AF - 46133\
t_ �
City of Fridley, Mirm.. , '
BUILDING PERMIT o
I�T. 4883
Date: ._..__��"'�t��._�.�-------
' � -`�`�
� ' ,. F �O �� eI
Owner: " . . . . � . ' --- `� :' ;�,�- •---�• • - �t.. � . �;,'' Builder ' __......_.._..___..__—_._
�-•--- --�-----.__--�-----..._ ...._._.�._._----..._
Address _��.� . "
,A
�..__.�. _. _... . �....���� Address _.----...... _ -::.�'� ..�_�.,°.. °:2.�.�.:��i .?�:ti �'�-..,�'._.....___------
�, '' L�, � TION F ILDING
No. _/.��..�..�.. . Street .._.-$2_�._.�r.._ ::_ .... .:.. ..._ .�..�#.....----- P "� of Lot ._.._...-•-----_.... ---_.. ._. _._.
. ..- -- '�'
Lot -------��--.----- Block --------•--- -----...---------..__---- Addition or Sub-Divisio�n ..�'t..�� -w--- °
. .._._ �. --- . _..
/,�� � - =---���'����
Corner Lot .........- - ......-----._.. Inside. Lot --- ---�!' - ..- •- -........ Setback ..... ...�..'�. ;�..._..---------- Sideyard .....----al.' ..�...... _�..� .............-- - --
Sewer IIeva.tion
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as: ,� �
� :�� - '� . :....._.. ..----. Front . . ..._,� Depth ... �,�....� Height .. __._ --� Sq. F� - /��w� . Ft ��±! ���'��,
f s� ,I /
� � s
, .__ , ...: ..... ..;...:.... �ron +r�;.. Depth ..���, ..-�'�' H ight �. .�...�.....�� Scl• Ft ��-d'-�� Cu. F't. .���'` .� �
•q�`." .... ---
T�e o Construction ._. ...�,�: .: _ _:-.. Est. Cost..,�_. � +�'�.f��. _..----- 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 compHance with all provisions of
ordinances oP the dty of Fridley.
4-!�-----...._.._.....__.._ __.�....._..._
In consideration of the payment of a fee of $.--- �-�----------., permit is hereby granted to....-------.---,------.--------------_------
._.___._.._.._ _. _.. _.._....._ to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all reapects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the dty limits attd this permit may be revoked at any time upon violatiari -o� any of the provisions of said
ordinances. ..��°' , � A
Inspector
NOTICE:
This permH does not covor the construcfion, fnstallallon for wiring, plumbing, gas heating, sewe� or watar. Be sure to see
the 8uildin8 InspeNor for separate permits for fhese kems. � ����°���
�•, q TH9S P'�.q(IIT Di�ES NOT AUTHORlZE V�OLAT�
_ (ON �F _ �Y t'F���a.ATE LAf�IL� C�JV NANT� Al��"
�`'�€� �� � QUILCJIf'��� FZL�-I i�';CTlOI�1S.�� —
Ownera Name
��e8a ��i�
�
Ai'PLIC�TI�N FOi� BIII�DING P�'
� CITY OF FRIDLEY, M�30Z'A
��
i�j�'���.�,� � e � � — _.
� - ��---�.
LOCATION OF BIIILDING
� _ A
No. Stree� ��_C� � Pert of Lot
R�/%�
Lot_„ � Blook . �ddition or S�b.Div._i�� ����� _-
Corner Lot,�,.Ins3de Lot_____, Se� Ba.ck c� � I Side-Yard �- �� ���
S� ELEVATION FOUNDATION ELEVATION
lpplicant attech to this form Certific�te of Survey of Lot �nd propos�i buildiag
location.
DE9CRTPTIOAi OF BUILDIlJG
To be used ass / `
�'roat � � Depth � � Height � ��'��
' °� a�'1 i � �� ,
Sq. Ft. � _ .
_���•�� `��
� �. i . - r
�
Sq. Ft. Cu. Ft.
q/+^�.� Estimated Cost � b � D�
Type �� Gnstruction_� ,.
To be
.,
The undersigaed her�by makes applicat3on for a perm3t for the work herein speciPied,
ag�ee5.ng to do al�. work in striat accordance with the Cit�► ardinance� and rul3ag of
the Departament of Buildings, and hereby dec]:ares that all the facts and representa-
tione stated 3n this e.ppl3cation are true snd ect.
n� ,� I �,� � q b � � sic�� � �
(A 5chedvle of Fee costs can be found on the Reverse Side.)
� �
� ,� _ --
BOILDING PERMIT FEE SCHEDULE
�vtion 2. The Inspector of Buildinga shall, before isau3ng any perm3:t
for the ereation of any bu3.lcling or atructure, or for any addition to
any exiating buildin� or atructure, or for ang alterations or repair�
to.a�► ex3ating bu3lding'or structure, upon epplication therefor, require
the pa�ment by the applicant for such permit vf fees to the amount here3.n
be3ow set Forth arnl in the ma,nner herein proeided to-wit:
2.1. For an� such pesmi� for the erection cf any fire-proof build,ing,.other
thstn a gaxa�e, warehouse, factory or grai.n elevator, or for the erection of
any fireproof addi�ion, Por s3milar accupanc�r, to anq existing buildin�
ahall be at the rate of .�1./�.0 for ee.ch one thous�.nd cubic fee�, or Fract3on
thereaf, in such cubical contents. _, ,
2.,2� For any such permit i'or the er�ction of any firegroof garege, were-
houa�� factory or gra.in elenator; or for the erection of ex�,y fireproof
addit3on for aimilar occupancy, to any exist�ng building eha11. b� at the.
rate of �7..2� for each one thouaand cubic feet, classii'ied as "f'�seproof�
b� 3ect3oa 502 of the Minneedpolis Bu3lding Code.
