are believed to be accurate, however, t6e undersigned or the City of Fridley does not insure the
accuracy of the above statements and does not assume liability for errors and/or omissions.
The above figures are good through November 15, 20
Date Prepared: Thursday, November 04, 2004 By
Page 1 of 1
NEW O CITY OF FIZIDLL=Y Effective 4/1I2004
ADDN [ J 6431 University Ave NE, Fridiey, MN 55432 (763} 572-3604 Bidg Insp
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address:
Legai Description: l.
Owner Name 8� Address:
Contractor.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
r�s�
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VO � � ��
7e1. # Ko�s'�72 ' �%5�
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MN LICENSE #
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Attach to this application, a Certificate of Survey of the t�
bt, with the proposed construction drawn on it to scale. `�.�L 1�
DESCRIPTION OF IMPROVEMENT '� �
/ ��i �
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Length � Width t�� Height �_ Sq. Ft. �7 `'t'
c
Length Width ?7 Height Sq. Ft.
Length � Width Hgt/Ground Sq. Ft.
Construction Type: v`�'�+� Estimated Cost: $-1 �� ,�
Driveway Curb Cut Width Needed: F� + 6 Ft = Ft x$ _$ '
�
DATE: • ' � APPLICANT: Tel. # �� �'' J ?Z '" �8 ��
Call (763) 5T2-3604 for Pertnit Fees if mailing i� application. Fax to 763-571-1287 if using credit card and we will call
you for card number,
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$
$
$
$
$
.$
$
$ �
$ /,�oa•oo
$
F�
CITY USE ONLY -
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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 [ ]
STIPULATIONS:
REScheck Compliance Certificate
2000 Minnesota Energy Code
REScheckSoflware Version 3.5 Release le
Data filename: C:�Program Files\ChecldREScheck�I.AMERE.rdc
PROJECT T1TLE: ANGI.E GARAGE RAMBLIIt
COUN'I'Y: Hennepin
STATE: Minnesota
ZONE: 2 �
CONSTRUCTION TYPE: Single Family
DATE: 11/03/04
DATE OF PLANS: NOVEMBER 03 2004
PRO]ECT DESCRIP'TION:
KEVIl�J LAMERE RES...
DE5' JNE�t/CONTRACTOR
SCHWIETERS HOME DESIGN ( RES. DRAFTING AND DESIGI�
COMPLIANCE: Passes
Maximum UA = 460
Your Home UA = 396
13.9'�o Bettet Than Code (UA)
Permit Number
c�aa Byroa�
Gross Glazing
Area or Cavity Cont. or poor
Perimeter R-Value R-Value U-Factor UA
Ceiling 1: Raised or Energy Tn�ss 2508
Wall 1: Wood Frame, 16" O.C. 2779
Windaw 1: Abave-Grade:Metal Fr�me:Double Pane with Low E 488
Door 1: Solid 39
Basement Wall 2: 5olid Concrete or Masonry 187
V�::ll height: 9.0'
Depth below grade: 8.7'
Insulation depth: 8.7'
Window 2:
Basement <= 5.6 ft2:Meta1 Frame:Double Pane with Low E 7
Window 3:
Basement > 5.6 ft2:Meta1 Frame:Double Pane with Low-E 77
Door 2: Glass 84
Furnace 1: Forced Hot Air, 90 AFUE
50.0 0.0
19.0 2.0
11.0 0.0
SO
126
0330 161
0.070 3
1
0.330 2
0.330 25
0.330 28
Propo�ed and Mxrimum U-Factor Averages
Pt+nPosed Maximum
Av�erage U Fador Allawod U Factor
Above�Grad�e Windows and G1ass �o�ors 0.330 0.370
Includes Foundation Windows > S.6 i2
Foundation Windows <= S.6 ft2 0.330 0.510
CAMPLIANCE STATEMENT: The ProPosed building d�t describad hene is oonsistent with t6e building Plans, specifications,
and other calculations submiued with the permit application. TLe pro�osed building has been de.sig�ad to maet the 2000 Minnesota
Energy Code requirements in REScheckVersi 3. Release le (fa�m�rly MECcJ�ec� and W oomply with the mendatory
raquirements listed in REScheck C
s�wa��� n� ff� - 3' a�vj'
FROM : Kevin LaMere FAX N0. : 763-572-1055 Nov. 15 2004 03:53PM P3
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FROM � Kevin LaMere
Kevin LaMere
b199 Heotther Ptnte
F�idley, Minnesotn 55432
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FROM � Kevin LaMere
FAX N0. : 763-572-1055 No�. 15 2004 03�53PM P2
hiC1U-1'�-2�4 S 5� 35 LILTF ! G MPLS '�63.'� 21166 �.�J?