OUSES �
2.3. For an� lsuch permit for the ereetion of any non-fireproof building
other t�ian a garage, warehouse, fac�org or grain elevator, or any non-..
Pireproof addition, for aimi].ar occupancy, to anq e�.sting build3ng.
Permit �7..00 for each one thousand cubic feet.
GARAGES .. -
�
2.4. For ar� such perinit for the erection of any non-fireproof garage,
warehouse, fac'torg or grain eleeator� or £or the erection of any non-
fireproof addit�.on, %r similar occupanc�, to aay exist3n� building �r
for ee.ch auch build3ng or add3tion. Ninet�r Cents for each one thousa,nd
cubic feet or fraction thereof, in the c:ubical contents thsreof with a
mirimnm p� �/�,..00. ' .
For ihe.purpose o£ computing fees for bu3.lding permita the�cubical contents
of any building or addit3on to a uniform height throughout b,y ncultiply3ag �
the ground area covered from a point aix.(6) inches below the floor line of
the basement or cellar to the average height of the upper eurface or ta the
evera�e height of the roof surface af the main gable of a pitched roof. .
�
2.5. For repairs or alterations to an exiating atructiare, the fee she].7. be .
at the re.te of �3.00 for each Five Iiundrect Dolla�s (�5�•40), or fraction
thereof 3n tlae cost of all proposed work. �
2.6. In no-c�se sha1l the fee charged for any permit e.s set forth in
Secti�-�" be less than $4.�.
,� �
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FaARV�Y A. CARTWRIGFiT � ��� &�� co+wr��rNa TN� �ccoRO� oF : •
. wwoaw couNrr suRVSrs J. E. M1LL, C�vu. �Ha�HS�R
aKwn+�NSO tMs
MiNM�1t?I COUNTY su�vcrs j,AND SUR VEYO�S - c. f. swNO�oFF
1Mtn►uw►o��s wwvErs .
Qtt6 rALM 9TRE�T N. W. RtallTtRtD YND[I! LAYYS OF' iTA1[ OF- M�NNtlOTA ClVIL EN�IM�RR '
tstns�n«sb trw
•UN�[r 4-745s �;���ySQ �Y OR�tNANCt Q1r ' CITY Or MINNtA�OLIi
owNee JAMES NELSC3N
S26 PLYMOUTM BUILDING FEOtnw� 8-6721 g��Ryp�
.uiDUltR1AL - �uD�ciwL HENNgPiN AT SIXTH • MINNEAPOLIS 3. MIN[VESOTA �'w����~� ��
�us�NCSf - ToroORwt�►Iit�� �Y OT�� dliti�i[��[ M16il�OPOI.ITAN LAND
. C11'7 LOT! - ►LATTINit . � ' $NR1ftYORf. [sYw�tpwEO ��s�
, G�.en Leater. I.r��ce 200,�7 �
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S' ` NAME /� N6de1�I� D ��R�z � DATE NAME �`�� �5���
HTG . CONTR . LADDRESS �J � � /� '�OB [ADDRESS ��3'% �� f��''�'L�:�
FL. `� v ROOM LENGTH ���W 1 DTH ���t1E I GHF �' � FL . /��,�''� ROOM LENGTH � W 1 DTH � HE I GHT �
WINDOWS AND DOORS.CRACKAGE AND AREA WINDOWS AND DOORS-CRACKAGE AND AREA G�L
N0. WIDTH HEIGHT No. OF LINEAL FT AREA �""�L N0. WIDTH HEIGHT N0. OF LINEAL FT. AREA O
LIGtiTS OF CRACK SQ. FT LIGHTS OF CRACK SQ. FT
� o _- — � e
� ' G � !�� !
�- a- �- � � ao
G � � 9 ' �' y s
COEF. BTU
INFILTRATION / � o INFILTRATION
GLASS 3 � /� GLASS
EXP. WAIL ��� EXP. WALL
NET EXP. WALL ��� � �/,o NET El(P. WALL
CEILING 3 � ,� �� �,Q CEILING ��
FLOOR �Vf'� FLOOR � �
,�
TOTAL BTU. � o? �� TOTAL BTU.
_ --- - —
FL. ��i� ROOM LENGTH �j WIDTH �� HEIGHT � FL. ��� ROOM LENGTH 3��WIDTH
WINDOWS AND DOORS-CRACKAGE AND AREA WINDOWS AND DOORS•CRACKAGE AND AREA
,NO. 1VIDTH HEIGHT N0. OF, LINEAL FT. AREA � S� N0. WIDTH HEIGHT N0. OF LINEAL FT. AREA
LIGHTS OF CRACK SG. FT. LIGHTS OF CRACK SQ. FT.
3 '�-a �- � 3 �-� r1 � 2 � a y �
� � �
COEF
� O
.� °
BTU
HEIGHT �
��L
���
? � l� �� a-� � � � S I �
SO'
COER BTU. COEF. BTU.
INFILTRATION � 3 D 3�'� INFILTRATION � �� J O P'O
GLASS
EXP. WALL
NET EXP. WALL
CEILING
FLOOR
FL. ��-�� ROOM LENGTH � WIDTH
WINDOWS AND DOORS-CRACKAGE AND AREA
N0. WIDTH HEIGHT N0. OF LINEAL FT. AREA
LIGHTS _OF-CRACK- Q-. FT.
� /!r �. �'� �.3
�
INFILTRATION
GLASS
EXP. WALL
NET EXP. WALL
CEILING
�-S
�Q � GLASS �� SO ����
EXP. WALL �/�
� �� NET EXP. WALL �� 0 ��
D � �� CEILING �� D B"a-a
FLOOR l ��
�D TOTAL BTU . � � � �p,�
���HEIGHT fi`i FL. �� ROOM LENGTH S,� WIDTH S,3 HEIGHT g°
WINDOWS AND DOORS-CRACKAGE AND AREA
��LN0. WIDTH HEIGHT N0. OF IINEAL FT. AREA �� ._
. - ---- - LIGHTS UF CRACK SG.-FT. - — -- - -
� � �� � �� � � � �
G � ��
��
COEF: BTU. COEF. BTU.
� .tNFILTRATION O �
3 �Q �� GLASS �' �Q � P%B�'
8 EXP. WALL =
� ��� � � � NET EXP. WALL (lf ,(, �D
SQ �� CEILING O ,��
� FLOOR
FLOOR s� f"i�y�0
�
TOTAL BTU. � �� TOTAL BTU.
�'/ L/N �� �c�L ° — --
/�
�n L s/t/ G� �G,*a°L S���o�r�.
TOTAL BTU. HEAT LOSS TOTAL E.D.R. STEAM TOTAL SQ. FT. H.W.
HEAT I NG UN I T �`� ��
rNAME - - DATE NAME
H T G. C 0 N T R. LADDRESS J O B [ADDRESS
FL. ��� ROOM LENGTH �� WIDTH �� HEIGHT � FL. ��OOM LENGTH WIDTH HEIGHT
WINDOWS AND DOORS.CRACKAGE AND AREA (��J WINDOWS AND DOORS-CRACKAGE AND AREA
N0. WIDTH HEIGHT No. 0� LINEAL FT AREA �O G� 0. WID,TH HEIGHT N0. OF LINEAL FT. AREA
LIqiTS OF CRACK S0. FT. LIGHTS OF CRACK S0. FT
3 ?� � /0 G � � � ,�'
� .� �-� 1
� D �
�s � � 9 rA � / �
COEF. BTU COEF. BTU
INFILTRATION � 7 �iO � INFILTRATION �j �G �
GLASS / � : � GLASS � �� (�g� ��
EXP. WALL �" EXP. WALL "� � �
NET EXP. WALL ��� �� NET EXP. WALL ��_
CEILING � � CEtLING �
FLOOR �� FLOOR 'i� �� 3�
� �� � �
TOTAL BTU. ��� � T L BTU. �, �
FL. �� ROOM LENGTH o� WIDTH % HEIGHT � FL. ROOM LENGTH WIDTH HEIGHT
WINDOWS AND DOORS•CRACKAGE AND AREA WINDOWS AND DOORS-CRACKAGE AND AREA
N0. WIDTH NEIGHT N0. OF LINEAL FT. AREA N0. OF LINEAL FT. AREA
LIGHTS- OF CRACK S0. FT. � N0. WIDTH HEIGHT LIGHTS OF CRACK S0. FT.
�:L � �,- � �' ,��
�►
�--- .
COEF. BTU. COEF. BTU.
GLASS
EXP. WALL
NET EXP. WALL
� INFILTRATION
�' GLASS
EXP. WALL
,� NET EXP. WALL
s� CEILING
FLOOR � �"� FLOOR
TOTAL BTU. � � TOTAL BTU.
FL. ��/�ROOM LENGTH� � WIDTH HEIGHT � FL. ROOM LENGTH WIDTH HEIGHT
WINDOWS AND DOORS-CRACKAGE AND AREA WINDOWS AND DOORS-CRACKAGE AND AREA
N0. WIDTH HEIGHT N0. OF LINEAL FT. AREA � N0. WIDTH HEIGHT N0. OF LINEAL FT. AREA
_ _ _ __ _ L 1 GHTS OE_CRACK_ SQ, _F_T. .�� � _ . .— --- - � L 1 qiTCr- OF CRACK � SQ:-FT.- — -�-- �-- - —
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� � .Z /�' �o /e/ a
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COEF: BTU.
INFILTRATION
GLASS
EXP. WALL
NET EXP. WALL
CEILING
FLOOR
TOTAL BTU.
TOTAL BTU. HEAT LOSS
HEATING UNIT
�� .INFI,LTRATION
� ���� GLASS
EXP. WALL
' � �,� NET EXP. WAIL
!,� � CEILING
FLOOR
TOTAL BTU.
TOTAL E.D.R. STEAM
FOTAL SQ. FT. H.W.
COEF.� BTU.
. s � NAME � _ `' s ?
HTG . CONTR . [ADDRESS ,'`�`G1�61�
FL . BQSG- yy,s ROOM LENGTH � W I DTH � HE I GHT
r
WINDOWS AND DOORS-CRACKAGE AND AREA yA,<
N0. WIDTH HEIGHT No. OF LINEAL FT AREA �d J��
LIqiT3 OF CRAp( S0. FT.