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Rlabll ♦ p�;A1L�N0 OF 13-COURa! MA�ONRY l�OUNDATlC�N WALLS, CONST1�vCT101� 1� TO e�
iN AOCOIl4ANCE W�TH TKI�t QOCUM�NT i aTANDARI� INDU4TRY pRACTICt�. NEP�q 70
DRAWINA PRE�A�ECI dT �CFlWlETERS HOME O�e14N AND DATtD S1aA4 I�OR 6p�CIf1C
iN�ORMATION.
1. TM�it dItAWHiOt ApPLI� TO 1� COURaE MA�pNRr FOUNDATION MIAII.A. SUI�t>INl; MEI�N7
If k0'T TO tXCEEO T1IY0 fTORitl1 �LUS A �3/l6CMBN! WI7'M 1100f irANi NOT TO tXCtld �0
rOOT CLtAR ANO FLOOR B�ANa NOT TO GXCi�D 1Q FOOT CLEAit. ePECtA1. CON'Ji�R�RA?!ON
Ai1D b�e1GN li RlQIlIRED �aR WAL�B BEYONO TIiEdB LiAA�T�.
2. Nit10R 70 TFIE iTART OF 811CKFILLINO, A4L WALL� ARE TO BE LATERA�LY aU'►ORTED AT
sOTH TOP ANO SOTTOM �Y �(.00R CON�TRUCTAN OR 8Y AD�QUATE TlMwCRARIf
sRACiNV.
'. AL.L �II.L MLAi�is ME 70 0! ATT/1CNC0 TO THE WALL� WtTM A MINtYU1M O� Ty1f0 ANCMOR�J
rLrlt ilLL alC7'tON. ALt 3ECTIOM� ARE TO NAV< AN ANCMOI� NIfTHfl1 12 INC11E• OF EACN
�NI�. A�I ANCMO� ii TO t!'�ACl� AT AL.L 1NAl� GOANERB ANO INTERiECTtONd.
t. !►LACI! iAAi SYCN iMAj FNiAL POHiTiON fs WlTHlN 1l2" OF TNAT SHOM►N 1N THE DETAiL�.
S. OOWlLS RROM �OOTlNG INTO T►!! WALL MAII B� bR��lEO AND 01101iT�D. OOWEIj i3p NQT
NE�Q TO �i T�iD TO TII� V�RTSCAC sT��'L.
�. TYlN4 OR iAlls 1N PL110E i� N07 AR�UIttEb PROV{p�p BUFPtCIRIi{T GAR! IS TAKEN TO
�NivRE rMR dI1R� 00 KOt MoVE OUT OF TOLERAN�E W1TM Iti�P!!CT TO POdtTeON AND
E�T ALL CLRAR COYER fl��tlIREMIENTl.
7. �RAIN TILR DANPPpaOFIN6 AND I OR WATERPROOFINQ� AND INaU1.ATiON, AS WE�� A8
THEnt IN�t�LLAT10N, �RE T4 8L' lN 11CCORDAMC� WITFI tH@ CODl.
•• I�OOTIMO iltE: ARi MINNMUMS 9A�ED 8N A 2000 PSP A��UMEd QEARING CAPIICITI'.
•. ��AOR ,IbllTS /�IIE t0 6E�lR A MlNIMUM OR =,d" ON �llt� �I.ATi AT TOM OI� WAL6. IMBT/�l.l.
CONYMIUOYi RW ep/lfip ANO CONNtCTORS As aFlOWN 1�N DffTAlL�. 1liCRlASE �tti ►LAtE
i1�E A8 NE�drO TO AAEl7 TME lil�QUIREMEMTS O� TNE ENlRGY COOE.