3 3z 20 � _3/ /�
DATE rNAME � /� � �' � S �� �
.I O B L ADDRESS � J � � �����'° �� "
FL . ROOM LENGTH �� W I DTH / HE I GHT�
W I NDOWS AND DOORS • CRpCKAGE AND AREA �� L
N0. WIDTH HEIGHT N0. OF LINEAL FT. AREA
LIGHTS OF CRACK S0. FT
�2 �� � � . �
COEF. BTU COEF. BTU
INFILTRATION s2 � INFILTRATtON ,� � �� ��%
GLASS / � � GLASS �% � Sa `��7 C�
EXP. WALL G � EXP. WALL � p �, � O
NET EXP. WALL ^� y � ��� S'� �O►�� NET EXP. WALL � t f �--- s V 0���,/'O
CEILING � CEILING � �� G
FLOOR � �I � �i FLOOR � �
� G-�- c. i .9 — � � �r -�-- G� � 3` e� �
TOTAL BTU. ' � � TOTAL BTU. �° ] '
FL. ROOM LENGTH � WIDTH ��I HEIGHT � FL._ ROOM LENGTH �� WIDTH _��HEIGHT�"
WINDOWS AND DOORS-CRACKAGE AND AREA WINDOWS AND DOORS•CRACKAGE AND AREA .,�' �
N0. WIDTH HEIGHT N0. OF LINEAL FT. AREA � �.J � N0. WIDTH HEIGHT N0. OF LINEAL FT. �AiiEp ��+ �
LIGHTS OF CRACK SC: FT. I.IGHTS OF CRACK SQ. FT.
3 3 � �. v / . . � � 3 � � � � �.�
. �. .
� COEF. BTU. COEF. BTU.
INFILTRATION 3 � �� � � INFILTRATION �C �"�
GLASS � ,~o � GLASS � 3 ° ��
EXP. WALL "�q EXP. WALL �r a�, �.� ��%
NET EXP. WALL � �~ �� NET EXP. WALL � S" ��
CEILING � � CEILING
FLOOR � �� C� � �' FLOOR Z� `�
i � �.- � �A,e �� o s� � .c� G� �. �.-�' e GD .� �
TOTAL BTU. �/ � � TOTAL BTU. �,� � '�
FL. ROOM LENGTH �� WIDTH �� HEfGHT FL. ROOM LENGTH z� WIDTH� . HEIGHT
WINDOWS AND DOORS-CRACKAGE AND AREA WINDOWS AND DOORS•CRACKAGE AND AREA
N0. OF LINEAL FT. AREA ('� � N0. OF LINEAL FT. AREA �S�'�
_ NO..__ WIDTH _HEJ__GH_T__ . Lag�{ �_� �� ____ J( �_ N0. WIDTH HEIGHT LIGHTS. OF CRACK S.Q�FT_._ `� �`_"�
�-�"- - - -- - - - - - - --
,2 .3 �'Z 2 � �. / �i 3 � � � c� � ��"�� � �� --
� � � � �+► �° ' � S�
.r----'
,/�
COEF� BTU. COEF. BTU.
INFILTRATION � � Y � . INFILTRATION �j'�� �, � �
GLASS �� S'�� � S�� GLASS � S 'sRG ��.�~5e�
EXP. WALL � � � - EXP. WALL
NET EXP. WALL � /��0 � NET EXP. WALL
CEIL'ING � � �° CEILING
FLOOR � ��I Z � FLOOR
� �-li �� �' Y �- s� /O �-
TOTAL BTU. �j0�, �°'°^ ? TOTAL BTU.
(� Z S�
TOTAL BTU. HEAT LOSS TOTAL E.D.R. STEAM
HEATING UNIT
r
r�
TOTAL SQ. FT. H.W.
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'l.> Ctnnpx+�� �� i� t�� �b��� �t� �t� ���� ���� �
� � fi�� �:Q ���� l��t+�'�+� ���2� �� ���;��
tFi���� ��+� ��+ �r� cr���t� �r ��? �r� ��m �:���p� a� �� �et�er,
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: �.u�+i��7.�,
�t.fi.7�1.,� -
8��3+d� it���tQr
�/�h
�s ���r �4.'���1E�
30 Gd 175 Claymore Lane
Na�erville� Illinois 60540
February 7. 1970
Mr. Clarence Belisle
Buildin� Tnspector
r�ridley Cit� Ha11
6�31 University Aveune, 1V.E..
Fr�dley� Minnesota, 5��21
1�ear Sira
Tn regards �o your letter concerning ou� house
at 1337 ��-llcrest Drive, we are arnra.re of the items
you. ment3on as needing to be finished and inter�d to
take care of them �.s soon �.s possible. T�owever, due
to a number of illness�s in my family which has pre-
�ented my return previously and. the fact that �e
are ivorking out of state temporar3ly m.akes it im-
possible to complete th.e items u�ithin the thirty
da� limit set. Since 1 work five days a wee7�,T have to
leave here l�.te �r3.day and ��t there some twelve hours
later� if and when my 1960 B�ick dec3.des to run �rh3.ch
3sntt alwa.gs, th.en return on Sund.a.y, leaging g�r�r few
hnurs to ti�ork and sleep on Saturday.
Th�mefore � we ��uo�ald
as T intend to re�urn the
able to comply ti,�i. th gour
that time� or �uly first.
yourconside�ation in this
is being sent to the Cit�r
Cca Cit� Atto�neg
like an egtension of time
first of June and should be
�eq�.est b� thirty days from
We would gre�.tly appreciate
matter. 8 copy of this lette�
Attorney.
Yours truly�
_.� /s^ �
��(�,��
�.G��n zester
d�� P�i - ' '
�
' REGULAR COUNCIL MEETING OF JULY 26, 1976
RECEIVING THE MINUTES OF THE PLANNING COMMISSION MEETING OF JULY 14, 1976:
�
-' I>� Y. KLUCSAR, SPECIAL USE PERMIT SP#76-10; 1337 HILLCREST DRIVE, N.E.:
V�
,ti
PAGE 3
Mr..Richard Sobiech, the P.ub]ic Works Director, pr�ceeded to explain the Klucsar
request for a special use permit which would allow the construction of a second
accessory building in excess of 240 square feet at the petitioner's home residence.