� �.�00 t:1 �'C ta DAYs
CONCR�TE • l.00A !il �•G � �i DAYs
si6!{. � ►Y � �OrdOQ Pil E�RADE d4j
�`�\CiCFiLL � AAND, i�pU1VAL6NT l�LtltO PREaat1RE ■ 2� P�F
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CITY OF FRIDLEY PERMIT NO.: 2004-02217
6431 U1�TIVERSITY AVENUE NE
FRIDLEY, NiN 55432 DATE ISSUED: 12/Ol/2004
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 6209 HEATHER PL NE
PIN : 133024430078
LEGAL DESC : HEATHER HILLS WEST .
: LOT 5 BLOCK 1
PERMIT TYPE : BUILDING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 266,203.00
SAC LJNITS 1
APPLICANT BUII,DING PERMIT FEE 1,928.95
KEVIN LAMERE PLAN CHECK FEE 1,253.82
6199 HEATHER PLACE FIRE SURCHARGE 266.20
FRIDLEY, MN 55432 STATE SURCHARGE, VALUE 133.10
SAC CHARGE 1,350.00
TOTAL 4,932.07
PAID WITH CHECK' # 10824
OWNER '
BATESON GEORGE F& ANN L
6196 HEATHER CIR NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit 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 work
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 Ins D�
SEPARATE PERMITS QUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CITY OF FRIDLEY PERMIT NO.: 200402217
6431 UNIVERSITY AVENUE NE
DATE ISSUED: 12/Ol/2004
FRIDLEY, MN 55432
(763) 572-3604 FAX: (763) 571-1287
: 6209 HEATHER PL NE PERMIT APPLICANT:
---� : i � /330 �j �ol ob �vnJ L�xE
<
: HEATHER HILLS WEST 6199 HEATHER PLACE
: LOT 5 BLOCK 1 FRIDLEY, MN 55432
BUILDING
RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
INSPECTION TYPE
FOOTING
FOUNDATION
ELECTRICAL ROUGH-IN
PLUMBING ROUGH-IN
HEATING ROUGH-IN
FRAMING
INSULATION
DRY WALL
SMOKE DETECTORS
ELECTRICAL FINAL
INSPECTION COMMENTS:
BUII.DING INSPECTION RECORD
24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS.
CALL FOR INSPECTIONS WEEI�AYS: 8 AM TO 5 PM
DATE INSPECTOR INSPECTION TYPE DATE INSPECTOR
PLUMBING FINAL
HEATING FINAL
FINAL
IN ACCORDANCE WITH CITY ORDINANCE, NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL
WORK HAS BEEN APPROVED, AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY T'HE BUILDING DEPARTMENT.
THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE.
�
NEW I l
ADDN [ J
ALTER [ ]
CITY OF FRIDLEY
6431 University Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 4/1/2004
(763) 572-3604 Bidg Insp
(763) 571-1287 Fax
Construction Address: � �� � ����
Legal Description: � � -.� � l � �-�-� �
Owner Name & Address: �J �1r1 � Tel. #� • �2 ' (95�
Contractor. MN LICENSE #
Address: � �et.'� rv � Z� ��' l"{ 2.-�c.�►
l�ll ,:-� ,.
Attach to this application, a Certificate of Survey of the ;�+� u-�•- �
bt, with the proposed construction drawn on it to scale. �,
��
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
lv
DESCRIPTION OF IMPROVEMENT ,
� (,,j.� � ,t � �L�( G �
Length � Width l.0 Height � Sq. Ft. �"L
c
Length Width �_ Height Sq. Ft. 7 D�
Length — Width Hgt/Ground Sq. Ft
Constn�ction Type: �� Estimated Cost: $ � .�G (o ��3 � ��
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$ '
�
DATE: ��� �' , APPLICANT: Tel. # `G � ��7Z ` �8 ��
Call (763) 572-3604 for PeRnit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ �qa8. ��"
$ � as3.�
$ �(����t�
$ 3 .t
$ t
.$
$
$
$ /,�va•oo
$
CITY USE ONLY -
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 per SAC Unit 1�j5 b`�
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ J Not Necessary [ J
TOTAL $ llJy � •0� STIPULATIONS:
FROIM : Ke� I n LaMere
FAX N0. : 763-572-1055 Nov. 15 2904 03:55PM P5
x911.� x950.7
� * * 201-85th Avmiue N.W. x920.6
* PIONEEIa ,..N, ��,,,� �
* Coon R�Ids, MN 55433
* eng ,naer a 1N1D °�"""� . 'NO�i1PE ""�"'E� (783j 783-1880 FAX:783-1883
Certiflcate of Survey tor: KEVIN LAMERE 9°'� ����a
House Address: 6208 Heather Place
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l.brog� 9ab �svotlon: 91�� (at door)
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L4T5 _ 5A & 5B . BLOCK _ 1. HEA _ - NORTH PLAT
MIOKA COUNTY, A/NVNESOTA
Me hsnby urtHy !e KEVIN�u�r+c tfia! !hh �urwy. P�an a' report wos Prepo�sd by me or undx my dkeet eupenAalai v�d
that I an o duly 1loona�d L ond Su►vs� undr 1�s law� of the Stota ot Allnnesota. De4sd thia 4}h
A.o.. 2004. day ot Novertiber
RMa�d: 11-8-04 (Revh�d Dkna�alans) SI ed:
Rwr�.a: »hs/o4 (surdr,9 dw�oean.) 9" o�c��tiN P.A.