Mr. Sobiech stated that Mr. Klucsar was present. Mr. Sobiech further stated that
�the public hearing was held by.the Planning Corrmiission on July 14, 1976, and a
motion was passed recommending approval, however, there were two stipulations. In
discussion �vith Mr. Klucsar, his intentions are to utilize the second accessory
building for storage purposes and to place such_structure in the northwest corner
of the property.
Councilman Starwalt stated that he had reviewed the property and felt that a survey
of the property would be in order and that Mr. Klucsar is aware of that.
MOTION by Councilman Starwalt to approve the request for a special use permit as
recommended by the.Planning Commission with the added stipulation that a suitable
survey be taken. Seconded by Councilwoman Kukowski. Upon a voice vote, all voting
aye, Mayor Nee declared the motion carried unanimously.
K. M�SROBIAN, VACATION REQUEST, SAV #,76-04; ALLEY BETWEEPI LIBERTY AND ELY:
Mr. Richard Sobiech, the Rublic Works Director stated that there was a great amount
of discussion concerning this as indicated in the Planninq Commission minutes, and
.•uFlless there is a desi,r•�.-to•-ga<,into the matter now, the request ;s for a public
"' c hearing. He stated that the date of August 9th is an error; it would have to be
September 20th in order�.to meet the requirements for a public notice and that the
petitioner has been so advised.
MOTION by Councilman Fitzpatick to set a public hearing for September_ 20, 1976.
Seconded by Councilwoman KukowSki. Upon a voice vote, all voting aye, Mayor Nee
dec]ared the motion �ar•r�.ed•.unanimously. �
HUMAN RESOURCES COMMISSION-MEETING OF JULY l, 1976:
1977 BUDGET REQUESTS:
Mayor Nee stated that the Planning Cortonission did not concur with the recommendation
of the Human Resourees•Correnission regarding the budget disbursement of $10,000.
Mr.Sobiech, the Public Works Director, said that any time minutes come from the
Planning Commission with.a statement that specifically says, "recommend to
Council", it is brought to the City Council's atteniion.
-• Mr. Nasim Qureshi, the City Manager, stated that Nancy Lambert, who is on the Human
Resources Corrunission, would like to discuss the matter further.
� Nancy Lambert then discussed the fact that there is an error in the minutes of
; which she was unaware. She further stated that the Human Resources Commission
' merely used the $10,000 figure as a simple divider. The Human Resources Commission
complied with a request from the Staff that request for funding be reviewed so
� that priorities could b� listed in accordance to the receiving of the funds, and
�, that was what they tried to do. Ms. Lambert stated that she discussed the
� Planning Commission's decision with Mrs. Shea, who was absent from the Commission's
; meeting, and they both felt that they were requested by the Staff to make
recommendations for budget money priorities and now, the Planning Co►mnission
� disagrees with this.
� Mayor Nee asked Ms. Lambert i,f she was aware that the City Council took the youth
.._�...�enter into the recr�ea�i.oA>area. She replied that she was not. She then asked if
� all requests from Senior Citizens are to be delegated under a Parks and Recreations
need. She stated that some funds should be designated for human develapment and
ecology.
__
,A--___..�
1`1G
' REGULAR COUNCIL MEETING OF JULY 26, 1976 PAGE 4 �
1
, Councilman Fitzpatrick then questioned if the 20� which was recommended for
social services would go to the IVorth Suburban Family Service Center. Ms. Lambert
' said that 20% of the budget should go to social services, and it was to be
decided later which agency vras to be the,recipient of the 20q. Ms. Lambert
further made reference to the Coon Rapids Pducleus Clinic whereby there was a
� duplication of services. For example, several alcoholic anonymous type
! programs which are being given elsetvhere.
Mr. Qureshi, the City Manager, stated that the City's desire was i:o get some
input from the Human Resources Commission to review some of the human concerns
and the money allocation be priortized. P�s. Lambert stated that the Human
Resources Commission should have a budget as the other cortmiissions have a budget
and when they receive a request for funding, they should not have to go to the
City Council contingency fund since the Parks and Recreations and other commissions
do not have to do this.
The City Manager stated that there is a budget for the Fluman Resources Commission
for its advisory activity studies and for all commissions and that no corrrQnnission
has an operating.budget. The budget is controlled by the City Council.
� Mayor Nee then commEnted that the Human Resources was a new commission, and the
P.arks and Recreatior� Commission had made recommendation for Parks and
� R�Creation services. The services requested are actually funded in the City
budget and the process started the year before; therefore, the reason that the
� Human Resources Cortmission had to ask for money out of the contingency this past
; year was that no budget process was established. However, for the coming year,
� a budget process wi1T be established, Mayor Nee said the Parks and Recreation �.
Cormiission makes their budget recommendations to Mr. Qureshi, the City Manager,
� and he sorts out his findings.
Councilman Standalt asked Ms. Lambert ��f she had seen the minutes and she
� responded that she had not as she never received a draft of the minutes. He
furtherr stated that she needed to have an admi�istrative budget and that in his
opinion, should not have a project-operating budget which you could expend at
� ._.. your own discretion. He stated no corrQnission has that. Councilman Starwalt
mentioned that the $10,000 figure would be striken and Ms. Lambert agreed.
MOTION by Councilman Starwalt to receive thQ minutes of the Planning Commission meeting
of July 14, 1976. Seconded by Councilwoman Kukowski. Upon a voice vote, all voting
�
aye, Mayor Nee declared the motion carried unanimously.
� RECEIVING THE MINUTES.OF THE CABLE TELEVISION MEETING OF JULY 7, 1976:
! MOTION by Councilman Hamernik to receive the minutes. Seconded by Councilwoman Kukowski.
� Upon a voice vote, all voting aye, Mayor Nee declared the motion carried unanimously.
� CONSIDERATION OF A REQUEST FROM P4INNESOTA HISTORICAL SOCIETY FOR FUNDS TO PERFORM
� FIELD CHECK FOR HISTORIC OR PREHISTORIC ARCHAEOLOGICAL STRUCTURES IN NORTH PARK:
I
� Mr. Qureshi, the City Manager, said that this field check is a requirement in areas
� where there is a potential for archaeological finds. Mr. Qureshi stated that we have
� received a$534.00 figure which is the approximate cos± of the first phase of the survey
for this project and the City Council should decide whether or not this money should
be spent. The City of Fridley is attempting to find out if the survey cost could be
� used as a part of the City's share of matching grants from the Department of Natural
� Resources.
Councilman Starwalt asked if there was anyone in the audience to discuss this. He
further stated that he would•like to see someone do the preliminary survey per gratis
from the foundation and thereby saving the foundation this expenditure.
SUBJECT P
City of Fridley � 13'705
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T •
i �
� �
� `y ____�_ COMMUNITY DEVELOPMENT DIV. ����/
r � � PROTECTIVE INSPECTION SEC.
�
1 ` �
1� /"'1 � CITY HALL FRIDLEY SS4$Y NUMBER REV. �ATE PAGE OF APPROVED BY
""'�'� ,'� 612-560-3450
910-F15 8/17/76 � �
J09 AODRESS 1337 Hillcrest Drive N.E.
1 LEGA� LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2Q 4 Nioore L31SE �.7.�.�.S SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Yoava Klu@sa�, 1337 Hi.11crest Drine N.E.
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
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
X NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 24' x 24' Stora e Buildin
9 CHANGE QF USE FROM TO
STIPULATIONS
Owner agrees that he will not attach the garage to the house and
therefore will not install frost footings for garage. Owner to maintain
3 feet�a 5 feet setbacks
Second accessory building approved by Council on August 16, 1976.
�/�r'S;�GL- �� 6' ��'� —.� �i,�� tdl��4�f.. f/U
���� �« �s� � �� s� � � �IARI�I��
6efote digging call local utilities
TEtEPHONE • ELECTRIC . ��S ���,
REC�UIRE� �Y ��
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOCZ FY'3IIl@
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. 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 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 4.262.40
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $ $2• �-3
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. � $23.04
PLAN CHECK FEE TOTAL FEE
$25.17
� G TUREOFCONTRAC ORAUTHORIZEDA6ENT (DATEI �1�IH PROPERLY V LIDATED THIS IS YOUR PEI�RM T/y
r. �� � � �/ / ,
.` e� �
SIGNATURE OF O 11F OWNER B ILDERI IDAT 1 BIDG INSP TE
r�
��
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL ALTERATION,
ADDITION, OR REPAIR BUILDING PERMIT
OWNER' S NAME :� �.P E/�� BUILDER:
ADDRESS : • f LG ���5� � ADDRESS :
NO•. STREET:
LOT : ``" O }
BLOCK : � ADDITION : �bf�� �F��� r G L�'
.
COItNER LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form �ao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
HESCRIPTION OF BUILDING
To Be Used As:
� ���`ff��_ Front :� � �� Depth : � `� ��- Aeight :� j`
---�
� � 7� a
Square Feet: Cubic Feet: � ,
Front: Depth: Height:
Square Feet; Cubic Feet:
�ipe of Construction: G(/�� �%� Estimated Cost: $ /J o2�0�- �0
To Be Completed:
The undersigned hereby ma.kes application for a permit for the work herein
specified, agreeing to do all work in stiict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. � -
� . L'
DATE : � � � �� S IGNAT[1RE : �-
(See Reverse Side For Additional Informat n. ) 2� ���.f (,�..,.,.l�,
r L i
7
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_,�
�BUILDING PERMIT FEE SCHEllULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erection of any building or structure, or for 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;
1�lEW CONSTRUCxION: S�,z�g],e Family Homes and Garages: $4.00/1000 cubic feet
PLAN CHECK: 25 percent.of building permit fee.
ADDITIONAL INFORMATION
Fox the purpose of computing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the gxound area
covered from a point six (6) inches below the floor line of the basement
or the ce�lar to the average heights of the upper surface or to the averages
�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 work.
Tn no case shall the fee charged for any permit as set forth in Section 2 be
less than $7.50.
VERIFICATION OF FOUNDATION
.
NOTE: 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 Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceedin� with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be ma.de ten (10) days prior
to the use or occupancy of �ny structure for which a building permit has been
issued; and said structure s�iall not be used or occup3ed until a Certificate
of Occupancy has been issued.
..
� . ,
�
i -
GERALD T. COYNE
3d0 BRUNSWICK NVE S.
GOLDEN YALLEY, MINN.
MINN. REG. NO. 4741
INDUSTRIHL — JUDICIAL
COMMERCIAL — TOPOGR^PHICAL
CITY LOTS — PLATTING
LOT SURVEYS COMPANY
LAND SUItVEYORS
REdi$1'EBED UNDEB I�AWB OF BTATE OF MINNE80TA
LICENBED BY ORDINAIVCE OF CITY OF MINNEApOLIB
5747 W. Broedway 533-9922
Minnaepolis, Minnesote 554I8
�11irUP1JDx8 �Pl'f�fttg�P
YOAiIA KLUCSAR
� �,
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�9aE fa)
RAYMOND A. PRASCH
6917 ID11H0 /1VE. N.
BROOKLYN PARK, MINN.