SCale: 1�= 30� Br
�°'�'� T°rs+os E Rotfia+bcd+er, LS. Reg, Na 20595
224 204373.OG1 ,�W Thanas R. BoruN. �„S. Reg. No. 40361
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House Ad
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x 912.
x 911.7
LAND SURVEYOFtS9�?C.dNL EN,(NEEftS
LAND PLANNERS • LANOSCAPE ARCHITECTS
of Survey for: KEVIN LAMERE
912.7
N
-�v 905.8
N89�18'03"W
x 910.7
J201-85th Avenue N.W. x9za•s
Coon, Raptds, MN 55433
� (763) 783-1880 FAX:783-1883
, X� N/Y5.
x �S � 920.4
907.5 24' RCP
� � � _ � � _ X � � _ � � � � �_ _
� 905.3
5 � x 408.5
� 5Ax 911.0 I I
BENCHMARK � � ( 924.6 �
T� OF PIPE 911.4 x
EL � 912.21 I � x 912.3 I
3 I 1 . BENCHMARK I
�� I 1$ 913.5 916.4 918.1 "'TOP OF PIPE I
� 9It.7 `- � I �N °•�20 x9189 � = 921.33
d' -t�r._ 1 91�.i
� O M N fe.JO DECh
I � � m� 913.2 14.0
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4 ti �- ""� 9I 7.3 t� �
WALKOUT � 9122 I 916.0 x I^
TOP OF BLOCK � 920.1 ( �
GARAGE SlAB � 917.3 + ��•��
� 10.83 �
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SERVICE NOT VISIBLE I ' S7EP GARAGE � COURSE DOWN
E.O,F. 2. Re�c�'l.. C.�����`' PROPOSED BUII.DING ELEVATIONS
000 o Denotes Emergency Overflow
x 000.o Denotes Exlsting Elevatron �yQ�,���� � Lowest Floor Efev�otlon: 914.5
oo. Denotes Proposed Elemtlon �,1� - �Top of Foundatfon Efevatlon: 923.3
---�- Denotes Dralnaqe Flow Dlrect�on � �C��^- Garage Stab Elevatlon: 29 2.2 (at door)
�� Denotes Dralnaqe & Utillty Easement � ,,�p�,,�,� propoesd bulldMg alts grading Is b accordance with the
(per recorded plot) �{"w'" 7��. gradfng plana approved by the c�ty «�ya,e�.
� � � ��IOTE: Contrxtor muat verlfy �I dknenelona !c drivaway deslg�.
--«- Denotes Offset ►ron ,
NOiE: Drivewaya are ahown for graph(e purposea only, tlnol drlveway
Bearings' shown are assu��`'me� ��tO a�y� o►�a i�ati«, will be determined by co�tractor.
�� ►�-ti he-��-.
LOTS 5A & 5B , BLUCK 1� ATHER HILLS NORTH PLAT 2
�
� ANOKA GOUN��T'Y�,�SOTA �,,�, �� ( ��� yt,J'
We hereby cert(fy to KEVlN LAMERE that this survey, plan or report was preparad by me or u� my dlrect supervtsiori and
thot I om a duly Ilcensed Land Surveyor under the laws of the State of Mtnnesota. Dated this � day of ,/Vo✓E/�P.�',2
A.D., 2004.
Scale. 1 inch = �O eet
204373.001 JFW
�
Signed: PIONEER ENGINEERING, .A.
By. �,-�
Terrence E. Rothenbacher, L.S. Reg. o. 20595
Thomas R. Balluff, L.S. Reg. No. 40361
24-JAN-2005 02:04PM FROM-COUNTRY LU1+ffiER
+7632624449 T-161 P.001/002 F-984
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12575 Oak View Ave. (763) 261-4444 or 1-800-247-0295
' BeCker, MN 55308 ��0RP0R"'�" � Metro (763) 262-4444
www.countrylumberbecker.com Fax (763) 262-4449
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FAX#: 76�2Q2-44d9
#! PAGES � (INCI,,TJpING COVER SHEE7�
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May 11 2005
Kevin Lamere
6209 Heather Place
Fridley MN 55432
Re: Heather Hills North Plat Lot 5 Block 1
Dear Sirs:
A final inspection was conducted on 5-11-05 for the completion of the dwelling at the above
address. The inspection noted that the construction was completed according to the
approved plan but the following items need to be completed before the building permit can
be finaled out;
1. Provide sod in the front and side yards by 6-30-05
2. Provide copy of verifying survey to City by 6-30-05
We will expect the above items to be completed by the scheduled dates and a reinspection
called for. The dwelling is approved for occupancy.
!f you have any questions concerning this matter, please feel free to contact me at 763-572-
3602.
N� t 1
ADDN ( J
ALTER [ J
�
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CITY OF FRlDLEY Effectiive 1/1/2002
6431 University Ave NE. Fridley, MN 55432 (763) 572�604 Bldg Insp
SINGLE FANqLY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: � �Q f''- / I'�'
Legai Description: � A�' J� 8 �'S 1 n �� �_�P��� � �(,p.� l�/�027�. ��a� .�
Owner Name 8 Address: �fe._v 1� �C,ourl�r� .[p2oQ �-4c.a,Ii�ox, f(. Te�. # 7(R3 5�� E OS �
ContraCtor. (�[tl aY TJl_n f o�X�O �/�1 C-- MN LICENSE #
Address: �3�.1 ID ���- �i �P l�(. �roG��,rJ L'�.�r�a- Te�. #�(�3 S(�O d/!,(3
LMNG AREA:
GARAGE AREA:
OECK AREA:
onaeR:
Attach to this application, a Certificate of Survey of the
lot, with the proposed consVuction drawn on it to scale.
DESCRIPTiON OF IMPROVEMENT
Length Vvdth Height Sq. Ft
Length Width Height Sq. F�
Length VVidth Hgt/Ground Sq. Ft
t►-ie► ro w�d I g u� Co .Q,� „n.n in m�oo� -
✓ ���
Construction Type: Estimated Cost: $ 32� �� _ y ��
•Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DATE: 71 I I I U�- APPLlCANT: C Tel. � I� f C.� C� -
�7 t�3 - SC�G a � d3
Call (763) 572-3604 fo� PeRnit Fees if mailing in application or Fax to T63-571-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ . as
$ � �O
$ �� � dd
$
$ �� �
$
�
$
�
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1200 per SAC Unit _ _ _
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Consen�ation Plan Review
Fee Determined by�Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ � d►� STIPULATIONS:
�c * �
* P10NEEp uv� a�mc,mas . ow. o�wmis �-85th Awnw N.N�
�, 8 � R�s • wosc.�c Mo.,�crs CO0" RO� IAN 35433
� * �4�'� i�3) 783-1de0 FiVf:7E3-iB83
Cez-ti�ficate of Survep lor, j' � r�
�Hottse Address: _ 62[I9 Heet,her PtA�
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MIOKA OO�NMTY. M�SpTA
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JOB ADDRESS
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310 Wexf'vrd Heigha Dr.
New Brighton, MN 55112
licensc #20003805
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•�X Footings will be 42" deep, 12" diameter • Rail height 36" min. • Step rise wili be 8° max.
• Structure wi11 be 2 x 10 GT • Rail space 4' max. • Posts will be 6 x 6
• Decking wifl be cedar • Step run will be 9° min.