MINN. REG. NO. 6743
I NVOICE NO. � � � 1
F. B. NO. l�b
SC�uE r' = 3 p �
O — DENOTES IRON
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Lot 20, Block 4, Moore Lake Hills, Anok� C�,�x�nty. Minnesota.
We hereby certify thef fhia ic e true end correct �epresentetion ,�
of e survey of the bounderiea of the ebave des�ribed (end end e°
fhe locetion of ell buildinge end visible encroechmente, if any, ;,
from o• on eeid laed. S�� �� �'_ r" �1"' ��„� - i �r � P` r"� a' _ w
�,,
Suneyad by os this 2�dey of. July iv,� LOT� URVEYS COMPANY ��
,
SUBJECT . O.
City of Fridley 216 7 2
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � RECE .
� ; L _ COMMUNITY DEVELOPMENT DIV.
r � � � PROTECTIVE INSPECTION SEC. /�� 7
`� _ �
--_.� � "',', CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APCROVED BY
i' 612-571-3450 910-F15 11/23/92 / /
108 ADDRESS 1337 Hillcrest Drive NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 20 4 Moore Ird.kE H111S SHEET
2 PROPERTYOWNER MAILADDRESS 21P PHONE
Yoava Klucsar 1337 Hillcrest Drive NE 574-9724
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Ching Johnson Co Inc. 3507 W 50th St M ls. MN 55410 920-1787 3409
4 ARCHITECT OR DESIGNER MAIL ADDFIESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Res ide ntia 1
7 CLASS OF WORK
❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE � REMOVE
X
8 DESCRIBE WORK
Reroo� Gaxage (6 S axes� Tear-o��
9 CHANOE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OH AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WOFK OR CONSTfiUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK 13 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 OFDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIPIED HEREIN Ofi NOT. THE GRANTING OF A PERMIT $3�-8 $, �Q
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PqOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCT N OR THE PERFORMANCE OF CONSTRUCTION. $�.5, OO k'i.re S�C $. 32
e PLAN CHECK FEE TOTAL FEE
l� �� ��� License SC $5,00 $20. 82
SIGNATURE OF CON i RACTOR OR AUTNORI2ED AGENT 1DATE1 /^ � U�HE P�EHIY� VA ATED THIS IS VQUR PER I/--�
_ � �/ ?
.,
SiGNATUREOFOWNERiIFOWNERBUILDEHI �OATEi LDG �NS� Oa7E
NEW [ ]
ADDN ( ]
ALTER [ ]
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Eifective 3/ 1192
consaucaon Adaress: `3 3`1 t} i�-�-��s�- D2 t�2.� �L�-�
Legal Description: 17r 11/� cti-r� �A-��
Owner Name & Address: ��cy��i� ��-�5� - SA � � - Tel. # �J �7� 47Z�/
Contractor: ��-z�1 C� �� N-„1 S eaJ Ca `r3 C. MN LICENSE # 3y � e/
Aaar�: 3s�� w- ��� s�- ,�P`5 � M� SSy 1� me�. #�� -t� ��
Attach to this application, a Certif cate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Le�gth
Length
Length
DESCRIPTION OF IMPROVEMENT
Width
Width
Width
Height
Height
Hgt/Ground
- ��
Sq. Ft.
Sq. Ft.
Sq. Ft.
� ����e � �
Corner Lot [] Inside Lot `�j Ft. Yd Setback Side Yard Set6acks
Ty� of Consiruction: f�,�/{��T n.gr���S 3�, St4-�a��-*'z Estimated Cost: $�Z5'�� ���� =`:
Approx. Completion Date: � �� 23 � Z ���
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x$ _$
DATE: ��-23 `� Z APPLICANT: q Tel. #�� `� I'-7 �%
Permit F� �
Fire Surcharge $,
5tate Surcharge $.
SAC Charge $
License Surcharge $_
Driveway Escrow $_
Park Fee $.
Sewer Main Charge $_
TOTAL
STIPULATIONS:
�c �' �=°
-�
��
<� »
�.C�L�
$ ��"> � �`��
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,OW Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Fee Deternuned by Engineering
Agreement Necessary [ ] Not Necessary [ ]
��
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of aay building or structure,
or for any addition to any existing building or sbructare, 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 $2,0�
$2,OQ1 to $25,000
$25,001 to $50,000
$50,(�1 to $1�,0(�
$100,001 to $S�,OQO
$5�,�1 to �1,000,000
$1,�Q,001 and up
FEES
$15 (Minimum F� is $15 plus surcharge)
$15 for first $SOQ plus $2 for �ch additional $100 or
fraction thereof, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1,�0
or fraction thereof, to and including $25,Q00
$252 for first $25,000 p�us $6.50 for each additional $1,�
or fraction ther�f, to and including $50,0�
$414.50 for first $50,�0 plus $4.50 for each additional
$1,000 or fraction thereof, to and including $1�,000
$639.50 for first $1�,� plus $3.50 for each additional
$1,� or fiaction thereof, to and including $500,(�0
$2039.50 for the first $500,� plus $3 for each additional
$1,� or fraction thereof, to and including $1,(�0,000
$3539.50 for the first $1,�,� plus $2 for �ch additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A" : Removal aad replacement of curb and gutter only - Driveway width plus 6 feet times
$13.50.
Altemate "B" : Removal and replacement of curb and gutter and install a 3 faot wide
approach with 6 inch depth - Driveway width plus 6 fi�et times $15.75 .
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow
for proper review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been
constructed will be required before proceeding with the framing-
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CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1.
2.
3.
4.
5.
6
Has been carefiilly examined
Is firee from nist or deterioration
Has no foreign objects lodged within
Is securely supported
Meets all current Code requirements for size
and total BTU's connected
Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater
yes�f No ( )
yes (� No ( )
/`
yes� No ( )
Yes �j No ( )
yes �) No ( )
yes ( ) No ( )
8. Has combustion air been provided for water heate
0
f��c�[- �j� �dv�t�4 l.� �
Remarks: . (,�� �� ��!!,Nl��
HEATING CO:
Signed By:
Date:
sus�Etr PER
City of Fridley
AT TME TOP OF TNE TWINS g � I L D I N G P E R M I T � 9 0 6 7
r
; � CEIP .
� ; y _��__ COMMUNITY DEVELOPM�NT OIV.
f � � PAOTEC7IVE INSPECTION SEC. ��� �
i = �
� r'°1 � CIiY HALL fF10LE� SS�JY NUMBEii REV DATfi VAGE OF APPROVED 8Y
�----� • •'' 612-571-3450 910-F15 3/25/99 / /
108 AODRESS �
1337 Hillcrest Dri e
t IEGAI lOT N0. BLOCK TRACT OR pDDIT10N SEE ATTACNED
OESCF. 2O 4 M ore Lak lls SHEET
2 PROPERTY OWNER MAIL ADOp�S$ ZIP PNONE
Nam N u en 33 572-1196
3 CONTRACTOR MAIL ADORESS Z�P PHONE UCENSE NO
& 85 - 365
a AfiCHITECT OR DESiGNER MAI ADORESS ZIP PMONE LICENSE NO.
20091282
5 ENGINEER MAIL ADDRE$S 21P PMONE IICENSE NO
8 USE OF BUILDING
esiden ial
7 CLASS OF WOFiK
❑ NEW O ADDITION O ALTERATIpN pX REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Gara e ear-off
9 CHANGE OF USE FROM TO
STIPULATIONS �
Underlayment must comply with the State Building Code.
CONSTRUCTION WORK IiOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMI7S ApE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYP� OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTILATING OH AIR CONOITIONING
THIS PERMIT BECOMES NUII AND VOID IF WORK OR CONSTRUCTION 20NING SQ. fT CU fT
AUTMORIZED IS NOT COMMENCEO V�IITHIN 80 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPEN�EO OR ABANDONEO FOF A PER100 OF 120 DAYS AS
ANV 71ME AFTER WORK IS COMMENCED. NO. OWLG. UNI7S OFFSTpEET PARKING
I MEREBY CERTIFV 7NAT I MAVE READ AND EXAMINEO THIS APPGICATION S7A�l.S GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. AI,L PROVISIONS Of LAWS yq�UAT10N SUR7AX
AND ORDINANCES GOVERNING TMIS TYPE Of WpRK WILL �E COMPlIEO
WITH WHETMER SPECIFIED MEREIN Ofi NOT. THE GRANTING OF A PERMIT �3,685 �I..B�F
DOES NOT PRESUME TO GIVE AUTNORITV TO VIOLATE OA CAMCEL TME pEIiMIT fEE SAC CNARGE
PROVISIONS OF ANY OTHER STATE Ofi LOCAL LAW REGULATING CON-
STRUCTION OR TNE PERFOR NCE OF CO TRUCTION $8%. ZS F e SC �3. E)8
3� � PLAN CNECK FEE T � FEE
Lice $5. $97.77
-_ S�GNGTUAEOFCON"AACTONOpAUTMOp�ZEDAGENT �D� Ei EN OP VALIO D TNIS IS�yQUR P FMI
� ii
4/
S�GN4TUqEO�OWNEQ���OWNEABWLOEAi iO�TE� s-' �B`[ �NSo � patE
Mar-19-99 11:23A
N�W L ]
ADDN [ ]
A�T� I ]
CITY OF FRIDLEY
SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2
BUILDING PFRMIT APPLICATIQN
P.OS
Effective 1/1/98
�
o� �j
, �� �2-
ConstructionAddress: i �
_��2���r� ��t ,Dr, u�..
�
Legal Description: I P�.� O�� �("� -('�-�- .
Owner Narne & Address: �- %Y1 Tel. # �i� " %/ r'l�
Contractor: - � r �' ;� MN LICENSE �1 o2v C1 �/oZ.�oZJ
73 ,
Address: � ' Tel. # �V``~'�j% �3�J
LIVING AREA:
GARAGE AREA:
Dk;CK AREA:
OTFLER;
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to uale.
D�SCRI:PTION OF IlVIPROVEMF.NT
LenBch , Width Height Sq. Fc.
LenSrth � Width Height Sq. Ft.
Ixnbth � Widch Hgt/Ground Sq. Ft_
Construction Type: f r� � r` Estimated Cost: $
(Fee Schedule on back)
Driveway Curb Cut Width Needed; Ft. + 6 Ft = Ft x$ =$
� �
DATE: _�� �j�j AP'PLICANT: Tel. � ' - 3�p�
r�--+
S�1'Y i1SE ONLY
Pecmit Fee $ �,�5 Fee Schedule on Reverse Side
Fire Sur�harge $ . .QO1 of Permit Valuation (1/lOth°� )
State Surcharge $ ,8 $.SO/$1,000 Valuation
SAC Chacge $ $1000 per SAC Unit
License Surcharge $ � al� $5.00 (State Licensed Resid�raial Cvntractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Concrol $ $450.00 Conaervation Plan Review
Park Fee $ Fec Determined by Engineering
Sevver Main Charge $ Agceement Necessary [] Not Necessary []
TOTAL
. STIPULATIONS:
i�
�
P.